Appendix C Screening Questions for Cognitive Interviews

OMB Control Number: 1220-0141

Expiration Date: 07/31/2027

Appendix C: Screening Questions for Cognitive Interviews

Initial screening questions

Q1. What is your age?

Under 18 → INELIGIBLE

18 to 29

30 to 49

50 to 64

65 or older

Q2 LAST WEEK, did you do ANY work for pay?

Yes

No

Q3 LAST WEEK, did you have a job either full or part time? Include any job from which you were temporarily absent.

Yes

No

RECRUIT AT LEAST 10 WHERE Q2 = YES OR Q3 = YES

Q4. Do you have children in your household?

I have children ages 0-5 living in my household

I have children ages 6-17 living in my household

I do not have minor age children living in my household

RECRUIT AT LEAST 10 WITH CHILDREN AGES 0-5 LIVIING IN THE HOUSEHOLD

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