NSI-4P Attachments

NIS-4P CR Attachments.pdf

National Inmate Survey (NIS) Prisons

NSI-4P Attachments

OMB: 1121-0311

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Attachment C NIS-4P ACASI Instrument

August 2022

National Inmate Survey, Year 4:
ACASI Specifications for Prisons
Revisions Highlighted for
OMB Review

Prepared for Bureau of Justice Statistics

Prepared by
RTI International
3040 E. Cornwallis Road
Research Triangle Park, NC 27709

RTI Project Number 0216099

Table of Contents
Interview Setup ..................................................................................................................... 3
CAPI Demographics ................................................................................................................ 4
Computer Tutorial ........................................................................................................................... 7
ACASI Demographics .....................................................................................................................10
Criminal History ................................................................................................................... 12
Sexual Identity and Pre-Incarceration Information ................................................................ 16
Sexual Activity with Inmates ................................................................................................ 22
Description of Non-Consensual Sexual Acts (NCSAs).............................................................. 45
Staff Sexual Misconduct ....................................................................................................... 48
Determination of Specific Incident for Inmate Incident Report .............................................. 53
Incident Characteristics for Inmate-on-Inmate Victimization ................................................. 57
Determination of Specific Incident for Staff Incident Report .................................................. 66
Incident Characteristics for Staff-on-Inmate Victimization ..................................................... 67
Other Victimization While Incarcerated ................................................................................ 75
Pat Downs and Strip Searches .............................................................................................. 76
Facility Conditions, Support, and Safety ................................................................................ 77
Mental Health...................................................................................................................... 81
Disability Status ................................................................................................................... 84
Restrictive Housing .............................................................................................................. 86
Parental Involvement........................................................................................................... 89
Childhood Experiences ......................................................................................................... 93
Living Area and Activities ..................................................................................................... 96
Altercations, Fights and Grievances .................................................................................... 100
Work Assignments ............................................................................................................. 104
Program Participation ........................................................................................................ 107
Visitors and Outside Contact .............................................................................................. 110
Post-Release Plans ............................................................................................................. 112
Interview Debriefing .......................................................................................................... 115

NIS-4P Instrument – Revisions for OMB
August 1, 2022

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 1121-0311.
I1

FACILITY ID
____________________

ENTER YOUR INTERVIEWER ID NUMBER:
__________ [ALLOW 6 DIGITS]

IS THIS INMATE BEING OFFERED AN INCENTIVE?
1
2

YES
NO
NIS-4P Instrument – Revisions for OMB
August 1, 2022

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
NIS-4P Instrument – Revisions for OMB
August 1, 2022

B1.

How old were you the first time you were arrested or taken into custody for any offense?
AGE: ________________ [RANGE: 6 – CALCAGE]
DK/REF

When were you admitted to this facility?
A5a.
A5b.
A5c.

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

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
2
3
4
5
6
7

LESS THAN 1 WEEK
AT LEAST 1 WEEK BUT LESS THAN 1 MONTH
AT LEAST 1 MONTH BUT LESS THAN 2 MONTHS
AT LEAST 2 MONTHS BUT LESS THAN 6 MONTHS
AT LEAST 6 MONTHS BUT LESS THAN 1 YEAR
AT LEAST 1 YEAR BUT LESS THAN 5 YEARS
AT LEAST 5 YEARS BUT LESS THAN 10 YEARS
NIS-4P Instrument – Revisions for OMB
August 1, 2022

8
10 YEARS OR MORE
DK/REF

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, 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

NIS-4P Instrument – Revisions for OMB
August 1, 2022

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.

NIS-4P Instrument – Revisions for OMB
August 1, 2022

[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.

[NO AUDIO REQUIRED] If you want the computer to read the question again, you can
press the AUDIO button [POINT TO AUDIO BUTTON].

[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.

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.

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?

NIS-4P Instrument – Revisions for OMB
August 1, 2022

[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.

NIS-4P Instrument – Revisions for OMB
August 1, 2022

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

A21

[IF A17 =2 AND A19 =2] Did you attend high school?
1

Yes
NIS-4P Instrument – Revisions for OMB
August 1, 2022

2
No
DK/REF
A22

Are you a U.S. citizen?
1
Yes
2
No
DK/REF

Have you ever served in the United States Armed Forces?
1 Yes
2 No
DK/REF

[IF V1 = 1] Are you currently serving in the United States Armed Forces?
1 Yes
2 No
DK/REF

[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

NIS-4P Instrument – Revisions for OMB
August 1, 2022

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

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
NIS-4P Instrument – Revisions for OMB
August 1, 2022

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,
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

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
NIS-4P Instrument – Revisions for OMB
August 1, 2022

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,
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

B21.

[IF B4 = 1] Are you currently sentenced and serving time in this facility for driving under the
influence or driving while intoxicated?
1
2

Yes
No
NIS-4P Instrument – Revisions for OMB
August 1, 2022

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

NIS-4P Instrument – Revisions for OMB
August 1, 2022

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

D2a1

[IF GENDER = 1] Which of the following best represents how you think of yourself?
1
2
3
95
DK/REF

D2b1

Gay
Straight; that is, not gay
Bisexual; that is, you are sexually attracted to both men and women
Two-Spirit
Something else

[IF GENDER = 2] Which of the following best represents how you think of yourself?
1
Lesbian or gay
2
Straight; that is, not lesbian or gay
3
Bisexual; that is, you are sexually attracted to both men and women
4
[IF A13c = 1] Two-Spirit
95 9 Something else
DK/REF

DEFINE SexualOrientationFill:
IF D2=1, then SexualOrientationFill = “lesbian or gay”
IF D2=3, then SexualOrientationFill = “bisexual”
IF D2 = 4, then SexualOrientationFill = “Two-Spirit”
ELSE SexualOrientationFill = BLANK
D3a

What sex were you assigned at birth, 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
[IF A13c = 1] Two-Spirit
95
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 = “describe yourself as Two-Spirit”

NIS-4P Instrument – Revisions for OMB
August 1, 2022

IF D3b = 95 AND A13c NE 1 THEN CURRSEX FILL = “do not describe yourself as male,
female, or transgender”
IF D3b = 95 AND A13c = 1 THEN CURRSEX FILL = “do not describe yourself as male, female,
Two-Spirt, or transgender”
DEFINE BIRTHSEX
IF D3a = 1 THEN BIRTHSEX = “male”
IF D3a = 2 THEN BIRTHSEX = “female”
ELSE BIRTHSEX = BLANK
D3c

[IF (D3a = 1 AND D3b = 2 OR 3 OR 4 OR 95) OR (D3a = 2 AND D3b = 1 OR 3 OR 4 OR 95)
Just to confirm what you entered, you were assigned [BIRTHSEX] 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 AND A13c = 1] Please answer this question again: Do you currently think of
yourself as male, female, Two-Spirit, or transgender?
[IF D3c = 2 AND A13c NE 1] Please answer this question again: Do you currently think of
yourself as male, female, or transgender?
1
Male
2
Female
3
Transgender
4
[IF A13c = 1] Two-Spirit
95
None of these
DK/REF

UPDATE GENDER
IF (D3c = 1 OR DK OR REF) OR (D3d = 1 AND D3e = 2 OR 3 OR 4 OR 95) OR (D3d = 2 AND
D3e = 1 OR 3 OR 4 OR 95) THEN GENDER = 3
IF BIRTHSEX = BLANK AND (D3b = 3 OR 4), THEN GENDER = 3
IF (D3d = DK OR REF) AND (D3e = 3 OR 4), THEN GENDER = 3

RANDOM = 95, CONTINUE TO D6
RANDOM = 5, SKIP TO FH_1

NIS-4P Instrument – Revisions for OMB
August 1, 2022

[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

[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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

D11

[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?
1
Yes
2
No
DK/REF

RANDOM = 95, SKIP TO D16
RANDOM = 5
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

Yes
No

DK/REF
D15

How did you support yourself during the 6 months before you were incarcerated?
Yes
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

D15a A job?
D15b Support from your family?
D15cSupport from your friends?
D15d A government program or public assistance?
D15e Illegal income?
D15f Some other type of support?
DK/REF
D16

1
1
1
1
1
1

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.
1
0
2
1
3
2
4
3
5
4
16
5 or more NUMBER OF CHILDREN: __________ [RANGE 0-25]
DK/REF

D18

[IF D17 > 1] During the 6 months before you were incarcerated, how many of those
[D17_FILL] children lived with you?
1
0
2
1
3
2
4
3
5
4
16
5 or moreCHILDREN LIVED WITH R: ____________ [RANGE 0-25]
DK/REF
[PROGRAMMER: Only show response options up to, and including, the response option
selected in D17.]

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?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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.

Males
[IF GENDER = 1]
DOAFILL1, have you
been touched on your
butt, thighs, or penis in
a sexual way by another
inmate?

1
Yes
2
No
DK/REF
E6[IF G E6

Females
[IF GENDER = 2]
DOAFILL1, have you
been touched on your
butt, thighs, breasts, or
vagina in a sexual way by
another inmate?

1Yes
2No
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.

1Yes
2No
DK/REF
E6E^[I

[IF GENDER = 3]
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

1
Yes
2
No
DK/REF
E8

Gender Inclusive
[IF GENDER = 3]
DOAFILL1, have you
been touched on your butt,
thighs, breasts, penis, or
vagina in a sexual way by
another inmate?

[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.

[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.

1Yes
2No
DK/REF

1
Yes
2
No
DK/REF
E10

[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.

[IF GENDER = 3]
DOAFILL1, have you
given or received oral sex
or a blowjob? Oral sex is
when one inmate puts their
mouth on the penis, vagina,
or butt of another inmate.
1
Yes
2
No
DK/REF

E10

1Yes
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[IF GENDER = 3]
DOAFILL1, have you had
vaginal sex? Vaginal sex is
when one inmate inserts
their finger, penis, or an
object into another inmate’s
vagina.
1Yes

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.

E12

E15

E16

E12

1Yes
2No
DK/REF

1
Yes
2
No
DK/REF
E14

2No
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.

[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
Yes
2
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.
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?

E14

E15

[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?
1Yes
2No
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.

1
Yes
2
No
DK/REF

E14

E15

Touch the NEXT button
to go to the next screen.

1
Yes
2
No
DK/REF
E17

2No
DK/REF
[IF GENDER = 3]
DOAFILL1, have you had
anal sex? Anal sex is when
one inmate inserts their
finger, penis, or an object
into another inmate’s butt.

[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?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[IF GENDER = 3]
DOAFILL1, have you had
any type of sex or sexual
contact with another inmate
other than sexual
touching, handjobs, oral
sex or blowjobs, vaginal
sex, or anal sex?
1
Yes
2
No
DK/REF
[IF E2 = 1 OR E6 = 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.

1
2

Yes
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?
1Yes
2No
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?
1Yes
2No
DK/REF
E20

[IF E2=1] DOAFILL1, did
another inmate use physical
force to touch your butt,
thighs, breast, penis, or
vagina in a sexual way?
1
Yes
2
No
DK/REF

E21

E22

[IF E6 =1] DOAFILL1,
did another inmate use
physical force to make
you give or receive a
handjob?

E22

[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, penis, or
vagina in a sexual way?
1
Yes
2
No
DK/REF
[IF E6 =1] DOAFILL1,
did another inmate use
physical force to make you
give or receive a handjob?
1
Yes
2
No
DK/REF

1
Yes
2
No
DK/REF
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

E23
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?

[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

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?
1Yes
2No
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?
1Yes
2No
DK/REF

E26

[IF E8 =1] DOAFILL1,
did another inmate use
physical force to make
you give or receive oral
sex or a blowjob?

E26

1 Yes
2 No
DK/REF
E27

[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

[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?

E27

1 Yes
2 No
DK/REF

1 Yes
2 No
DK/REF
E28 [IF E10 = 1] DOAFILL1,

E28

[IF E10 = 1] DOAFILL1,

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[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?

E29

did another inmate use
physical force to make
you have vaginal sex?

did another inmate use
physical force to make you
have vaginal sex?

1Yes
2No
DK/REF

[IF E10 = 1] DOAFILL1,
did another inmate,
without using physical
force, pressure you or
make you feel that you
had to have vaginal sex?

E29

1Yes
2No
DK/REF

E32

[IF E12 = 1]
DOAFILL1, did another
inmate use physical force
to make you have anal
sex?

E32

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?

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?

[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?

[IF E14 = 1] DOAFILL1,
did another inmate,

[IF E12 = 1] DOAFILL1,
did another inmate use
physical force to make you
have anal sex?
1Yes
2No
DK/REF

E33

[IF E12 = 1] DOAFILL1,
did another inmate, without
using physical force,
pressure you or make you
feel that you had to have
anal sex?
1Yes
2No
DK/REF

E34

1Yes
2No
DK/REF
E35

[IF E14 = 1]

E32

1Yes
2No
DK/REF

1 Yes
2 No
DK/REF
E35

1Yes
2No
DK/REF

1 Yes
2 No
DK/REF
E33

[IF E12 = 1] DOAFILL1,
did another inmate use
physical force to make
you have anal sex?

[IF E10 = 1] DOAFILL1,
did another inmate, without
using physical force,
pressure you or make you
feel that you had to have
vaginal sex?

[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,
vaginal sex, or anal sex?
1Yes
2No
DK/REF

E35

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[IF E14 = 1] DOAFILL1,
did another inmate, without

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

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?

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, vaginal
sex, or anal sex?

1Yes
2No
DK/REF

DEFINE forced:
If at least one of (E16, E18, E20, E22, E24, E26, E28, E32, E34) is YES,
then forced = YES
else forced = NO
DEFINE pressured:
If at least one of (E17, E19, E21, 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 ?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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?

[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:
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

29
•
•
•
E37a

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 ?
[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?

[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?

[IF GENDER = 3 AND (E22 = 1 OR E23 = 1 OR E26 = 1 OR E27 = 1 OR E28 = 1 OR E29 = 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,
[IF E28 OR E29 = 1] Have vaginal sex, or
[IF E32 OR E33 = 1] Have anal sex?
1
2
3

1 time
2 times
3 – 10 times
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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 ?
• 4 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , ; 3RD ITEM END WITH , or;
4TH ITEM END WITH ?
E41a

[IF E41 = 3] DOAFILL1, how many times altogether were you
[ForcedOrPressuredFill2:
•
•
•
•

[IF E22 OR E23 = 1] Give or receive oral sex or a handjob,
[IF E26 OR E27 = 1] Give or receive oral sex or a blowjob,
[IF E28 OR E29 = 1] Have vaginal sex, or
[IF E32 OR E33 = 1] Have anal sex?

[IF E41 = 4] DOAFILL1, how many times altogether were you
[ForcedOrPressuredFill2]:
•
•
•
•

[IF E22 OR E23 = 1] Give or receive oral sex or a handjob,
[IF E26 OR E27 = 1] Give or receive oral sex or a blowjob,
[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 ?
• 4 ITEMS – 1ST ITEM END WITH , ; 2ND ITEM END WITH , ; 3RD ITEM END WITH , or;
4TH ITEM END WITH ?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

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 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

E39a

[IF E39 = 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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

E39b

[IF E39 = 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

E42

[IF E20 = 1 OR E21 = 1] DOAFILL1, how many times altogether were you
[ForcedOrPressuredFill2] let another inmate touch your butt, thighs, breasts, penis, or
vagina in a sexual way?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF

E42a

[IF E42 = 3] DOAFILL1, how many times altogether were you
[ForcedOrPressuredFill2] let another inmate touch your butt, thighs, breasts, penis, 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

E42b

[IF E42 = 4] DOAFILL1, how many times altogether were you
[ForcedOrPressuredFill2] let another inmate touch your butt, thighs, breasts, penis, or
vagina in a sexual way?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF

E40

[IF E36 > 1 OR E37 > 1 OR E41 > 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 OR E41 = 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?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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
Males
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?

Females

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 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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Gender Inclusive

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
E202

[IF E2 = 2 AND E6 =
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 touch
your butt, thighs,
breasts, penis, or
vagina in a sexual
way?
1
Yes
2
No
DK/REF

E212

[IF E2 = 2 AND E6 =
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, penis, or
vagina in a sexual
way?
1

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes

2
No
DK/REF
E222 [IF E2 = 2 AND E6 = 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 a
handjob?

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

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?

E232 [IF E2 = 2 AND E6 = 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 a
handjob?

1
Yes
2
No
DK/REF

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

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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?

E262

1
Yes
2
No
DK/REF
E272

[IF E2 = 2 AND E6 =
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 or a blowjob?
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, without
using physical force,
pressure you or make you
feel that you had to give or
receive oral sex or a
blowjob?

E272

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?

E282

1
Yes
2
No
DK/REF
E292

[IF E2 = 2 AND E8 = 2

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
No
DK/REF
[IF E2 = 2 AND E6 =
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

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?

E292

1
Yes
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

[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?

E322

1
Yes
2
No
DK/REF

E332 [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?

E332

1
Yes
2
No
DK/REF

1
Yes
2
No
DK/REF
E332

1
Yes
2
No
DK/REF

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 use physical
force to make you have any

E342

[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

[IF E2 = 2 AND E6 =
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?

E342

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
No
DK/REF
[IF E2 = 2 AND E6 =
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

type of sex or sexual contact
other than sexual touching,
handjobs, oral sex or
blowjobs, or anal sex?

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 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

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,
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
E352

1
Yes
2
No
DK/REF

[IF E2 = 2 AND E6 =
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, handjobs,
oral sex or blowjobs,
vaginal sex, or anal
sex?
1
2

Yes
No
DK/REF

UPDATE forced:
If at least one of (E162, E182, E202, E222, E242, E262, E282, E322, E342) is YES,
then forced = YES
else forced = NO
UPDATE pressured:
If at least one of (E172, E192, E212, 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 = “????”
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[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]:
•
•
•

[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?

[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:
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

40
•
•
•
E356

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 ?

[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?

[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?

[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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[IF GENDER = 3 AND (E222 = 1 OR E232 = 1 OR E262 = 1 OR E272 = 1 OR E282 = 1 OR
E292 = 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,
[IF E282 OR E292 = 1] Have vaginal sex, or
[IF E322 OR E332 = 1] Have anal sex?

[IF E366 = 3] 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,
[IF E282 OR E292 = 1] Have vaginal sex, or
[IF E322 OR E332 = 1] Have anal sex?

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

E368

[IF E366 = 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,
[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 ?
• 4 ITEMS – 1ST ITEMS END WITH ,; 2ND ITEM END WITH ,; 3RD ITEM END WITH , or;
4TH 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

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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

E369

[IF E202 = 1 OR E212 = 1] DOAFILL1, how many times altogether were you
[ForcedOrPressuredFill2] let another inmate touch your butt, thighs, breasts, penis, or vagina in a
sexual way?
1
1 time
2
2 times
3
3 – 10 times
4
11 times or more
DK/REF

E370

[IF E369 = 3] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let
another inmate touch your butt, thighs, breasts, penis, 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

E371

[IF E369 = 4] DOAFILL1, how many times altogether were you [ForcedOrPressuredFill2] let
another inmate touch your butt, thighs, breasts, penis, or vagina in a sexual way?
NUMBER OF TIMES: _______________ [RANGE: 11 – 300]
DK/REF

E365

[IF E353 > 1 OR E356 > 1 OR E366 > 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 OR E366 = 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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

DESCRIPTION OF NON-CONSENUAL SEXUAL ACTS (NCSAs)
DEFINE NCSA:
IF E16 = 1 OR E17 = 1 OR E18 = 1 OR E19 = 1 OR E20 = 1 OR E21 = 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 E202 = 1 OR E212 = 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, E20, E22, E24, E26, E28, E32, E34, E162, E182, E202, E222, E242,
E262, E282, E322, E342) is YES,
then forced = YES
else forced = NO
UPDATE pressured:
If at least one of (E17, E19, E21, E23, E25, E27, E29, E33, E35, E172, E192, E212, 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 + E41 + E42 + E353 + E356 + E359 + E362 +E366 + E369 = 1 THEN
#NCSA1 = did it
IF E36 + E37 + E38 + E39 + E41 + E42 + E353 + E356 + E359 + E362 + E366 + E369 > 1 THEN
#NCSA1 = did it ever
IF ALL (E36, E37, E38, E39, E41, E42, E353, E356, E359, E362, E366, E369) = DK OR REF THEN
#NCSA1 = did it ever
DEFINE #NCSA2
IF E36 + E37 + E38 +E39 + E41 + E42 + E353 + E356 + E359 + E362 + E366 + E369 = 1 THEN
#NCSA2 = were you
IF E36 + E37 + E38 +E39 + E41 + E42 + E353 + E356 + E359 + E362 +E366 +E369 > 1 THEN
#NCSA2= were you ever
IF ALL (E36, E37, E38, E39, E41, E42, E353, E356, E359, E362, E366, E369) = DK OR REF THEN
#NCSA2 = were you ever
DEFINE #NCSA3
IF E36 + E37 + E38 + E39 + E41 + E42 + E353 + E356 + E359 + E362 + E366 + E369 = 1 THEN
#NCSA3 = was it
IF E36 + E37 + E38 + E39 + E41 + E42 + E353 + E356 + E359 + E362 + E366 + E369 > 1 THEN
#NCSA3 = was it ever
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

IF ALL (E36, E37, E38, E39, E41, E42, E353, E356, E359, E362, E366. E369) = DK OR REF THEN
#NCSA3 = was it ever
DEFINE #NCSA4
IF E36 + E37 + E38 + E39 + E41 + E42 + E353 + E356 + E359 + E362 + E366 + E369 = 1 THEN
#NCSA4 = did you
IF E36 + E37 + E38 + E39 + E41 + E42 + E353 + E356 + E359 + E362 + E366 + E369 > 1 THEN
#NCSA4 = did you ever
IF ALL (E36, E37, E38, E39, E41, E42, E353, E356, E359, E362, E366, E369) = DK OR REF THEN
#NCSA4 = did you ever
DEFINE #NCSA5
IF E36 + E37 + E38 + E39 + E41 + E42 + E353 + E356 + E359 + E362 + E366 + E369 = 1 THEN
#NCSA5 = why didn’t you
IF E36 + E37 + E38 + E39 + E41 + E42 + E353 + E356 + E359 + E362 + E366 + E369 > 1 THEN
#NCSA5 = why didn’t you ever
IF ALL (E36, E37, E38, E39, E41, E42, E353, E356, E359, E362, E366, E369) = DK OR REF THEN
#NCSA5 = why didn’t you ever
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

[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

[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

[IF NCSA = 1] DOAFILL1, when you were [ForcedOrPressuredFill2] have sex or
sexual contact with another inmate, [#NCSA2] injured?
1
Yes
2
No
DK/REF
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

No
2
2
2
2
2
2
2
2
2
2

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 OR 3] 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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1

No
2
2
2

1
1
1
1

2
2
2
2

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.

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

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[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

DOAFILL1, have any facility staff offered you favors or special privileges in exchange for sex or
sexual contact?
1
Yes
2
No
DK/REF

DOAFILL1, have you willingly had sex or sexual contact with any facility staff?
1
Yes
2
No
DK/REF

[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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[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

[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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

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 OR 3] 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 G4 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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

DETERMINATION OF SPECIFIC INCIDENT FOR INMATE INCIDENT REPORT
DEFINE NUMBER_OF_TIMES:
IF E36=1 OR E353=1 OR E37=1 OR E356=1 OR E41 = 1 OR E366 = 1, NUMBER_OF_TIMES = “1
time”
IF E36=2 OR E353=2 OR E37=2 OR E356=2 OR E41 = 2 OR E366 = 2, NUMBER_OF_TIMES= “2
times”
IF E36=3 OR E353=3 OR E37=3 OR E356 = 3 OR E41 = 3 OR E366 = 3, NUMBER_OF_TIMES= “3 to
10 times”
IF E36=4 OR E353=4 OR E37=4 OR E356=4 OR E41 = 4 OR E366 = 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)
OR E41 = (DK OR REF) OR E366 = (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 OR E42 = 1 OR E369 = 1, NUMBER_OF_TIMES_TOUCH
= “1 time”
IF E38=2 OR E359=2 OR E39=2 OR E362=2 OR E42 = 2 OR E369 = 2,
NUMBER_OF_TIMES_TOUCH=”2 times”
IF E38=3 OR E359=3 OR E39=3 OR E362=3 OR E42 = 3 OR E369 = 3, NUMBER_OF_TIMES_TOUCH
= “3 to 10 times”
IF E38=4 OR E359=4 OR E39=4 OR E362=4 OR E42 = 4 OR E369 = 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)
OR E42 = (DK OR REF) OR E369 = (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.
[IF GENDER=3] Earlier you reported that DOAFILL2 you were [ForcedOrPressuredFill2] let
another inmate touch your butt, thighs, breasts, penis, or vagina in a sexual way
[NUMBER_OF_TIMES_TOUCH]. Please think about that experience as you answer the next
questions.
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Touch the NEXT button to go to the next screen.

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

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.
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[IF GENDER = 3] Earlier you reported that DOAFILL2 you were [ForcedOrPressuredFill2] let
another inmate touch your butt, thighs, breasts, penis, 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.
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.
[IF GENDER = 3] 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, penis, 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 butt, thighs, breasts, or vagina in a sexual way?
DIR5h. [IF E20 = 1 OR E21 = 1 OR E202 = 1 OR E212 = 1] Be
touched on your butt, thighs, breasts, penis, or vagina in a sexual
way?
DK/REF

Yes
1

No
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.
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Touch the NEXT button to go to the next screen.

[IF GENDER = 3] 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, penis, or vagina in a sexual way.
Touch the NEXT button to go to the next screen.

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[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 DIR2 OR DIR4 is displayed AND GENDER= 3, then I-ON-I_FILL = “another inmate touching your
butt, thighs, breasts, penis, 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”
IF DIR5 is displayed AND GENDER= 3, then I-ON-I_FILL = “sex or sexual contact with another inmate
or another inmate touching your butt, thighs, breasts, penis, 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…
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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
IIC4

No
2
2
2
2

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

Yes
1
1
1
1

[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

No
2
2
2
2

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

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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1
1
1
1
1
1
1

No
2
2
2
2
2
2
2
2
2
2

IIC8

Do you think this [RECENT_FILL] happened because of your…

IIC8a. Race or ethnicity?
IIC8b. Age?
IIC8c. Religion?
IIC8d. Gang affiliation?
IIC8e. [IF GENDER = 3] 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

IIC33

Yes
1
1
1
1

No
2
2
2
2

[IF D2 = 1 OR 3 OR 4D2a=2 OR D2b=2 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

Yes
1
1
1

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=1 AND IIC10a = DK OR REF
then PerpGenderFill1 = “they”
If IIC9=2
then PerpGenderFill1 = “they”
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

No
2
2
2

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 = 1 AND IIC10a = DK OR REF
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
2
3

Older than you
Younger than you
About the same age as you
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

DK/REF
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

IIC18

[IF IIC9 = 1] Before this incident happened, had you had any arguments or fights with this
inmate?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[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 OR 3] 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
2

Yes
No
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1

No
2
2
2
2

1
1
1
1

2
2
2
2

DK/REF
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?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1

No
2

1
1

2
2

1
1
1

2
2
2

IIC28a7. The inmate lost privileges?
IIC28a8. The inmate was charged with a crime?
DK/REF

1
1

2
2

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 or more of the inmates were charged with a crime?
DK/REF
IIC29

Yes
1

No
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

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.
IIC31b.
IIC31c.
IIC31d.
IIC31e.
IIC31f.
IIC31g.
IIC31h.

Joined a gang?
Carried a weapon?
Fought more?
Worked out in order to bulk up?
Avoided certain areas?
Kept to yourself more?
Stayed in your own cell or housing area more?
Joined a religious group?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1
1
1
1
1

No
2
2
2
2
2
2
2
2

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

1
1
1
1
1
1
1

2
2
2
2
2
2
2

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
1

2
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 G3 = DK OR REF) OR (G2 < > 1 AND G6 = DK OR REF) OR
((G4 AND G5 < > 1) AND 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.

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[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.
SI4b.
SI4c.
SI4d.

In your own cell, room, or sleeping area?
In the cell, room, or housing area of another inmate?
Somewhere else in the facility?
Off facility grounds?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

DK/REF
SI5

[IF SI4c =1] Where were you when the incident happened?

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. Told that your family would be deported?
SI9l. Told that you would lose visitation privileges?
DK/REF

Yes
1
1
1
1
1
1
1
1
1
1
1
1

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
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?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

No
2
2
2
2
2
2
2
2
2
2
2
2

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?
SI11d. Gang affiliation?
SI11e. [IF GENDER = 3] 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
SI32

Yes

1
1
1
1

2
2
2
2

[IF D2 = 1 OR 3 OR 4a=2 OR D2b=2 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…

SI12b1. Male?
SI12b2. Female?
DK/REF

Yes
1
1

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:
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

Yes
1
1
1
1

No
2
2
2
2

[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

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?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1

No
2
2

SI16a3. A volunteer in the facility?
DK/REF
SI16b

No
2
2
2

Yes
1

No
2

1
1
1

2
2
2

1
1

2
2

[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
1
1

[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
SI17b

[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

During the [RECENT_FILL2] were you injured?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1

No
2

1
1
1

2
2
2

1
1

2
2

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 OR 3] 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

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
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.
SI23b.
SI23c.
SI23d.
SI23e.

A correctional officer?
An administrative staff person?
A medical or healthcare staff person?
An instructor or teacher?
A counselor or other mental health care provider?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1
1

No
2
2
2
2
2

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

1
1
1
1
1
1

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

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

No
2

1
1
1
1
1

2
2
2
2
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
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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1

No
2
2

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

1
1

2
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

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

PAT DOWNS AND STRIP SEARCHES
L0

[IF G11a = 1] 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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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.

Are there inmates in this facility who you think of as your friends?
1
Yes
2
No
DK/REF

Are there inmates in this facility who you can talk to about your personal problems?
1
Yes
2
No
DK/REF

Are there inmates in this facility who would protect you if another inmate was trying to hurt you?
1
Yes
2
No
DK/REF

Are there correctional officers or other staff at this facility who you can talk to about your
problems?
1
Yes
2
No
DK/REF

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

How crowded is it in your housing unit?
1
Not at all crowded
2
Slightly crowded
3
Pretty crowded
4
Very crowded
DK/REF

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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

How much privacy do you have in your housing unit?
1
None
2
A little
3
Some
4
A lot
DK/REF

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

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

None
A little
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

3
4

Some
A lot

DK/REF
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

[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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

[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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

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

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

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

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

About how often in the past 30 days did you feel worthless?
1

All of the time
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
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
1

No
2
2
2
2
2
2
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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

Are you blind, or do you have serious difficulty seeing even when wearing glasses?
1 Yes
2 No
DK/REF

Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating,
remembering, or making decisions?
1 Yes
2 No
DK/REF

Do you have serious difficulty walking or climbing stairs?
1 Yes
2 No
DK/REF

Do you have difficulty dressing or bathing?
1 Yes
2 No
DK/REF

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

[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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Q8 Did a doctor, school counselor, or other professional ever tell you that you have…

Q8a.
Q8b.
Q8c.
Q8d.

ADD or ADHD?
Dyslexia?
A learning disability?
Autism or Asperger’s?

Yes
1
1
1
1

No
2
2
2
2

DK/REF

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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.
RH4b.
RH4c.
RH4d.
RH4e.
RH4f.
RH4g.
RH4h.

Because you were a danger to yourself?
For mental health reasons?
Due to COVID restrictions?
For medical reasons other than COVID?
Because you asked to be placed there for your own protection?
As a punishment for breaking rules?
For a cool down period?
For some other reason?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1
1
1
1
1

No
2
2
2
2
2
2
2
2

DK/REF
RH5

[IF RH4f = 1] What facility rules were you accused of breaking that led to you being assigned to
disciplinary or administrative segregation, or solitary confinement [IF RH2 > 1, INCLUDE “the
most recent time”]?

RH5a. Fighting with another inmate?
RH5b. Verbally assaulting staff?
RH5c. Physically assaulting staff?
RH5d. Possession of contraband?
RH5e. Having sexual contact with staff?
RH5f. Having sexual contact with another inmate?
RH5g. Noncompliance?
RH5h. Some other rule or rules?
DK/REF
RH6

Yes
1
1
1
1
1
1
1
1

No
2
2
2
2
2
2
2
2

[IF RH4f = 1] Were you given a hearing after being placed in disciplinary or administrative
segregation, or solitary confinement to determine if you were guilty of breaking facility rules?
1
Yes
2
No
DK/REF

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

RH8

[IF RH1 = 1 AND A9a NE 1] During the [IF RH2 > 1, INCLUDE “most recent”] time you were
in disciplinary or administrative segregation, or solitary confinement, were you in a cell by
yourself for all or most of the time?
[IF A9a = 1] Are you being housed in a cell by yourself?
1 Yes
2 No
DK/REF

RH9

[IF RH8 = 2 AND A9a = 2 AND RH1 = 1] How many other inmates were in the cell with you the
[IF RH2 > 1, INCLUDE “most recent”] time you were in disciplinary or administrative
segregation, or solitary confinement?
[IF RH8 = 2 AND A9a = 1] How many other inmates are in the cell with you?
NUMBER OF INMATES: _______ [RANGE: 1 – 90]
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?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[IF A9a = 1] Are you able to leave your cell at least once every day?
1
Yes
2
No
DK/REF
RH12

[IF RH1 = 1] Did you have the same access to your lawyer or attorney as you did before you were
placed in disciplinary or administrative segregation, or solitary confinement [IF RH2>1,
INCLUDE “this most recent time”]?
[IF A9a = 1] Do you have the same access to your lawyer or attorney as you did before you were
placed in disciplinary or administrative segregation, or solitary confinement?
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

RH15

[IF RH14 = 1 AND RH1 = 1] How often 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 RH14 = 1 AND A9a = 1] How often has a trained counselor or mental health professional
checked on you while you have been in disciplinary or administrative segregation, or solitary
confinement?
1
Every day
2
A few times a week
3
Once a week
4
Less than once a week
DK/REF

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Section PIV: Parental Involvement
PIV1 Is your biological mother - 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)] Think 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] Think 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] Think 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] Think 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
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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

PIV7 [IF CALCAGE GT 17 AND (PIV5 = 1 OR PIV6 GT 17)] Think 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] Think 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] Think 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] Think 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
2
3

Very involved
Somewhat involved
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 ] 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] At any time since you were born, have your
biological parents been married to each other?
1
Yes
2
No
DK/REF
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
4

Less than 3 years
At least 3 years but less than 10 years
At least 10 years but less than CALCAGE years
CALCAGE years
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

DK/REF
PIV12 [IF CALCAGE GT 17 AND ((PIV4 = 2 OT 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
2

Yes
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
2
3
4
5
6
7
8
9
10
11
12

An adoptive father
An stepfather
A foster father
Your mother’s boyfriend
A grandfather
An uncle
A brother, including a step- or half-brother
A cousin
A minister or member of the clergy
A teacher
A neighbor
Some other man

DK/REF
PIV14 Were you living with a male parent or 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 female parent figure at the time you were 14 years old?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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
RANDOM = 95, SKIP TO M0

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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
CE4

Very
Often
1
1

Often

Sometimes

Rarely

Never

2
2

3
3

4
4

5
5

1
1

2
2

3
3

4
4

5
5

[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?

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Very
Often

Often

Sometimes

Rarely

Never

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

[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
CE6

Very
Often
1
1

Often

Sometimes

Rarely

Never

2
2

3
3

4
4

5
5

[IF CALCAGE GT 17] How often did you have each of the following experiences before age 18?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

[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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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
LA_18 How much privacy do you have in your housing unit?
1
2
3
4

None
A little
Some
A lot
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

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
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

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

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?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1

No
2
2
2
2

1
1

2
2

1
1

2
2

DK/REF
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
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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

100

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
2
3
4
DK/REF

1 time
2 times
3 – 10 times
11 times or more

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

101

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

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.
AFG12b.
AFG12c.
AFG12d.
AFG12e.
AFG12f.

You received knife or stab wounds?
You received broken bones?
Your teeth were chipped or knocked out?
You received internal injuries?
You were knocked unconscious?
You received bruises, a black eye, sprains, cuts, scratches,
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1
1
1

No
2
2
2
2
2
2

102

swelling, welts, or burns?
DK/REF
AFG13

[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

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.
AFG1b.
AFG1c.
AFG1d.
AFG1e.

A drug violation, such as possession, use, or dealing in drugs?
Possession of a weapon?
Possession of stolen property?
Possession of any other unauthorized substance or item?
Verbal assault on a correctional officer or other staff member?
NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1
1

No
2
2
2
2
2

103

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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

1
1
1
1
1

2
2
2
2
2

104

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 – 8 hours
9 – 16 hours
17 – 24 hours
25 – 32 hours
33 hours or more

1
2
3
4
5
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
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

1 – 8 hours
9 – 16 hours
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105

3
4
5

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

1
1
1
1

2
2
2
2

WA11 [IF WA1 = 2 AND WA4 = 2] DOAFILL1, have you ever had a work assignment?
1
2

Yes
No

DK/REF
WA12

[IF WA11 = 1] When was the last time you had a work assignment at this prison?
1
2
3

Within the past month
1 – 3 months ago
4 – 6 months ago
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106

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
1
1
1
1

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

No
2
2
2
2
2

107

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.
PP_4b.
PP_4c.
PP_4d.
PP_4e.
DK/REF
PP_5

You completed the program?
You quit or dropped out of the program?
You are no longer allowed to participate in the program?
The program is no longer available at this facility?
Some other reason?

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
PP_6

Yes
1
1
1
1
1

Yes
1
1
1
1
1
1
1

No
2
2
2
2
2
2
2

Yes
1
1

No
2
2

[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?
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108

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

1
1
1

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.
PP_10b.
PP_10c.
PP_10d.
PP_10e.
DK/REF

You completed the program?
You quit or dropped out of the program?
You are no longer allowed to participate in the program?
The program is no longer available at this facility?
Some other reason?

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.
PP_11b.
PP_11c.
PP_11d.
PP_11e.
PP_11f.
PP_11g.
DK/REF

You are not interested in the program?
You are not eligible to participate in the program?
You are too busy to attend the program?
You don’t need education training?
You don’t think the program would be useful?
Education programs are no longer offered at this facility?
Some other reason?

Yes
1
1
1
1
1
1
1

No
2
2
2
2
2
2
2

Yes
1
1
1

No
2
2
2

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?
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109

PP_12d. To learn some new skills?
PP_12e. Some other reason?
DK/REF

1
1

2
2

PP_13 [IF PP_7 = 1] What types of education programs did you participate in DOAFILL2?

PP_13a.
PP_13b.
PP_13c.
PP_13d.
PP_13e.
DK/REF

Basic education classes up through 8th grade?
High school or GED classes?
College level classes?
English as a Second Language or ESL classes?
Some other education program?

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
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

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Yes
1
1
1
1
1
1

No
2
2
2
2
2
2

1
1

2
2

110

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

VOC_2a. Had in-person visits?

VOC_2b. Talked on the phone?

VOC_2c. Received letters?
VOC_2d. Had some other type of contact such as emails, text messaging,
video visiting, DVDs, CDs, or tape recordings?

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

VOC_4a. They live too far away?

VOC_4b. They cannot afford to travel to this prison?

VOC_4c. They don’t want to see you while you are incarcerated?
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
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111

VOC_5

DOAFILL1, have you had any contact with your friends or acquaintances?
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

VOC_6a. Had in-person visits?

VOC_6b. Talked on the phone?

VOC_6c. Received letters?
VOC_6d. Had some other type of contact such as emails, text
messaging, video visiting, DVDs, CDs, or tape recordings?

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

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

VOC_8a. They live too far away?

VOC_8b. They cannot afford to travel to this prison?

VOC_8c. They don’t want to see you while you are incarcerated?
VOC_8d. You are not allowed to have visitors?

VOC_8e. You do not want to have visitors?
VOC_8f. They are not healthy enough to travel?
DK/REF

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

112

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

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113

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.
PRP9b.
PRP9c.
PRP9d.
PRP9e.
PRP9f.
PRP9g.
PRP9h.
DK/REF

In your own house, apartment, condo or mobile home?
In someone else’s house, apartment, condo or mobile home?
In transitional housing for former inmates such as a halfway house?
In a residential treatment facility?
In a rooming house, hotel, or motel?
In a car, truck, or other motor vehicle?
In a homeless shelter, on the street, or in some outdoor location?
In some other place?

PRP10 [IF PRP3 NE 2 OR PRP1=1] Do you plan to get a job after you are released from prison?
1
Yes
2
No
DK/REF
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August 1, 2022

114

PRP12 [IF PRP3 NE 2 OR PRP1=1] Do you have plans to go to school after you are released from prison?
1
Yes
2
No
DK/REF

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115

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.

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

Did anyone tell you directly that you were required to participate in this study?
1
Yes
2
No
DK/REF

[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
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116

[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.
____________________________ [ALLOW 150 CHARACTERS]
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117

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

M24

Yes
No

[IF M22 = 1] In what way was the privacy of the interview setting compromised during this
interview?
_______________________________ [ALLOW 150 CHARACTERS]
[IF I3 = 1] Did the inmate take the incentive that was offered?
1
2

M26

YES
NO

PLEASE PROVIDE ANY OTHER COMMENTS ABOUT THE INTERVIEW THAT WOULD
BE USEFUL FOR THE PROJECT TEAM TO KNOW:
NIS-4P Prison Instrument – Revisions for OMB
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118

___________________________ [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.

NIS-4P Prison Instrument – Revisions for OMB
August 1, 2022

Attachment D: NIS-4P PAPI Questionnaires

Attachment D Contents
Four PAPI questionnaires are included in the attachment, as described below:
Form 1: Intended for female inmates who have been in the facility for 12 months or longer.
Form 2: Intended for male inmates who have been in the facility for 12 months or longer.
Form 3: Intended for female inmates who have been in the facility for a period less than 12 months.
Form 4: Intended for male inmates who have been in the facility for a period less than 12 months.

Attachment D: NIS-4P PAPI Questionnaires

OMB No.:
Exp.:

1121-0311
06/30/2023

NATIONAL INMATE
SURVEY - PRISONS
Conducted by the Bureau of Justice Statistics
and
RTI International

NOTICE: Public reporting for this collection of information is estimated to average 15 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 1121-0311.

Attachment D: NIS-4P PAPI Questionnaires

6. Are you currently being held in this facility for any
of the following:

SECTION A

Mark

Please answer the question in the space provided or
mark your answer in the box, like this . To protect
your privacy, do not put your name on this survey.
1. On what date were you admitted to this facility?
If you cannot remember the exact date, please write
down whatever you can remember, such as the year
and the month.
________ / ________ / ________
Month
Day
Year

“Yes” or “No” for each item.

Yes

A violent offense, such as physical or
sexual assault, rape, robbery,
manslaughter, attempted murder, or
murder?

A drug offense, such as possessing,
selling, or manufacturing drugs?

A property offense, such as burglary,
larceny, auto theft, bad checks, fraud,
forgery or grand theft?

Any other offense?

2. How old are you?
7. How long have you been in this facility?

Age: _______

Less than 1 week....................................................
At least 1 week but less than 1 month ...................
At least 1 month but less than 2 months ................
At least 2 months but less than 6 months...............
At least 6 months but less than 1 year ...................
At least 1 year but less than 5 years .......................
At least 5 years but less than 10 years ...................
10 years or more ....................................................

3. Are you of Hispanic, Latino, or Spanish origin?
Yes .........................................................................
No ..........................................................................

1
2

4. Which of these categories describes your race:
Mark

“Yes” or “No” for each item.

Yes

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or other Pacific Islander

2
3
4
5
6
7
8

8. 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?
Yes .........................................................................
No ..........................................................................

1
2

9. Which of the following best represents how you
think about yourself?

5. What is the highest level of school you have
completed?
Less than a high school graduate ...........................
High school graduate or GED ...............................
Some college .........................................................
College degree or more .........................................

Lesbian or gay........................................................
Straight; that is, not lesbian or gay ........................
Bisexual; that is, you are sexually attracted
to both men and women .........................................
Something else .......................................................

1
2
3
4

1
2

3
4

Attachment D: NIS-4P PAPI Questionnaires

10. What sex were you assigned at birth on your
original birth certificate?
Male ........................................................................
Female ....................................................................

15. This question is about wanted or voluntary sex or
sexual contact you have had with other inmates in
this facility. In the past 12 months, did you do any
of the following:

1
2

“Yes” or “No” for each item.

Yes

Touch another inmate's body in a sexual
way or have your body touched in a
sexual way?

Have oral sex with another inmate at
this facility?

Have vaginal sex with another inmate
at this facility?

Have anal sex with another inmate at
this facility?

Have any type of sex or sexual contact
with another inmate at this facility other
than sexual touching, oral sex, vaginal
sex, or anal sex?

Mark
11. Do you currently think of yourself as…?
Male .......................................................................
Female ...................................................................
Transgender ...........................................................
None of these .........................................................

1
2
3
4

12. Before you entered this facility, had anyone ever
physically forced, pressured, 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?
Yes ..................................
No ...................................

1
2

Continue to item 13
Go to item 14

These next questions ask about unwanted sex or
sexual contact you have had with other inmates in
this facility. By unwanted, we mean sex or sexual
contact that you did not want to happen.

13. Were you physically forced, pressured, or made to
feel you had to have sex or sexual contact before
you were 18 years old, after you turned 18, or
both?
Before you were 18 ...............................................
After you turned 18 ...............................................
Both .......................................................................

16. In the past 12 months, did another inmate use
physical force to make you do any of the following:

2
3

Mark
14. Before you entered this facility, were you
physically forced, pressured, or made to feel that
you had to have sex or sexual contact while you
were an adult or juvenile in a jail, prison, or other
correctional facility?
Yes .........................................................................
No ..........................................................................

1
2

“Yes” or “No” for each item.

Yes

Touch their body in a sexual way or have
your body touched in a sexual way?

Have oral sex with them?

Have vaginal sex with them?

Have anal sex with them?

Have any type of sex or sexual contact
with them other than sexual touching,
oral sex, vaginal sex, or anal sex?

Attachment D: NIS-4P PAPI Questionnaires

17. In the past 12 months, did another inmate, without
using physical force, pressure you or make you feel
that you had to do any of the following:
Mark

“Yes” or “No” for each item.

Yes

20. In the past 12 months, when you were physically
forced, pressured, or made to feel that you had to
have sex or sexual contact with another inmate, did
you ever:

Mark

Touch their body in a sexual way or have
your body touched in a sexual way?

Have oral sex with them?

Have vaginal sex with them?

“Yes” or “No” for each item.

Yes

Receive knife or stab wounds?

Receive broken bones?

Receive anal or vaginal tearing?

Have anal sex with them?

Have your teeth chipped or knocked out?

Have any type of sex or sexual contact
with them other than sexual touching,
oral sex, vaginal sex, or anal sex?

Receive internal injuries?

Get knocked unconscious?

Receive bruises, a black eye, sprains,
cuts, scratches, swelling, or welts?

18. In the past 12 months, how many times altogether
were you physically forced, pressured, or made to
feel like you had to have sex or sexual contact with
another inmate?
0 times ..................
1 time ....................
2 times ..................
3–10 times ............
11 times or more ...

→

SECTION B

Go to SECTION B

These next questions ask about sex or sexual contact
you have had with staff at this facility. By staff, we
mean the employees of this facility and anybody who
works as a volunteer in this facility.

2
3

→

Continue to item 19

4
5

21. This question is about willing sex or sexual contact
you have had with any staff at this facility. In the
past 12 months, did you do any of the following:

19. In the past 12 months, when you were physically
forced, pressured, or made to feel that you had to
have sex or sexual contact with another inmate,
were you ever:
Mark

“Yes” or “No” for each item.

Yes

Mark

Persuaded or talked into it?

Given a bribe or blackmailed?

Given drugs or alcohol to get you drunk
or high?

Offered protection from other inmates?

“Yes” or “No” for each item.

Yes

Touch a facility staff person's body in a
sexual way or have your body touched in
a sexual way?

Give or receive a handjob from a facility
staff person?

Have oral sex (blowjob) with a facility
staff person?

Have vaginal sex with a facility staff
person?

Have anal sex with a facility staff person?

Trying to pay off or settle a debt that you
owed?

Threatened with harm or a weapon?

Physically held down or restrained?

Physically harmed or injured?

Attachment D: NIS-4P PAPI Questionnaires

22. In the past 12 months, did a facility staff person
use physical force to make you do any of the
following:
Mark

“Yes” or “No” for each item.

Yes

25. In the past 12 months, when you had sex or sexual
contact with facility staff, did any single incident
ever involve more than one facility staff person?
Yes .........................................................................
No ..........................................................................

1
2

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Mark

Have vaginal sex with them?

Persuaded or talked into it?

Have anal sex with them?

Given a bribe or blackmailed?

Given drugs or alcohol to get you drunk
or high?

Offered protection from other inmates?

Offered protection from another
correctional officer?

Trying to pay off or settle a debt that
you owed?

Threatened with harm or a weapon?

Physically held down or restrained?

Physically harmed or injured?

26. In the past 12 months, when you had sex or sexual
contact with facility staff, were you ever:

23. In the past 12 months, did a facility staff person
without using physical force, pressure you or make
you feel that you had to do any of the following:
Mark

“Yes” or “No” for each item.

Yes

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Have vaginal sex with them?

Have anal sex with them?

→

Go to SECTION C
on page 5

→

Continue to item 25

2
3

Yes

27. In the past 12 months, when you had sex or sexual
contact with facility staff, was it ever with:
Mark

24. This question is about both wanted and unwanted
sex with staff at this facility. In the past 12 months,
how many times altogether have you had any type
of wanted or unwanted sex or sexual contact with
staff at this facility?
0 times ..................
1 time ....................
2 times ..................
3–10 times ............
11 times or more ...

“Yes” or “No” for each item.

4
5

“Yes” or “No” for each item.

Yes

Male facility staff?

Female facility staff?

Attachment D: NIS-4P PAPI Questionnaires

28. In the past 12 months, when you had sex or sexual
contact with facility staff, did you ever:
Mark

“Yes” or “No” for each item.

Yes

SECTION C

Receive knife or stab wounds?

Receive broken bones?

Receive anal or vaginal tearing?

Have your teeth chipped or knocked out?

Receive internal injuries?

Get knocked unconscious?

Receive bruises, a black eye, sprains,
cuts, scratches, swelling, or welts?

These last two questions are about your experience
with this survey.
29. How upsetting did you find it to answer questions
about your own experiences with sex and sexual
assault in this facility?
Not upsetting at all .................................................
Somewhat upsetting ...............................................
Very upsetting........................................................

1
2
3

30. How accurate are the answers you gave in this
survey?
Not very accurate ...................................................
Fairly accurate .......................................................
Very accurate .........................................................

After you have completed the survey, please put it
in the envelope and seal it before you turn it in.
Thank You!

1
2
3

Attachment D: NIS-4P PAPI Questionnaires

OMB No.:
Exp.:

1121-0311
06/30/2023

NATIONAL INMATE
SURVEY - PRISONS
Conducted by the Bureau of Justice Statistics
and
RTI International

Attachment D: NIS-4P PAPI Questionnaires

6. Are you currently being held in this facility for any
of the following:

SECTION A

Mark

“Yes” or “No” for each item.

Yes

A violent offense, such as physical or
sexual assault, rape, robbery,
manslaughter, attempted murder, or
murder?

A drug offense, such as possessing,
selling, or manufacturing drugs?

A property offense, such as burglary,
larceny, auto theft, bad checks, fraud,
forgery or grand theft?

Any other offense?

2. How old are you?
7. How long have you been in this facility?

Age: _______

1
2

4. Which of these categories describes your race:
Mark

“Yes” or “No” for each item.

Yes

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or other Pacific Islander

2
3
4
5
6
7
8

1
2

9. Which of the following best represents how you
think about yourself?

Lesbian or gay .......................................................
Straight; that is, not lesbian or gay ........................
Bisexual; that is, you are sexually attracted
to both men and women .........................................
Something else .......................................................

1
2
3
4

1
2

3
4

Attachment D: NIS-4P PAPI Questionnaires

15. This question is about wanted or voluntary sex or
sexual contact you have had with other inmates in
this facility. In the past 12 months, did you do any
of the following:

1
2

1
2
3
4

12. Before you entered this facility, had anyone ever
physically forced, pressured, 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?
Yes ..................................
No ...................................

1
2

Continue to item 13
Go to item 14

Touch another inmate's body in a sexual
way or have your body touched in a
sexual way?

Give or receive a handjob from another
inmate at this facility?

Have oral sex (blowjob) with another
inmate at this facility?

Have anal sex with another inmate at
this facility?

Have any type of sex or sexual contact
with another inmate at this facility other
than sexual touching, handjobs, oral sex
or blowjobs, or anal sex?

16. In the past 12 months, did another inmate use
physical force to make you do any of the following:

1
2

Mark

14. Before you entered this facility, were you
physically forced, pressured, or made to feel that
you had to have sex or sexual contact while you
were an adult or juvenile in a jail, prison, or other
correctional facility?
Yes .........................................................................
No ..........................................................................

Yes

These next questions ask about unwanted sex or
sexual contact you have had with other inmates in
this facility. By unwanted, we mean sex or sexual
contact that you did not want to happen.

“Yes” or “No” for each item.

1
2

“Yes” or “No” for each item.

Yes

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Have anal sex with them?

Have any type of sex or sexual contact
with them other than sexual touching,
handjobs, oral sex or blowjobs, or anal
sex?

Attachment D: NIS-4P PAPI Questionnaires

17. In the past 12 months, did another inmate, without
using physical force, pressure you or make you feel
that you had to do any of the following:
Mark

“Yes” or “No” for each item.

Yes

Mark

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Have anal sex with them?

Have any type of sex or sexual contact
with them other than sexual touching,
handjobs, oral sex or blowjobs, or anal
sex?

20. In the past 12 months, when you were physically
forced, pressured, or made to feel that you had to
have sex or sexual contact with another inmate, did
you ever:

→

Go to SECTION B

→

Continue to item 19

Receive knife or stab wounds?

Receive broken bones?

Receive anal tearing?

Have your teeth chipped or knocked out?

Receive internal injuries?

Get knocked unconscious?

Receive bruises, a black eye, sprains,
cuts, scratches, swelling, or welts?

These next questions ask about sex or sexual contact
you have had with staff at this facility. By staff, we
mean the employees of this facility and anybody who
works as a volunteer in this facility.

21. This question is about willing sex or sexual contact
you have had with any staff at this facility. In the
past 12 months, did you do any of the following:

19. In the past 12 months, when you were physically
forced, pressured, or made to feel that you had to
have sex or sexual contact with another inmate,
were you ever:
Mark

Yes

SECTION B

2
3

“Yes” or “No” for each item.

Yes

Mark

“Yes” or “No” for each item.

Yes

Touch a facility staff person's body in a
sexual way or have your body touched in
a sexual way?

Persuaded or talked into it?

Given a bribe or blackmailed?

Give or receive a handjob from a facility
staff person?

Given drugs or alcohol to get you drunk
or high?

Have oral sex (blowjob) with a facility
staff person?

Offered protection from other inmates?

Trying to pay off or settle a debt that
you owed?

Have vaginal sex with a facility staff
person?

Have anal sex with a facility staff person?

Threatened with harm or a weapon?

Physically held down or restrained?

Physically harmed or injured?

Attachment D: NIS-4P PAPI Questionnaires

22. In the past 12 months, did a facility staff person
use physical force to make you do any of the
following:
Mark

“Yes” or “No” for each item.

Yes

1
2

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a handjob
from them?

Have oral sex (blowjob) with them?

Mark

Have vaginal sex with them?

Persuaded or talked into it?

Have anal sex with them?

Given a bribe or blackmailed?

Given drugs or alcohol to get you drunk
or high?

Offered protection from other inmates?

Offered protection from another
correctional officer?

Trying to pay off or settle a debt that
you owed?

Threatened with harm or a weapon?

Physically held down or restrained?

Physically harmed or injured?

26. In the past 12 months, when you had sex or sexual
contact with facility staff, were you ever:

23. In the past 12 months, did a facility staff person
without using physical force, pressure you or make
you feel that you had to do any of the following:
Mark

“Yes” or “No” for each item.

Yes

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Have vaginal sex with them?

Have anal sex with them?

→

Go to SECTION C
on page 5

→

Continue to item 25

2
3

Yes

27. In the past 12 months, when you had sex or sexual
contact with facility staff, was it ever with:
Mark

“Yes” or “No” for each item.

4
5

“Yes” or “No” for each item.

Yes

Male facility staff?

Female facility staff?

Attachment D: NIS-4P PAPI Questionnaires

28. In the past 12 months, when you had sex or sexual
contact with facility staff, did you ever:
Mark

“Yes” or “No” for each item.

Yes

SECTION C

Receive knife or stab wounds?

Receive broken bones?

Receive anal tearing?

Have your teeth chipped or knocked out?

Receive internal injuries?

Get knocked unconscious?

Receive bruises, a black eye, sprains,
cuts, scratches, swelling, or welts?

1
2
3

After you have completed the survey, please put it
in the envelope and seal it before you turn it in.
Thank You!

1
2
3

Attachment D: NIS-4P PAPI Questionnaires

OMB No.:
Exp.:

1121-0311
06/30/2023

NATIONAL INMATE
SURVEY - PRISONS
Conducted by the Bureau of Justice Statistics
and
RTI International

Attachment D: NIS-4P PAPI Questionnaires

6. Are you currently being held in this facility for any
of the following:

SECTION A

Mark

“Yes” or “No” for each item.

Yes

A violent offense, such as physical or
sexual assault, rape, robbery,
manslaughter, attempted murder, or
murder?

A drug offense, such as possessing,
selling, or manufacturing drugs?

A property offense, such as burglary,
larceny, auto theft, bad checks, fraud,
forgery or grand theft?

Any other offense?

2. How old are you?
7. How long have you been in this facility?

Age: _______

1
2

4. Which of these categories describes your race:
Mark

“Yes” or “No” for each item.

Yes

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or other Pacific Islander

2
3
4
5
6
7
8

1
2

9. Which of the following best represents how you
think about yourself?

1
2
3
4

1
2

3
4

Attachment D: NIS-4P PAPI Questionnaires

15. This question is about wanted or voluntary sex or
sexual contact you have had with other inmates in
this facility. Since you arrived at this facility, did
you do any of the following:

1
2

1
2
3
4

1
2

Continue to item 13
Go to item 14

Touch another inmate's body in a sexual
way or have your body touched in a
sexual way?

Have oral sex with another inmate at
this facility?

Have vaginal sex with another inmate
at this facility?

Have anal sex with another inmate at
this facility?

Have any type of sex or sexual contact
with another inmate at this facility other
than sexual touching, oral sex, vaginal
sex, or anal sex?

16. Since you arrived at this facility, did another
inmate use physical force to make you do any of
the following:

1
2
3

Yes

These next questions ask about unwanted sex or
sexual contact you have had with other inmates in
this facility. By unwanted, we mean sex or sexual
contact that you did not want to happen.

“Yes” or “No” for each item.

1
2

“Yes” or “No” for each item.

Yes

Touch their body in a sexual way or have
your body touched in a sexual way?

Have oral sex with them?

Have vaginal sex with them?

Have anal sex with them?

Have any type of sex or sexual contact
with them other than sexual touching,
oral sex, vaginal sex, or anal sex?

Attachment D: NIS-4P PAPI Questionnaires

17. Since you arrived at this facility, did another
inmate, without using physical force, pressure you
or make you feel that you had to do any of the
following:
Mark

“Yes” or “No” for each item.

Yes

Touch their body in a sexual way or have
your body touched in a sexual way?

Have oral sex with them?

Have vaginal sex with them?

Have anal sex with them?

Have any type of sex or sexual contact
with them other than sexual touching,
oral sex, vaginal sex, or anal sex?

20. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, did you ever:
Mark

→

Go to SECTION B

→

Continue to item 19

Receive broken bones?

Receive anal or vaginal tearing?

Have your teeth chipped or knocked out?

Receive internal injuries?

Get knocked unconscious?

Receive bruises, a black eye, sprains,
cuts, scratches, swelling, or welts?

These next questions ask about sex or sexual contact
you have had with staff at this facility. By staff, we
mean the employees of this facility and anybody who
works as a volunteer in this facility.

4
5

21. This question is about willing sex or sexual contact
you have had with any staff at this facility. Since
you arrived at this facility, did you do any of the
following:

19. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, were you ever:
Mark

SECTION B

2
3

Yes

Receive knife or stab wounds?

18. Since you arrived at this facility, how many times
altogether were you physically forced, pressured,
or made to feel like you had to have sex or sexual
contact with another inmate?
0 times ..................
1 time ....................
2 times ..................
3–10 times ............
11 times or more ...

“Yes” or “No” for each item.

Yes

Mark

Persuaded or talked into it?

Given a bribe or blackmailed?

Given drugs or alcohol to get you drunk
or high?

Offered protection from other inmates?

“Yes” or “No” for each item.

Yes

Touch a facility staff person's body in a
sexual way or have your body touched in
a sexual way?

Give or receive a handjob from a facility
staff person?

Have oral sex (blowjob) with a facility
staff person?

Have vaginal sex with a facility staff
person?

Have anal sex with a facility staff person?

Trying to pay off or settle a debt that you
owed?

Threatened with harm or a weapon?

Physically held down or restrained?

Physically harmed or injured?

Attachment D: NIS-4P PAPI Questionnaires

22. Since you arrived at this facility, did a facility staff
person use physical force to make you do any of
the following:
Mark

“Yes” or “No” for each item.

Yes

25. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, did any single
incident ever involve more than one facility staff
person?

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a handjob
from them?

Have oral sex (blowjob) with them?

Have vaginal sex with them?

Have anal sex with them?

Yes .........................................................................
No ..........................................................................

“Yes” or “No” for each item.

Yes

Mark

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a handjob
from them?

Have oral sex (blowjob) with them?

Have vaginal sex with them?

Have anal sex with them?

→

Go to SECTION C
on page 5

→

Continue to item 25

2
3

“Yes” or “No” for each item.

Yes

Persuaded or talked into it?

Given a bribe or blackmailed?

Given drugs or alcohol to get you drunk
or high?

Offered protection from other inmates?

Offered protection from another
correctional officer?

Trying to pay off or settle a debt that you
owed?

Threatened with harm or a weapon?

Physically held down or restrained?

Physically harmed or injured?

27. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, was it ever
with:

24. This question is about both wanted and unwanted
sex with staff at this facility. Since you arrived at
this facility, how many times altogether have you
had any type of wanted or unwanted sex or sexual
contact with staff at this facility?
0 times ..................
1 time ....................
2 times ..................
3–10 times ............
11 times or more ...

26. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, were you ever:

23. Since you arrived at this facility, did a facility staff
person without using physical force, pressure you
or make you feel that you had to do any of the
following:
Mark

Mark

4
5

“Yes” or “No” for each item.

Yes

Male facility staff?

Female facility staff?

Attachment D: NIS-4P PAPI Questionnaires

28. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, did you ever:
Mark

“Yes” or “No” for each item.

Yes

SECTION C

Receive knife or stab wounds?

Receive broken bones?

Receive anal or vaginal tearing?

Have your teeth chipped or knocked out?

Receive internal injuries?

Get knocked unconscious?

Receive bruises, a black eye, sprains,
cuts, scratches, swelling, or welts?

1
2
3

After you have completed the survey, please put it
in the envelope and seal it before you turn it in.
Thank You!

1
2
3

Attachment D: NIS-4P PAPI Questionnaires

OMB No.:
Exp.:

1121-0311
06/30/2023

NATIONAL INMATE
SURVEY - PRISONS
Conducted by the Bureau of Justice Statistics
and
RTI International

Attachment D: NIS-4P PAPI Questionnaires

6. Are you currently being held in this facility for any
of the following:

SECTION A

Mark

“Yes” or “No” for each item.

Yes

A violent offense, such as physical or
sexual assault, rape, robbery,
manslaughter, attempted murder, or
murder?

A drug offense, such as possessing,
selling, or manufacturing drugs?

A property offense, such as burglary,
larceny, auto theft, bad checks, fraud,
forgery or grand theft?

Any other offense?

2. How old are you?
7. How long have you been in this facility?

Age: _______

1
2

4. Which of these categories describes your race:
Mark

“Yes” or “No” for each item.

Yes

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or other Pacific Islander

2
3
4
5
6
7
8

1
2

9. Which of the following best represents how you
think about yourself?

1
2
3
4

1
2

3
4

Attachment D: NIS-4P PAPI Questionnaires

15. This question is about wanted or voluntary sex or
sexual contact you have had with other inmates in
this facility. Since you arrived at this facility, did
you do any of the following:

1
2

1
2
3
4

1
2

Continue to item 13
Go to item 14

Touch another inmate's body in a sexual
way or have your body touched in a
sexual way?

Give or receive a handjob from another
inmate at this facility?

Have oral sex (blowjob) with another
inmate at this facility?

Have anal sex with another inmate at
this facility?

Have any type of sex or sexual contact
with another inmate at this facility other
than sexual touching, handjobs, oral sex
or blowjobs, or anal sex?

16. Since you arrived at this facility, did another inmate
use physical force to make you do any of the following:

1
2

Mark

Yes

These next questions ask about unwanted sex or
sexual contact you have had with other inmates in
this facility. By unwanted, we mean sex or sexual
contact that you did not want to happen.

“Yes” or “No” for each item.

1
2

“Yes” or “No” for each item.

Yes

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Have anal sex with them?

Have any type of sex or sexual contact
with them other than sexual touching,
handjobs, oral sex or blowjobs, or anal
sex?

Attachment D: NIS-4P PAPI Questionnaires

17. Since you arrived at this facility, did another inmate,
without using physical force, pressure you or make
you feel that you had to do any of the following:
Mark

“Yes” or “No” for each item.

Yes

Mark

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Have anal sex with them?

Have any type of sex or sexual contact
with them other than sexual touching,
handjobs, oral sex or blowjobs, or anal
sex?

20. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, did you ever:

→

Go to SECTION B

→

Continue to item 19

Receive knife or stab wounds?

Receive broken bones?

Receive anal tearing?

Have your teeth chipped or knocked out?

Receive internal injuries?

Get knocked unconscious?

Receive bruises, a black eye, sprains,
cuts, scratches, swelling, or welts?

These next questions ask about sex or sexual contact
you have had with staff at this facility. By staff, we
mean the employees of this facility and anybody who
works as a volunteer in this facility.

21. This question is about willing sex or sexual contact
you have had with any staff at this facility. Since
you arrived at this facility, did you do any of the
following:

19. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, were you ever:
Mark

Yes

SECTION B

2
3

“Yes” or “No” for each item.

Yes

Mark

Persuaded or talked into it?

Given a bribe or blackmailed?

Given drugs or alcohol to get you drunk
or high?

Offered protection from other inmates?

Trying to pay off or settle a debt that
you owed?

Threatened with harm or a weapon?

Physically held down or restrained?

Physically harmed or injured?

“Yes” or “No” for each item.

Yes

Touch a facility staff person's body in a
sexual way or have your body touched in
a sexual way?

Give or receive a handjob from a facility
staff person?

Have oral sex (blowjob) with a facility
staff person?

Have vaginal sex with a facility staff
person?

Have anal sex with a facility staff person?

Attachment D: NIS-4P PAPI Questionnaires

22. Since you arrived at this facility, did a facility staff
person use physical force to make you do any of
the following:
Mark

“Yes” or “No” for each item.

Yes

25. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, did any single
incident ever involve more than one facility staff
person?

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Have vaginal sex with them?

Have anal sex with them?

Yes .........................................................................
No ..........................................................................

“Yes” or “No” for each item.

Yes

Mark

Touch their body in a sexual way or have
your body touched in a sexual way?

Give them a handjob or receive a
handjob from them?

Have oral sex (blowjob) with them?

Have vaginal sex with them?

Have anal sex with them?

→

Go to SECTION C
on page 5

→

Continue to item 25

2
3

“Yes” or “No” for each item.

Yes

Persuaded or talked into it?

Given a bribe or blackmailed?

Given drugs or alcohol to get you drunk
or high?

Offered protection from other inmates?

Offered protection from another
correctional officer?

Trying to pay off or settle a debt that you
owed?

Threatened with harm or a weapon?

Physically held down or restrained?

Physically harmed or injured?

27. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, was it ever
with:

26. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, were you ever:

23. Since you arrived at this facility, did a facility staff
person without using physical force, pressure you
or make you feel that you had to do any of the
following:
Mark

Mark

4
5

“Yes” or “No” for each item.

Yes

Male facility staff?

Female facility staff?

Attachment D: NIS-4P PAPI Questionnaires

28. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, did you ever:
Mark

“Yes” or “No” for each item.

Yes

SECTION C

Receive knife or stab wounds?

Receive broken bones?

Receive anal tearing?

Have your teeth chipped or knocked out?

Receive internal injuries?

Get knocked unconscious?

Receive bruises, a black eye, sprains,
cuts, scratches, swelling, or welts?

1
2
3

After you have completed the survey, please put it
in the envelope and seal it before you turn it in.
Thank You!

1
2
3

Attachment E NIS-4P ACASI Consent Form

Bureau of Justice
Statistics

National Inmate Survey
Consent to Participate in Research

COVID-19 Introduction
Before the interviewer describes the study, they will tell you about the safety measures they are taking in
response to the COVID-19 pandemic. Interviewers use hand sanitizer frequently, clean all surfaces
between interviews, and will practice social distancing during the interviews. The interviewers do not
have any symptoms, and to the best of their knowledge, do not have COVID-19, but they cannot
guarantee that. For your protection, you and the interviewer are both required to wear a mask and
practice social distancing while you are together.

Study Introduction
The National Inmate Survey is a research study being done by the Bureau of Justice Statistics and RTI
International, a not-for-profit research organization. [You are one of about (175/275/375) inmates at this
facility who have been randomly selected to participate. /All eligible inmates at this facility will be asked
to participate.] Approximately 40,000 inmates will be interviewed at about 240 facilities across the
United States. The main purpose of this research study is to learn more about sexual assault in prisons.
Your participation in this study is completely voluntary.

Description of the Study
This interview will take about 35 minutes. To start, the interviewer will ask you some questions about
your background and education and enter your answers into the computer. Next, the interviewer will
show you how to use the computer and you will complete the rest of the survey on your own. You will be
able to see the questions on the computer screen and listen to them through headphones. You will enter
your answers directly into the computer by touching the screen. The interviewer will be nearby in case
you have questions but won’t be able to see your answers.
You will be randomly assigned to receive either detailed questions about your own experiences with sex
and sexual assault in this facility (such as the types of sexual acts and where they occurred) or questions
about your childhood and your experiences in this facility. In addition, you will be asked about your
criminal history and military service. You will never be asked to identify anyone by name. You are the
only one who will know which questions you are asked. Not even the interviewer will know unless you
discuss the questions with him or her. To thank you for participating in the study, you will receive [a
snack / a stamped envelope].

Possible Risks or Discomforts
Some of the questions in this interview are personal and they could make you feel uncomfortable or upset.
You can skip any questions you do not want to answer, and you can stop the interview at any time.
Please tell the interviewer if you want to stop or take a break during the interview. If you find the
questions upsetting for any reason, the interviewer can also provide you with instructions for contacting a
mental health counselor employed by this facility or retained by this study.

Benefits
You will not receive any direct benefits for participating in this study. However, the results of this study
may help improve the well-being of inmates in correctional facilities across the United States.

Voluntary Participation
If you choose not to participate, or if you begin the survey and decide to stop before the end, the terms or
length of your confinement will not be affected, and you will not lose any benefits or services that you
now receive or might receive in the future. Whether you participate will not affect your legal status, your
relationship with this facility, or any decisions regarding your release from this facility in any way.

Confidentiality
The Bureau of Justice Statistics and RTI are required by federal law to protect your privacy and
confidentiality. Your name will never be connected to the answers you put into the computer. Your
answers will be combined with the answers from other inmates and will be used for statistical and
research purposes only. The information you put into the computer will not be shared with anyone at this
facility or anyone who is not working on the study in a way that would identify you or connect your
answers to you individually. Secure systems are used to keep your data safe when it is electronically
transferred from the laptop to RTI. A dataset of all the answers provided by inmates will be created and
used for research in the field of criminal justice. The dataset will not include your name or other personal
identifiers. It is a federal crime for anyone on the project team to release your confidential information.
There are, however, exceptions to our promise of confidentiality. If you tell the interviewer you intend to
seriously harm yourself or a specific person, or that you plan to commit a crime in the future, he or she
may need to inform correctional staff here or authorities outside the facility who are responsible for
protecting prison inmates.
[FOR 16/17 YEAR OLD RESPONDENTS ONLY: Also, if you tell the interviewer out loud that you are
being abused at this facility, he or she, or their supervisor may need to report that information to the
agency in this state that investigates abuse. Once a report is made, no member of the project team has
control over how the information is used.]

Further Questions
You may keep a copy of this form. If you have any questions about the project, you may ask the
interviewer. If you have questions later, you may write to the National Inmate Survey (Project 0216099)
at RTI International, P.O. Box 12194, Research Triangle Park, NC 27709-2194. If you have questions
about your rights as a project participant, you can write to RTI's Office of Research Protection at the same
address.

Attachment F NIS-4P PAPI Consent Form

Bureau of Justice
Statistics

National Inmate Survey
Consent to Participate in Research
COVID-19 Introduction
Before the interviewer describes the study, they will tell you about the safety measures they are taking in
response to the COVID-19 pandemic. Interviewers use hand sanitizer frequently, clean all surfaces
between interviews, and will practice social distancing during the interviews. The interviewers do not
have any symptoms, and to the best of their knowledge, do not have COVID-19, but they cannot
guarantee that. For your protection, you and the interviewer are both required to wear a mask and
practice social distancing while you are together.

Study Introduction
The National Inmate Survey is a research study being done by the Bureau of Justice Statistics and RTI
International, a not-for-profit research organization. [You are one of about (175/275/375) inmates at this
facility who have been randomly selected to participate. /All eligible inmates at this facility will be asked
to participate.] Approximately 40,000 inmates will be interviewed at about 240 facilities across the United
States. The main purpose of this research study is to learn more about sexual assault in prisons. Your
participation in this study is completely voluntary.

Description of the Study
This interview will take about 15 minutes. The interviewer will provide you with the questionnaire which
you will complete by yourself. The questionnaire includes detailed questions about your own experiences
with sex and sexual assault in this facility (such as the types of sexual acts and where they occurred).
You will never be asked to identify anyone by name. Once you have completed the questionnaire you will
seal in in an envelope and give it back to the interviewer. Neither the interviewer nor anyone at this
facility will ever see your completed questionnaire. To thank you for participating in the study, you will
receive [a snack / a stamped envelope].

Possible Risks or Discomforts
Some of the questions in this interview are personal and they could make you feel uncomfortable or upset.
You can skip any questions you do not want to answer and you can stop the interview at any time. If you
find the questions upsetting for any reason, the interviewer can provide you with instructions for
contacting a mental health counselor employed by this facility or retained by this study.

Confidentiality
The Bureau of Justice Statistics and RTI are required by federal law to protect your privacy and
confidentiality. Your name will never be connected to the answers you put on the questionnaire. Your
answers will be combined with the answers from other inmates and will be used for statistical and
research purposes only. The information you put on the questionnaire will not be shared with anyone at
this facility or anyone who is not working on the study in a way that would identify you or connect your
answers to you individually. A dataset of all the answers provided by inmates will be created and used
for research in the field of criminal justice. The dataset will not include your name or other personal
identifiers. It is a federal crime for anyone on the project team to release your confidential information.
There are, however, exceptions to our promise of confidentiality. If you tell the interviewer you intend to
seriously harm yourself or a specific person, or that you plan to commit a crime in the future, he or she
may need to inform correctional staff here or authorities outside the facility who are responsible for
protecting prison inmates.
[FOR 16/17 YEAR OLD RESPONDENTS ONLY: Also, if you tell the interviewer out loud that you are
being abused at this facility, he or she, or their supervisor may need to report that information to the
agency in this state that investigates abuse. Once a report is made, no member of the project team has
control over how the information is used.]

Attachment G NIS-4P FI Script to Read After ACASI Consent

Interviewer Script to be Read After ACASI Consent Form
Instructions for Interviewer: You must read the following script out loud to the inmate and confirm that
he/she understands the information before concluding the informed consent process.
I want to go over the main points covered in this form to make sure everything is clear:





This interview is completely voluntary. That means you can decide whether you want to participate or not.
If you don’t participate, you will not lose any benefits or services you currently have or might have in the
future.
If you start the interview and then want to stop before the end, that’s okay.
And, you can skip any questions you don’t want to answer.

Do you understand?
IF THE INMATE ANSWERS, “NO,” ANSWER ANY QUESTIONS THE INMATE HAS AND THEN
RETURN TO THE CONSENT FORM AND RE-READ THE TEXT IN THE SECTIONS LABELED,
“POSSIBLE RISKS OR DISCOMFORTS” AND “VOLUNTARY PARTICIPATION”. POINT TO THE
TEXT ON THE INMATE’S COPY OF THE CONSENT FORM.
It is possible that some of the questions may make you feel uncomfortable or upset. If that happens and you want to
take a break or you want to talk to someone about how the questions made you feel, you can tell me you want to
take a break or want to speak with someone.
The form I just read aloud to you also talks about how we protect your privacy. The answers you enter into the
computer, even those about being abused or harmed, will never be connected to your name and nobody, not even
me, will know how you answered them.
READ FOR 16 AND 17 YEAR OLDS ONLY:
However, if you tell me out loud that you are being abused at this facility I, or my supervisors, may need to
report that information to the agency in this state that investigates abuse. Once we make a report, we have no
control over what will be done with the information.
Do you understand that what you enter into the computer, even if it is about abuse will always be
kept private?
IF THE INMATE ANSWERS ‘NO’, ANSWER ANY QUESTIONS THE INMATE HAS AND
THEN RETURN TO THE CONSENT FORM AND RE-READ THE TEXT ENTITLED
CONFIDENTIALITY AND POINT TO THIS TEXT ON THE INMATE’S COPY OF THE
CONSENT FORM.
Do you understand that if you say something out loud about being abused, that information is not
secret and may be reported to a state agency?
IF THE INMATE ANSWERS ‘NO’, ANSWER ANY QUESTIONS THE INMATE HAS AND
THEN RETURN TO THE CONSENT FORM AND RE-READ THE TEXT ENTITLED
CONFIDENTIALITY AND POINT TO THIS TEXT ON THE INMATE’S COPY OF THE
CONSENT FORM
So, please do not say anything out loud to me about being abused unless you want me to pass that
information on to the agency in this state that investigates abuse. Do you have any questions?

If you would like to participate in the interview, please tell me now and we will begin.
INMATE CAN KEEP A COPY OF THE CONSENT FORM IF HE/SHE WANTS ONE.

Attachment H NIS 4P FI Script to Read After PAPI Consent

Interviewer Script to be Read After PAPI Consent Form
Instructions for Interviewer: You must read the following script out loud to the inmate and confirm that
he/she understands the information before concluding the informed consent process.
I want to go over the main points covered in this form to make sure everything is clear:





This interview is completely voluntary. This means you can decide whether you want to participate or
not.If you don’t participate, you will not lose any benefits or services you currently have or might have in
the future.
If you start the interview and then want to stop before the end, that’s okay.
And, you can skip any questions you don’t want to answer.

READ FOR 16 AND 17 YEAR OLDS ONLY:
However, if you tell me out loud that you are being abused at this facility I, or my supervisors, may need to
report that information to the agency in this state that investigates abuse. Once we make a report, we have no
control over what will be done with the information.
Do you understand that what you mark on the questionnaire, even if it is about abuse will always be
kept private?
IF THE INMATE ANSWERS ‘NO’, ANSWER ANY QUESTIONS THE INMATE HAS AND
THEN RETURN TO THE CONSENT FORM AND RE-READ THE TEXT ENTITLED
CONFIDENTIALITY AND POINT TO THIS TEXT ON THE INMATE’S COPY OF THE
CONSENT FORM.
Do you understand that if you say something out loud about being abused, that information is not
secret and may be reported to a state agency?
IF THE INMATE ANSWERS ‘NO’, ANSWER ANY QUESTIONS THE INMATE HAS AND
THEN RETURN TO THE CONSENT FORM AND RE-READ THE TEXT ENTITLED
CONFIDENTIALITY AND POINT TO THIS TEXT ON THE INMATE’S COPY OF THE
CONSENT FORM.
So, please do not say anything out loud to me about being abused unless you want me to pass that
information on to the agency in this state that investigates abuse. Do you have any questions?

If you would like to participate in the interview, please tell me now and we will begin.
INMATE CAN KEEP A COPY OF THE CONSENT FORM IF HE/SHE WANTS ONE.

Attachment I: NIS-4P Facility Questionnaire Specs

2023 NATIONAL INMATE SURVEY—PRISONS

U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
[STATE NAME] FACILITY QUESTIONNAIRE

General Information
The National Inmate Survey (NIS) is a study designed to help Congress and the Department of Justice
understand more about sexual victimization in U.S. jails and prisons. This study is mandated by Congress
under the Prison Rape Elimination Act (PREA) of 2003. The NIS also seeks to gain valuable information
on facilities through the NIS Facility Questionnaire. The purpose of the Facility Questionnaire is to gather
administrative data about the facilities sampled for the National Inmate Survey that will allow the
Bureau of Justice Statistics to better understand facility characteristics associated with sexual
victimization in prisons.
Reporting Instructions
•
•
•
•
•
•

Click on the blue tab at the bottom of this Instructions worksheet for the Facility Questionnaire
worksheet
On the Facility Questionnaire worksheet, each sampled facility appears in a column; questions
appear on the rows. Please complete all questions for each facility.
If the answer to a question is “not available” or “unknown,” enter “DK” in the space provided.
If the answer to a question is “not applicable,” enter “NA” in the space provided.
If the answer to a question is “none” or “zero,” enter “0” in the space provided.
When exact numeric answers are not available, please provide estimate.

Submission Instructions
Please email the completed file to: [email protected].
Help Is Available
If you have any questions, need help completing the form, or prefer an alternate submission option,
please contact your NIS in Prisons Logistics Manager, LM NAME, at LM PHONE or [email protected].
BURDEN STATEMENT

OMB No. 1121-0311

Approval Expires MM/YYY

Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays
a currently valid OMB control number. The burden of this collection is estimated to average 30 minutes per facility,
including reviewing instructions, searching existing data sources, gathering necessary data, and completing and

Attachment I: NIS-4 Facility Questionnaire Specs

reviewing this form. Send comments regarding this burden estimate or any aspect of this survey, including
suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW,
Washington, DC 20531. Do not send your completed form to this address.

Question

Facility A NAME

Facility B NAME

Facility C Name

1. What are the functions of the facility? Please answer Yes or No for each function.

1A. General adult population confinement
1B. Alcohol / Drug treatment confinement
1C. Reception / Diagnosis / Classification
1D. Mental health treatment
1E. Medical treatment / Hospitalization confinement
1F. Primarily for persons returned to custody (e.g., parole
violators)
1G. Geriatric care
1H. Youthful offenders
1I. Close management / Administrative segregation /
Disciplinary segregation / Solitary confinement
1J. Faith and character-based
1K. Re-entry
1L. Some other function
If you answered “Yes” to Question 1L above,
PLEASE DESCRIBE THIS OTHER FUNCTION:

Yes

2. What is the rated operational bed capacity of the facility? By rated operational bed capacity, we
mean the number of beds or inmates assigned by a rating official.
ENTER RATED OPERATIONAL BED CAPACITY:

3. Please provide the current number of inmates held by custody security level. If this facility
houses no inmates for a specific custody security level, enter 0. Please include any inmates who
are temporarily absent from the facility (e.g., for court appearances, brief furloughs, and
medical leave). Do not include inmates who are on escape or absent without leave (AWOL).
3A. Super maximum / Intensive Management Unit custody inmates
/ Restrictive housing
3B. Maximum / Close / High custody inmates

Attachment I: NIS-4 Facility Questionnaire Specs

3C. Medium custody inmates
3D. Minimum custody inmates
3E. Administrative custody inmates (e.g., Federal medical facilities)
3F. Not classified / Other (e.g., unsentenced or sentenced and
awaiting classification)
TOTAL NUMBER OF INMATES HELD (CALCULATED)

4. Of the total number of inmates held at the facility, approximately how many…

4A. have been identified as currently having a serious and
persistent mental illness? Please include inmates whether or not
they are currently receiving medication for their mental illness.
4B. have been identified as having a cognitive impairment or
intellectual disability?
4C. are currently assigned to disciplinary restrictive housing such as
administrative segregation or disciplinary segregation?
4D. are currently affiliated with a gang or Security Threat Group?
4E. speak little or no English?

Check if
Estimate

4F. self-identify as LGBTQ?

If an inmate self-identifies as LGBTQ, is that self-identification taken into account when making
housing assignments at this facility?
o
o

Yes
No

5. Do inmates at the facility have access to a language line that provides on-demand language
interpretation or translation services?
o
o

Yes
No

6. During the past 12 months, that is since this date last year, was this facility operating under a
court-ordered corrective action plan or consent decree?
o
o

Yes
No

For Questions 7 – 13, please think only about paid staff who are not contractors.

Attachment I: NIS-4 Facility Questionnaire Specs

7. Regardless of the source of the funding used to cover the positions, how many Full-Time
Equivalency (FTE) positions for [state/federal] employees does the facility currently have? Please
include both uniformed and non-uniformed staff.
ENTER NUMBER OF FTEs:
8. How many of the FTE [state/federal] positions allocated to this facility are currently vacant?
Please do not include positions that are temporarily vacant because the staff person is on
medical leave, military leave, maternity leave, etc.
ENTER NUMBER OF VACANT FTE POSITIONS:
9. Is a hiring freeze currently in place at the facility?
o
o

Yes
No

10. Please provide the number of staff at the facility by the age and gender categories below.
Male
10A. Total number of staff employed at the facility
10B. Total number of staff under 30 years of age
10C. Total number of staff 30-44 years of age
10D. Total number of staff 45 years of age or
older
10E. Number of security staff employed at the facility
(INCLUDE officers of all ranks and other uniformed staff
who, regardless of their staff titles, are in direct contact
with inmates and involved in their daily custody care,
supervision, or monitoring)
10F. Number of security staff under 30 years of
age
10G. Number of security staff 30-44 years of age
10H. Number of security staff 45 years of age or
older

Female

Check if
Estimate

Attachment I: NIS-4 Facility Questionnaire Specs

11. During the past 12 months, that is since this date last year, how many staff were new to their
current position at the facility? That is, how many staff were either new hires to the facility or
who moved into positions they had not worked in before?
ENTER NUMBER OF STAFF IN NEW POSITIONS:
12. During the past 12 months, that is since this date last year, how many security staff left, for
whatever reason, and no longer work at the facility? Please include quits, layoffs, discharges,
retirements, deaths, transfers, and other separations.
ENTER NUMBER OF SECURITY STAFF WHO LEFT:
13. How many of the security staff have:

13A. Less than 1 year of service with the DOC
13B. 1-2 years of service with the DOC
13C. 3-5 years of service with the DOC
13D. More than 5 years of service with the DOC
TOTAL NUMBER OF SECURITY STAFF
(CALCULATED)

Check if Estimate

14. What is the total number of PREA-related training hours entry level security staff are required to
complete from their date of hire through their first year of employment?
ENTER NUMBER OF HOURS:
15. When does a new security staff person who begins employment at the facility have to complete
all required PREA-related trainings?
1 = From date of hire until cleared to work with inmates (prior to starting position)
2 = Within first 24 hours of starting position
3 = After first 24 hours but within first week (7 days) of starting position
4 = After first week but within first month (30 days) of starting position
5 = After first month but within first six months (180 days) of starting position
6 = After first six months but within first year (365 days) of starting position
7 = Some other timeframe
ENTER RESPONSE BY NUMBER:
If you selected response #7 to Question 15 above,
PLEASE DESCRIBE THE OTHER TIMEFRAME:

Attachment I: NIS-4 Facility Questionnaire Specs

16. Which of the following methods are used at the facility to educate inmates about the fact that
sexual activity is not allowed at the facility? Please select a Yes or No response for each method.
Procedure
16A. Facility staff
16B. Posters / Signs
16C. Brochures / Flyers / Pamphlets
16D. Handbook that describes facility rules and policies
16E. Video
16F. Peer educator
16G. New inmate orientation
16H. Some other way

Yes

If you answered ‘Yes’ to Questions 16H above,
PLEASE DESCRIBE THE OTHER METHOD USED TO EDUCATE INMATES:
17. Is there a Sexual Assault Nurse Examiner (SANE) onsite at the facility if an inmate needs to be
seen?
o
o

Yes
No

If you answered ‘No’ in Question 17
If there is a need for an inmate at the facility to be seen by a SANE, how does that visit happen?
PLEASE PROVIDE TEXT RESPONSE:
18. During the past 12 months, that is since this date last year, about how many violations of facility
rules were reported and resulted in a guilty finding? Please include less serious violations such
as use of abusive language or failure to attend class, as well as more significant violations such
as possession of contraband and physical assaults.
ENTER NUMBER OF GUILTY FINDINGS:

19. During what part of the day do most violations that result in a guilty finding occur in this
facility?
1 = After midnight but before 6:00 AM
2 = Between 6:00 AM and noon
3 = After noon but before 6:00 PM
4 = Between 6:00 PM and midnight

Attachment I: NIS-4 Facility Questionnaire Specs

ENTER RESPONSE BY NUMBER:
20. During the past 12 months, that is since this date last year, how many allegations of sexual
abuse or sexual harassment were made by inmates against other inmates, staff, or volunteers at
the facility?
ENTER NUMBER OF ALLEGATIONS:
Please answer this question if your answer in Question 20 was “1” or more:
21. During the past 12 months, that is since this date last year, were allegations of sexual abuse or
sexual harassment at the facility investigated by staff at the facility, referred to staff working
outside of the facility, or referred to a separate organization? Please answer Yes or No for each.

21A. Staff at the facility investigated
21B. Referred to staff working outside the facility
21C. Referred to a separate organization

Yes

22. Does the facility have a policy that an inmate who makes an allegation of sexual abuse or sexual
harassment must be notified of the outcome of the investigation?
o
o

Yes
No

23. During the past 12 months, that is since this date last year, how did COVID-19 affect each of
these practices?

24a. Number of inmates
released early
24b. Amount of time security
staff spent in the housing units
24c. Amount of inmate
movement within the facility
24d. Inmate participation in
recreational activities
24e. Inmate participation in
employment opportunities
24f. Number of visitors inside
the facility

Increased Increased
No
Decreased Decreased
a lot
a little
change
a little
a lot

Attachment I: NIS-4 Facility Questionnaire Specs

24g. Number of volunteers
inside the facility

Thank you for providing this important information!

Attachment J: NIS-4P IRB Approvals

APPROVAL
January 14, 2019
Rachel Caspar
919-541-6376, x26376
[email protected]
Dear Rachel Caspar:
On 12/11/2018, the IRB Committee reviewed the following submission below and approved it
with required modifications. On 01/11/19, the required modifications you submitted were
reviewed and accepted.
Type of Review:
Title:
Investigator:
IRB ID:
Funding Source:
Customer/Client Name:
Project/Proposal Number:
Contract/Grant Number:
IND, IDE, or HDE:

Initial Study
National Inmate Survey (NIS-4) 2018-19
Rachel Caspar
STUDY00020413
Dept of Justice BJS
Dept of Justice BJS
0216099
2017-RP-BX-K053
None

At a convened meeting, the IRB Committee approved the protocol from 12/11/2018 to
12/10/2019. Before 12/10/2019 or within 30 days of study close, whichever is earlier, you are to
submit a completed continuing review and required attachments to request continuing approval
or closure. You can submit a continuing review by navigating to the active study and clicking
Create Modification / CR.
If continuing review approval is not granted before the expiration date of 12/10/2019, approval
of this study expires on that date.
In conducting this protocol, you are required to follow the requirements listed in the Investigator
Manual (HRP-103), which can be found by navigating to the IRB Library within the IRB system.
Sincerely,
The RTI Office of Research Protection

Attachment J: NIS-4P IRB Approvals

APPROVAL
February 4, 2019
Rachel Caspar
919-541-6376, x26376
[email protected]
Dear Rachel Caspar:
On 2/4/2019, the IRB reviewed the following submission:
Type of Review:
Title:
Investigator:
IRB ID:
Funding Source:
Customer/Client Name:
Project/Proposal Number:
Contract/Grant Number:
IND, IDE, or HDE:

Modification
National Inmate Survey (NIS-4) 2018-19
Rachel Caspar
MOD00000512 for 20413
Dept of Justice BJS
Dept of Justice BJS
0216099
2017-RP-BX-K053
None

The IRB approved the modification under 28 CFR 46 from 2/4/2019 to 12/10/2019. Before
12/10/2019 or within 30 days of study close, whichever is earlier, you are to submit a completed
continuing review and required attachments to request continuing approval or closure. You can
submit a continuing review by navigating to the active study and clicking Create Modification /
CR.
If continuing review approval is not granted before the expiration date of 12/10/2019, approval
of this study expires on that date.
In conducting this protocol, you are required to follow the requirements listed in the Investigator
Manual (HRP-103), which can be found by navigating to the IRB Library within the IRB system.
Sincerely,
The RTI Office of Research Protection

Attachment J: NIS-4P IRB Approvals

APPROVAL
December 4, 2019
Rachel Caspar
919-541-6376, x26376
[email protected]
Dear Rachel Caspar:
On 12/3/2019, the IRB Committee reviewed the following submission:
Type of Review:
Title:
Investigator:
IRB ID:
Funding Source:
Customer/Client Name:
Project/Proposal Number:
IND, IDE, or HDE:

Continuing Review
National Inmate Survey (NIS-4) 2018-19
Rachel Caspar
CR00000506
Dept of Justice BJS
Dept of Justice BJS
0216099
None

At a convened meeting, the IRB Committee approved the protocol under 28 CFR 46
from 12/3/2019 to 12/2/2020. Before 12/2/2020 or within 30 days of study close,
whichever is earlier, you are to submit a completed continuing review and required
attachments to request continuing approval or closure. You can submit a continuing
review by navigating to the active study and clicking Create Modification / CR.
If continuing review approval is not granted before the expiration date of 12/2/2020,
approval of this study expires on that date.
In conducting this protocol, you are required to follow the requirements listed in the
Investigator Manual (HRP-103), which can be found by navigating to the IRB Library
within the IRB system.
Sincerely,
The RTI Office of Research Protection

Page 1 of 1

Attachment J: NIS-4P IRB Approvals

APPROVAL
April 8, 2020
Rachel Caspar
919-541-6376, x26376
[email protected]
Dear Rachel Caspar:
On 3/17/2020, the IRB Committee reviewed the submission below and approved it with a
required modification. On 4/8/2020, the required modification you submitted was
reviewed and accepted.
Type of Review:
Title:
Investigator:
IRB ID:
Funding Source:
Customer/Client Name:
Project/Proposal Number:
IND, IDE, or HDE:

Modification
National Inmate Survey (NIS-4) 2018-19
Rachel Caspar
MOD00000810
Dept of Justice BJS
Dept of Justice BJS
0216099
None

At a convened meeting, the IRB Committee approved the modification under 28 CFR 46
from 3/17/2020 to 12/2/2020. Before 12/2/2020 or within 30 days of study close,
whichever is earlier, you are to submit a completed continuing review and required
attachments to request continuing approval or closure. You can submit a continuing
review by navigating to the active study and clicking Create Modification / CR.
If continuing review approval is not granted before the expiration date of 12/2/2020,
approval of this study expires on that date.
In conducting this protocol, you are required to follow the requirements listed in the
Investigator Manual (HRP-103), which can be found by navigating to the IRB Library
within the IRB system.
Sincerely,
The RTI Office of Research Protection

Page 1 of 1

Attachment J: NIS-4P IRB Approvals

APPROVAL
November 11, 2020
Rachel Caspar
919-541-6376, x26376
[email protected]
Dear Rachel Caspar:
On 11/9/2020, the IRB reviewed the following submission:
Type of Review:
Title:
Investigator:
IRB ID:
Funding Source:
Customer/Client Name:
Project/Proposal Number:
Contract/Grant Number:
IND, IDE, or HDE:

Continuing Review
National Inmate Survey (NIS-4) Prisons
Rachel Caspar
CR00000684 for 20413
Dept of Justice BJS
Dept of Justice BJS
0216099
2017-RP-BX-K053
None

The IRB approved continuing review under 28 CFR 46 from 11/9/2020 to 11/8/2021. Before 11/8/2021
or within 30 days of study close, whichever is earlier, you are to submit a completed continuing review
and required attachments to request continuing approval or closure. You can submit a continuing review
by navigating to the active study and clicking Create Modification / CR.
If continuing review approval is not granted before the expiration date of 11/8/2021, approval of this
study expires on that date.
In conducting this study, you are required to follow the requirements listed in the Investigator Manual
(HRP-103), which can be found by navigating to the IRB Library within the IRB system.
Sincerely,
The RTI Office of Research Protection

Attachment J: NIS-4P IRB Approvals

APPROVAL
October 15, 2021
Rachel Caspar
919-541-6376, x26376
[email protected]
Dear Rachel Caspar:
On 10/14/2021, the IRB reviewed the following submission:
Type of Review:
Title:
Investigator:
IRB ID:
Funding Source:
Customer/Client Name:
Project/Proposal Number:
Contract/Grant Number:
IND, IDE, or HDE:

Continuing Review
National Inmate Survey (NIS-4) Prisons
Rachel Caspar
CR00000845
Dept of Justice BJS
Dept of Justice BJS
0216099
2017-RP-BX-K053
None

The IRB approved the study on 10/14/2021 to 10/13/2022 inclusive. This study was
approved under 28 CFR 46. Any changes to the approved study protcol or documents
must be submitted to the IRB as a modification for review and approval prior to
implementation. Within 30 days of study completion, you should request to close the
study in IRB Express. You can submit a modification or study closure by navigating to
the active study and clicking Create Modification / CR.
In conducting this protocol, you are required to follow the requirements listed in the
Investigator Manual (HRP-103), which can be found by navigating to the IRB Library
within the IRB system.
Sincerely,
The RTI Office of Research Protection

Page 1 of 1

Attachment J: NIS-4P IRB Approvals

APPROVAL
May 2, 2022
Rachel Caspar (she/her)
919-541-6376, x26376
[email protected]
Dear Rachel Caspar (she/her):
On 3/15/2022 the IRB Committee reviewed the submission below and approved it with
required modifications. On 5/2/2022, the required modifications you submitted were
reviewed and accepted.
Type of Review: Modification / Update
Title: National Inmate Survey (NIS-4) Prisons
Investigator: Rachel Caspar (she/her)
IRB ID: MOD00001438
Funding Source: Dept of Justice BJS
Customer/Client Name: Dept of Justice BJS
Project/Proposal Number: 0216099
Contract/Grant Number: 2017-RP-BX-K053
IND, IDE, or HDE: None
At a convened meeting, the IRB Committee approved the modification from 3/15/2022 to
10/13/2022. This study was reviewed under 28 CFR 46. Any changes to the approved
study protocol or documents must be submitted to the IRB as a modification for review
and approval prior to implementation. Before 10/13/2022 or within 30 days of study
close, whichever is earlier, you are to submit a completed continuing review and required
attachments to request continuing approval or closure. You can submit a modification or
a continuing review by navigating to the active study and clicking Create Modification /
CR.
If continuing review approval is not granted before the expiration date of 10/13/2022
approval of this study expires on that date.
In conducting this study, you are required to follow the requirements listed in the
Investigator Manual (HRP-103), which can be found by navigating to the IRB Library
within the IRB system.
Sincerely,
The RTI Office of Research Protection

Page 1 of 1

Attachment J: NIS-4P IRB Approvals

APPROVAL
July 28, 2022
Rachel Caspar (she/her)
919-541-6376, x26376
[email protected]
Dear Rachel Caspar (she/her):
On 7/27/2022, the IRB reviewed the following submission:
Type of Review:
Title:
Investigator:
IRB ID:
Funding Source:
Customer/Client Name:
Project/Proposal Number:
Contract/Grant Number:
IND, IDE, or HDE:

Modification / Update
National Inmate Survey (NIS-4) Prisons
Rachel Caspar (she/her)
MOD00001543
Dept of Justice BJS
Dept of Justice BJS
0216099
2017-RP-BX-K053
None

The IRB approved the modification on 7/27/2022 to 10/13/2022. This study was
approved under 28 CFR 46. Any changes to the approved study protcol or documents
must be submitted to the IRB as a modification for review and approval prior to
implementation. Within 30 days of study completion, you should request to close the
study in IRB Express. You can submit a modification or study closure by navigating to
the active study and clicking Create Modification / CR.
In conducting this protocol, you are required to follow the requirements listed in the
Investigator Manual (HRP-103), which can be found by navigating to the IRB Library
within the IRB system.
Sincerely,
The RTI Office of Research Protection

Page 1 of 1

Attachment J: NIS-4P IRB Approvals

APPROVAL
September 7, 2022
Rachel Caspar
919-541-6376, x26376
[email protected]
Dear Rachel Caspar:
On 9/6/2022, the IRB reviewed the following submission:
Type of Review:
Title:
Investigator:
IRB ID:
Funding Source:
Customer/Client Name:
Project/Proposal Number:
Contract/Grant Number:
IND, IDE, or HDE:

Continuing Review
National Inmate Survey (NIS-4) Prisons
Rachel Caspar (she/her)
CR00000992
Dept of Justice BJS
Dept of Justice BJS
0216099
2017-RP-BX-K053
None

The IRB approved the study on 9/6/2022 to 9/5/2023. This study was approved under 28
CFR 46. Any changes to the approved study protcol or documents must be submitted to
the IRB as a modification for review and approval prior to implementation. Within 30
days of study completion, you should request to close the study in IRB Express. You can
submit a modification or study closure by navigating to the active study and clicking
Create Modification / CR.
In conducting this protocol, you are required to follow the requirements listed in the
Investigator Manual (HRP-103), which can be found by navigating to the IRB Library
within the IRB system.
Sincerely,
The RTI Office of Research Protection

Page 1 of 1

Attachment L: Thank You Letters

[DATE]
[NAME OF COMMISSIONER/SECRETARY]
[TITLE]
[STREET ADDRESS 1]
[STREET ADDRESS 2]
[CITY, STATE, AND ZIP CODE]
Dear [COMMISSIONER/SECRETARY NAME]:
Thank you for your recent participation in the Bureau of Justice Statistics’ Fourth National Inmate Survey
(NIS) in Prisons. The commitment you and others in the [STATE DOC/BOP] have shown to helping us
understand more about sexual victimization in U.S. prisons is commendable. We appreciate the
consideration our interviewers were shown during data collection at [XX] facilities [in your state].
The Bureau of Justice Statistics and RTI International worked with many practitioners and researchers in
developing the instrument and protocols for the survey. We hope your staff found the process to be well
organized and efficient. Data collection will be followed by a period of data cleaning, weighting, and
analysis. We anticipate beginning to release findings from the study starting in 2024.
Thank you again for your assistance. We welcome any feedback you might have about the experience.
Please feel free to contact Amy Lauger, Chief of the Re-entry, Recidivism, and Special Projects Unit and
PREA Program Manager at BJS, at [email protected] or 202-353-5955. She can also be contacted
for more information about future NIS reports.
Sincerely,
[INSERT ELECTRONIC SIGNATURE]
Alex R. Piquero, Ph.D.
Director
Bureau of Justice Statistics

Attachment L: Thank You Letters

[DATE]
[FACILITY ADMINISTRATOR NAME]
[TITLE]
[STREET ADDRESS 1]
[STREET ADDRESS 2]
[CITY, STATE, AND ZIP CODE]
Dear [FACILITY ADMINISTRATOR NAME]:
Thank you for allowing the Bureau of Justice Statistics (BJS) and RTI International (RTI) to interview
inmates in your facility as part of the Fourth National Inmate Survey (NIS) in Prisons. Your facility’s
help was crucial to ensuring the success of NIS and generating national statistics of the characteristics of
the U.S. prison population.
In particular, I would like to express my appreciation to [INSERT NAMES OF KEY STAFF WHO
WORKED DIRECTLY WITH RTI] for their help with the study. They facilitated our work in an efficient
and friendly manner. Please convey my thanks to them and all the other facility staff who assisted in this
effort.
Thank you again for your cooperation and assistance. We hope you found the process to be well
organized and efficient. After a period of data cleaning, weighting, and analysis, we anticipate beginning
to release findings from the study in 2024.
We welcome any feedback you would like to share about the experience. Please feel free to contact Amy
Lauger, Chief of the Re-entry, Recidivism, and Special Projects Unit and PREA Program Manager at
BJS, at [email protected] or 202-353-5955 with comments or questions.
Sincerely,
[INSERT ELECTRONIC SIGNATURE]
Alex R. Piquero, Ph.D.
Director
Bureau of Justice Statistics

File Type	application/pdf
Author	Emily McFarlane
File Modified	2022-11-16
File Created	2022-11-16