National Worker Survey

Appendix E. Respondent Screener

Formative Research: Implementing RDS on Worker Survey

OMB No.: 1290-0043

Expiration: 10/31/2025

Public reporting burden for this screener questionnaire is estimated to average 5 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the screener questionnaire. This collection of information is voluntary. You are not required to respond to this collection of information unless it displays a valid OMB control number. Please send comments regarding the burden estimate or any other aspect of this collection of information to the U.S. Department of Labor, Chief Evaluation Office, 200 Constitution Ave NW., Washington, DC 20210, or email [email protected] and reference OMB control number 1290-0043. NOTE: Please do not send your completed screener questionnaire to this address.

Introduction to self-administered screener (on landing page):

Thank you for your interest. Westat is working with the U.S. Department of Labor to learn about where people work, the jobs they do, and how they are paid -- and we need your help.

We are talking to people to get feedback about the survey, including how to recruit people who work in different types of jobs. If you qualify, we will ask you to answer questions about our materials and procedures. The interview will last no more than 60 minutes. You will receive a $50 e-gift card after completing the session as a thank you.

Your participation and feedback will help us improve our recruitment procedures so that the study can represent people who work in different types of jobs across the country.

Screener Questions

To ensure that we include a broad mix of individuals, please answer the following screening questions. It should take only about 5 minutes of your time.

S1. Are you 18 years old or older?

• Yes

• No Go to IE statement

S2. Are you currently working for pay?

• Yes

• No Go to IE statement

Some people work more than one job. If you work more than one job, please answer the next questions about your main job, that is the job where you usually work the most hours.

S3. Are you self-employed or do you own your own business?

• Yes  Go to IE statement

• No

S4. Are you an independent contractor?

• Yes  Go to IE statement

• No

S5. If you work more than 40 hours in a week, do you receive overtime pay?

• Yes

• No  Go to IE statement

• Don’t know

S6. Which of the following best describes where you work/what you do? (check only one, for main job)

• Restaurant, bar, or fast food

• Grocery store or supermarket

• Department or discount store

• Amusement such as an amusement park, arcade, or casino

• Building services such as a janitor or cleaner

• Nursing home

• Hotel or motel

• Home health care

• Landscaping

• Security guard

• Center or home child day care

• Residential construction

• Other: ______________________

Demographic Questions

S7. What is your age?

____ years old

S8. What is your gender?

• Male

• Female

• Transgender

• I use a different term

S9. What is your race?

Select all that apply.

• American Indian or Alaska Native

• Asian

• Native Hawaiian or other Pacific Islander

• Black or African American

• White

• Some other race, please specify: __________

• I do not wish to provide this information

S10. Are you of Hispanic, Latino/a, or Spanish origin?

• Yes

• No

• I do not wish to provide this information

S11. What is the highest degree or level of school you have COMPLETED?

• Less than high school

• High school diploma or GED

• Some college credit, no degree

• Associate’s degree

• Bachelor’s degree

• Master’s degree, Doctorate degree, or other professional degree beyond Bachelor’s degree

S12. Do you have internet access at home (other than a cell phone)?

• Yes

• No

S13. Are you able to come into Westat’s headquarters located in Rockville, MD to participate in the interview? (If you are not local or unable to be interviewed in person, you are still eligible to complete the interview via Zoom)

• Yes -> skip to contact info

• No

S15. Have you ever used Zoom before?

• Yes

• No

S16. Are you willing to use Zoom for this interview?

• Yes

• No

Thank you for your answers! You are eligible for the study. Please enter your contact information below. If you are chosen for the study, someone from Westat will be in touch with you within two business days. We will destroy this information after the interview is over.

Name:

Phone number:

Email address:

IE Statement:

We’re sorry but you do not qualify for this study. Thank you for your time.