Administration for Children and Families Youth Programs – Sexual Orientation and Gender Identity (SOGI) Items

Instrument 1. SOGI Measures Pretest: Youth Screener for Cognitive Interviews

OMB No.: 0970-0355

Expiration Date:

Instrument 1. SOGI Measures Pretest: Youth Screener for Cognitive Interviews

THE PAPERWORK REDUCTION ACT OF 1995

This collection of information is voluntary and will be used to provide the Administration for Children and Families with information to help refine and guide the development of measures on sexual orientation and gender identity. Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. 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 number and expiration date for this collection are OMB #: 0970-0355, Exp.: XX/XX/XXXX. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Melissa Thomas at [email protected].

Fall 2024

YOUTH SCREENER (TO BE ADMINISTERED ONLINE)

Thank you for your interest in this study! We are testing some survey questions and want your feedback to learn if the questions are clear and easy to understand, and if there are better ways to ask them. The questions we are testing will be used by the Administration for Children and Families, also known as ACF. ACF is part of the U.S. Department of Health and Human Services, and it works to support the health and well-being of people, including youth. ACF will use the questions we are testing with youth participating in a variety of programs. ACF has hired Mathematica, an independent research company, for this study.

The purpose of the study is to make improvements to questions on sexual orientation and gender identity to make sure they are appropriate for youth and that they work for youth with different backgrounds. If you are selected for the study and choose to participate, you will be asked to attend an hour long virtual discussion group. In that discussion group, you will be asked to review questions and share your thoughts on the way the questions are asked, the response options, and how other people your age may understand those questions.

If you are interested in participating in the study, please complete the following screener questions below. These screener questions will help us determine if you are eligible for the study and will help make sure we receive feedback from a diverse set of youth. It is important to know that:

• These screener questions ask about some of your personal characteristics. All the information you provide in the screener questions will be kept private. Your answers will not be shared with your parents or guardians, teachers, or anyone outside of our study team. If you choose to participate in the focus group, we will not ask you to share your own answers to these questions with the others in your group.

• Your name will not be linked to your answers and no information will be reported that could identify you.

• Responding to these questions should take about 5 minutes. You do not have to answer any questions that you are not comfortable answering.

1. What grade are you in?

m 7th 1

m 8th 2

m 9th 3

m 10th 4

m 11th 5

m 12th 6

m Not enrolled in any school/home-schooled 7

2. How old are you?

3. What is your race and/or ethnicity?

Select all that apply.

 American Indian or Alaska Native

For example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation

of Montana, Native Village of Barrow Inupiat Traditional Government,

Nome Eskimo Community, Aztec, Maya, etc.

 Asian

For example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, Japanese, etc.

 Black or African American

For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc.

 Hispanic or Latino

For example, Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, etc.

 Middle Eastern or North African

For example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, Israeli, etc.

 Native Hawaiian or Pacific Islander

For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc.

 White

For example, English, German, Irish, Italian, Polish, Scottish, etc.

3.

4. When you are at home or with your family, what language or languages do you usually speak?

Select all that apply

m English 1

m Spanish 2

m Other (please specify) ___________________________________ 3

5. Are you…?

Select all that apply

□ Male 1

□ Female 2

□ Transgender, non-binary, or another gender 3

6. Which of the following best describes how you currently think of yourself?

Select one

□ Gay or lesbian 1

□ Straight, that is not gay or lesbian 2

□ Bisexual 3

□ I use a different term (please describe) 4

□ I don’t know 9

7. What state do you live in?

8. How would you describe the area where you live?

m Urban (for example, you live in a city such as New York City, Chicago,

Atlanta, Pittsburgh, Cincinnati, Nashville, etc.) 1

m Suburban (for example, you live in an area near to, but outside of a city) 2

m Rural (for example, you live in a small town) 3

9. Are you interested in participating in a virtual, small group discussion with 3-4 other people your age? You will review some questions about sexual orientation and gender identity and then talk about the survey questions with the group. You will NOT be asked to reveal your sexual orientation or gender identity in the group. We want to hear your thoughts on the survey questions – for example, are they clear, easy to understand, and are there ways to improve the questions. The discussion group will take one hour. If you are eligible and participate, you will receive $50.

m Yes, interested 1

m No, not interested 2

Thank you for your responses! If you are eligible and interested in the study, we will contact you with next steps.

[Please click the SUBMIT button.]