Supporting Healthy Marriage Demonstration Evaluation
Youth Survey
Wave 2 Data Collection
May 22, 2009
SHM 30-Month Child/Youth Survey
Contents
Section A. Social and Emotional Adjustment 1
Perceptions of Self, Others, and World: Self-Concept 1
Section B. Social Competence and Self-Regulation 1
General and Prosocial Behavior 1
Section C. Parent-Child Relationships 1
Nonresident Parent Involvement 1
Section D. Family Routines 1
Section E. Sibling and Peer Relationships 1
Section F. Romantic Relationships 1
Section G. Educational Engagement 1
Section H. Child and Youth Perspectives of the Parents’ Relationship 1
Child and Youth Reactions to Inter-parental Conflict 1
Section I. Marriage Expectations and Knowledge 1
Section J. Physical Health 1
Section K. Delinquency and Substance Use 1
NOTE: ASK QUESTIONS TO ALL RESPONDENTS UNLESS OTHERWISE NOTED
I am going to read a list of items that sometimes describe kids. Please tell me if you strongly agree, agree, disagree, or strongly disagree with the following statements as they describe you. Describe yourself as you see yourself at the present time, not as you wish to be in the future.
|
Strongly Agree |
Agree |
Disagree |
Strongly Disagree |
REF |
DK |
A1a. I trust others |
1 |
2 |
3 |
4 |
7 |
8 |
A1b. I feel alone in the world |
1 |
2 |
3 |
4 |
7 |
8 |
A1c. I have lots of friends |
1 |
2 |
3 |
4 |
7 |
8 |
A1d. I would like to have a lot more friends. |
1 |
2 |
3 |
4 |
7 |
8 |
A1e. I am popular with kids my age. |
1 |
2 |
3 |
4 |
7 |
8 |
A1f. I wish that more people my age liked me. |
1 |
2 |
3 |
4 |
7 |
8 |
A1g. I can talk about my thoughts or feelings |
1 |
2 |
3 |
4 |
7 |
8 |
A1h. I find it hard to make friends. |
1 |
2 |
3 |
4 |
7 |
8 |
For each question, please tell me how true each statement has been true of your behavior or feeling s over the past month? [INSERT STATEMENT] Over the past month, is this true, sometimes, or not true of your behaviors and actions.
|
True |
Sometimes true |
Not true |
REF |
DK |
A2a. I felt miserable or unhappy. |
1 |
2 |
3 |
7 |
8 |
A2b. I didn’t enjoy anything at all. |
1 |
2 |
3 |
7 |
8 |
A2c. I felt so tried I just sat around and did nothing. |
1 |
2 |
3 |
7 |
8 |
A2d. I was very restless. |
1 |
2 |
3 |
7 |
8 |
A2e. I felt I was no good any more. |
1 |
2 |
3 |
7 |
8 |
A2f. I cried a lot. |
1 |
2 |
3 |
7 |
8 |
A2g. I found it hard to think properly or concentrate. |
1 |
2 |
3 |
7 |
8 |
A2h. I hated myself. |
1 |
2 |
3 |
7 |
8 |
A2i. I was a bad person. |
1 |
2 |
3 |
7 |
8 |
A2j. I felt lonely. |
1 |
2 |
3 |
7 |
8 |
A2k. I thought nobody really loved me. |
1 |
2 |
3 |
7 |
8 |
A2l. I thought I could never be as good as other kids. |
1 |
2 |
3 |
7 |
8 |
A2m. I did everything wrong. |
1 |
2 |
3 |
7 |
8 |
All kids act different ways depending on how they’re feeling. Please tell me if the following behaviors were never, sometimes, usually or always true of you during the past month.
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
A3a. I didn’t get long with other kids. |
1 |
2 |
3 |
4 |
7 |
8 |
A3b. I lied or cheated |
1 |
2 |
3 |
4 |
7 |
8 |
A3c. I acted too young for my age |
1 |
2 |
3 |
4 |
7 |
8 |
A3d. I argued a lot |
1 |
2 |
3 |
4 |
7 |
8 |
A3e. I had trouble concentrating or paying attention |
1 |
2 |
3 |
4 |
7 |
8 |
A3f. I bragged a lot |
1 |
2 |
3 |
4 |
7 |
8 |
A3g. I couldn’t sit still |
1 |
2 |
3 |
4 |
7 |
8 |
A3h. I was disobedient at school |
1 |
2 |
3 |
4 |
7 |
8 |
A3i. I was afraid of doing bad |
1 |
2 |
3 |
4 |
7 |
8 |
A3j. I talked too much |
1 |
2 |
3 |
4 |
7 |
8 |
A3k. I picked on others. |
1 |
2 |
3 |
4 |
7 |
8 |
A3l. I got picked on by others. |
1 |
2 |
3 |
4 |
7 |
8 |
Over the last year, how many times have you gotten into a fight and hit, kicked or hurt someone? Would you say...
Never 1
Once or twice 2
More than two times 3
REFUSED 7
DON’T KNOW 8
NOTE: ASK ITEMS B1A-B1F OF ALL AGES; ASK ITEM B1G OF AGES 11-17 ONLY
Please tell me how often each of the following statements was true of you in the last month. Would you say never, sometimes, usually, or always?
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
B1a. I showed respect for teachers and neighbors. |
1 |
2 |
3 |
4 |
7 |
8 |
B1b. I got along well with other kids. |
1 |
2 |
3 |
4 |
7 |
8 |
B1c. I tried to understand other people's feelings. |
1 |
2 |
3 |
4 |
7 |
8 |
B1d. I tried to work out problems with classmates, family, or friends. |
1 |
2 |
3 |
4 |
7 |
8 |
B1e. I helped other kids at school with things like homework, sports, or other activities |
1 |
2 |
3 |
4 |
7 |
8 |
B1f. I volunteered in programs to help others in need like food or clothing drives, [FOR AGES 11-17 ADD: working at a homeless shelter] |
1 |
2 |
3 |
4 |
7 |
8 |
B1g. I tried to see things from another person’s point of view. |
1 |
2 |
3 |
4 |
7 |
8 |
NOTE: ASK ITEMS B2A – B2M OF AGES 11-17 ONLY; ASK ITEMS B2N – B2T OF ALL AGES.
And how often were each of the following statements true of you in the last month? Would you say never, sometimes, usually, or always?
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
B2a. I waited my turn during activities. |
1 |
2 |
3 |
4 |
7 |
8 |
B2b. I coped well with disappointment or frustration. |
1 |
2 |
3 |
4 |
7 |
8 |
B2c. I accepted it when things do not go my way. |
1 |
2 |
3 |
4 |
7 |
8 |
B2d. My feelings got hurt. |
1 |
2 |
3 |
4 |
7 |
8 |
B2e. When I got upset, I whined or complained. |
1 |
2 |
3 |
4 |
7 |
8 |
B2f. I controlled my temper when there was a disagreement. |
1 |
2 |
3 |
4 |
7 |
8 |
B2g. I stopped and calmed down when I was frustrated or upset. |
1 |
2 |
3 |
4 |
7 |
8 |
B2h. I thought before I acted. |
1 |
2 |
3 |
4 |
7 |
8 |
B2i. I did what I was told to do. |
1 |
2 |
3 |
4 |
7 |
8 |
B2j. When I wanted something, I was patient when waiting. |
1 |
2 |
3 |
4 |
7 |
8 |
B2k. I followed the rules. |
1 |
2 |
3 |
4 |
7 |
8 |
B2l. I stuck with an activity until it was finished. |
1 |
2 |
3 |
4 |
7 |
8 |
B2m. I could concentrate and focus on one activity at a time. |
1 |
2 |
3 |
4 |
7 |
8 |
B2n. I ignored kids who were fooling around in class. |
1 |
2 |
3 |
4 |
7 |
8 |
B2o. I fought or argued with adults |
1 |
2 |
3 |
4 |
7 |
8 |
B2p. I told new kids my name without being asked to tell it. |
1 |
2 |
3 |
4 |
7 |
8 |
B2q. When people were angry with me, I controlled my anger. |
1 |
2 |
3 |
4 |
7 |
8 |
B2r. When someone told me a rule that I thought was unfair, I asked about the rule in a nice way. |
1 |
2 |
3 |
4 |
7 |
8 |
B2s. When I disagreed with my parents, I yelled and screamed. |
1 |
2 |
3 |
4 |
7 |
8 |
B2t. I asked friends for help with my problems. |
1 |
2 |
3 |
4 |
7 |
8 |
Now I’m going to ask you some questions about your relationship with your [BASELINE MOTHER] and [BASELINE FATHER].
[ASK about baseline mother with whom CHILD/YOUTH does not live with.] First, can you tell me if you have talked to or spent time with your baseline mother in the past month?
Yes q 1
No q 2
REFUSED q 97
DON’T KNOW q 98
IF NO, SKIP ALL QUESTIONS ABOUT THE [BASELINE MOTHER]-CHILD RELATIONSHIP.
[ASK about baseline father with whom CHILD/YOUTH does not live with.] Have you talked to or spent time with your [BASELINE FATHER] in the past month?
Yes q 1
No q 2
REFUSED q 97
DON’T KNOW q 98
IF NO, SKIP ALL QUESTIONS ABOUT THE [BASELINE FATHER]-CHILD RELATIONSHIP.
NOTE TO REVIEWERS: The survey firm will work with us to determine how the skip patterns will work in this section, but for the purpose of this review note that all questions will be asked about both the baseline mother and the baseline father, regardless of whether or not the child is living with both parents at the time of the survey.
ITEMS C3-C6 WILL NOT BE ASKED OF AGES 8.5-10
Would you say that your [BASELINE MOTHER] has met all of your friends, most of your friends, some of your friends, or none of your friends?
All 1
Most 2
Some 3
None 4
REFUSED 7
DON’T KNOW 8
Would you say that your [BASELINE FATHER] has met all of your friends, most of your friends, some of your friends, or none of your friends?
All q 1
Most q 2
Some q 3
None q 4
REFUSED q 7
DON’T KNOW q 8
How much does your [BASELINE MOTHER] know about your close friends, that is, who they are? [READ CATEGORIES]
Nothing q 1
Just a little q 2
Some things q 3
Most things q 4
Everything q 5
REFUSED q 7
DON’T KNOW q 8
How much does your [BASELINE FATHER] know about your close friends, that is, who they are? [READ CATEGORIES]
Nothing q 1
Just a little q 2
Some things q 3
Most things q 4
Everything q 5
REFUSED q 7
DON’T KNOW q 8
During the past 12 months, how often did your [BASELINE MOTHER] attend events or activities you and your friends participated in? Would you say never, sometimes, usually or always?
Never q 1
Sometimes q 2
Usually q 3
Always q 4
REFUSED q 7
DON’T KNOW q 8
During the past 12 months, how often did your [BASELINE FATHER] attend events or activities you and your friends participated in? Would you say never, sometimes, usually or always?
Never q 1
Sometimes q 2
Usually q 3
Always q 4
REFUSED q 7
DON’T KNOW q 8
When you have a problem, how often do you talk to your [BASELINE MOTHER] about it?
Never q 1
Sometimes q 2
Usually q 3
Always q 4
REFUSED q 7
DON’T KNOW q 8
When you have a problem, how often do you talk to your [BASELINE FATHER] about it?
Never q 1
Sometimes q 2
Usually q 3
Always q 4
REFUSED q 7
DON’T KNOW q 8
NOTE: ASK ITEM C11A and C11B ONLY TO RESPONDENTS 8.5-10 YEARS OLD
ASK ITEMS C11C-C11F ONLY TO RESPONDENTS 8.5-13 YEARS OLD
ASK ITEM C11G ONLY TO RESPONDENTS AGES 11-13 YEARS OLD
ASK ITEM C11H-11K ONLY TO AGES 14-17 YEARS OLD
ASK ITEMS C11M ONLY TO AGES 11-17
ASK ITEMS C11N AND C11O TO ALL RESPONDENTS
Over the past month, which of the following things have you done with your [BASELINE MOTHER]? Have you…. [READ RESPONSE]…WAIT FOR ANSWER.
|
YES |
NO |
REF |
DK |
C11a. Worked on a project for school? |
1 |
2 |
7 |
8 |
C11b. Talked about things you’re doing in school? |
1 |
2 |
7 |
8 |
C11c. Gone on an outing to a park, zoo, or playground? |
1 |
2 |
7 |
8 |
C11d. Gone shopping? |
1 |
2 |
7 |
8 |
C11e. Played a sport or outdoor game, or went to a sporting event? |
1 |
2 |
7 |
8 |
C11f. Asked your [BASELINE MOTHER] for help with friends? |
1 |
2 |
7 |
8 |
C11g. Talked about your school work or grades? |
1 |
2 |
7 |
8 |
C11h. Talked about someone you're dating or a party you went to? |
1 |
2 |
7 |
8 |
C11i. Asked your [BASELINE MOTHER] for advice or help on education or schooling decisions, training, or job decisions? |
1 |
2 |
7 |
8 |
C11j. Asked your [BASELINE MOTHER] for advice or help on friendships or close personal relationships? |
1 |
2 |
7 |
8 |
C11k. Played a sport, exercised, or went to a sporting event? |
1 |
2 |
7 |
8 |
C11l. Talked about other things you're doing in school? |
1 |
2 |
7 |
8 |
C11m. Asked your [BASELINE MOTHER] for advice or help on friendships or close personal relationships? |
1 |
2 |
7 |
8 |
C11n. Gone to a religious service or event? |
1 |
2 |
7 |
8 |
C11o. Gone to a movie, play, museum, or concert? |
1 |
2 |
7 |
8 |
NOTE: ASK ITEM C12A AND C12B ONLY TO RESPONDENTS 8.5-10 YEARS OLD
ASK ITEMS C12C-12F ONLY TO RESPONDENTS 8.5-13 YEARS OLD
ASK ITEM C12G ONLY TO RESPONDENTS AGES 11-13 YEARS OLD
ASK ITEM C12H-12K ONLY TO AGES 14-17 YEARS OLD
ASK ITEMS C12M ONLY TO AGES 11-17
ASK ITEMS C12N-C12P TO ALL RESPONDENTS
Over the past month, which of the following things have you done with your [BASELINE FATHER]? Have you…. [READ RESPONSE]…WAIT FOR ANSWER.
|
YES |
NO |
REF |
DK |
C12a. Worked on a project for school? |
1 |
2 |
7 |
8 |
C12b. Talked about things you’re doing in school? |
1 |
2 |
7 |
8 |
C12c. Gone on an outing to a park, zoo, or playground? |
1 |
2 |
7 |
8 |
C12d. Gone shopping? |
1 |
2 |
7 |
8 |
C12e. Played a sport or outdoor game, or went to a sporting event? |
1 |
2 |
7 |
8 |
C12f. Asked your [BASELINE FATHER] for help with friends? |
1 |
2 |
7 |
8 |
C12g. Talked about your school work or grades? |
1 |
2 |
7 |
8 |
C12h. Talked about someone you're dating or a party you went to? |
1 |
2 |
7 |
8 |
C12i. Asked your [BASELINE FATHER] for advice or help on education or schooling decisions, training, or job decisions? |
1 |
2 |
7 |
8 |
C12j. Asked your [BASELINE FATHER] for advice or help on friendships or close personal relationships? |
1 |
2 |
7 |
8 |
C12k. Played a sport, exercised, or went to a sporting event? |
1 |
2 |
7 |
8 |
C12l. Talked about other things you're doing in school? |
1 |
2 |
7 |
8 |
C12m. Asked your [BASELINE FATHER] for advice or help on friendships or close personal relationships? |
1 |
2 |
7 |
8 |
C12n. Gone to a religious service or event? |
1 |
2 |
7 |
8 |
C12o. Gone to a movie, play, museum, or concert? |
1 |
2 |
7 |
8 |
C12p. Over the past month, have you visited or gone on an outing with your grandparents, aunts or uncles? |
1 |
2 |
7 |
8 |
The following questions are about how you express feelings in your family. Do the following statements describe you and your family never, sometimes, usually, or always?
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
C13a. I let my [BASELINE MOTHER] know when I am feeling happy |
1 |
2 |
3 |
4 |
7 |
8 |
C13b. When I'm angry about something, I talk with my [BASELINE MOTHER] |
1 |
2 |
3 |
4 |
7 |
8 |
C13c. When I am feeling sad [ADD FOR AGES 11-17:or depressed], I let my [BASELINE MOTHER] know |
1 |
2 |
3 |
4 |
7 |
8 |
C13d. I let my [BASELINE FATHER] know when I am feeling happy |
1 |
2 |
3 |
4 |
7 |
8 |
C13e. When I'm angry about something, I talk with my [BASELINE FATHER] |
1 |
2 |
3 |
4 |
7 |
8 |
C13f. When I am feeling sad [ADD FOR AGES 11-17: or depressed], I let my [BASELINE FATHER] know |
1 |
2 |
3 |
4 |
7 |
8 |
How well can you and your [BASELINE MOTHER] [FOR AGES 14-17 ADD: share ideas or] talk about things that are important to you? Would you say very well, somewhat well, not very well, or not well at all?
Very well q 1
Somewhat well q 2
Not very well q 3
Not well at all q 4
REFUSED q 7
DON’T KNOW q 8
How well can you and your [BASELINE FATHER] [FOR AGES 14-17 ADD: share ideas or] talk about things that are important to you? Would you say very well, somewhat well, not very well, or not well at all?
Very well q 1
Somewhat well q 2
Not very well q 3
Not well at all q 4
REFUSED q 7
DON’T KNOW q 8
NOTE: ITEMS C16B-C16D WILL NOT BE ASKED OF AGES 8.5-10
Thinking about your relationship with your parents, would you strongly agree, agree, disagree, or strongly disagree with the following statements?
|
Strongly Agree |
Agree |
Disagree |
Strongly Disagree |
REF |
DK |
C16a. I don’t get much attention at home |
1 |
2 |
3 |
4 |
7 |
8 |
C16b. My parents respect my feelings |
1 |
2 |
3 |
4 |
7 |
8 |
C16c. My parents trust my judgment |
1 |
2 |
3 |
4 |
7 |
8 |
C16d. My parents understand me |
1 |
2 |
3 |
4 |
7 |
8 |
C16e. I trust my parents |
1 |
2 |
3 |
4 |
7 |
8 |
C16f. My parents really care about me. |
1 |
2 |
3 |
4 |
7 |
8 |
How close do you feel to your [BASELINE MOTHER]? [READ CATEGORIES]
Not at all close q 1
Somewhat close q 2
Quite close q 3
Very close q 4
REFUSED q 7
DON’T KNOW q 8
How close do you feel to your [BASELINE FATHER]? [READ CATEGORIES]
Not at all close q 1
Somewhat close q 2
Quite close q 3
Very close q 4
REFUSED q 7
DON’T KNOW q 8
In your family, do the following things happen never, sometimes, usually, or always?
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
C19a. My [BASELINE MOTHER] and I argue |
1 |
2 |
3 |
4 |
7 |
8 |
C19b. My [BASELINE MOTHER] screams or yells at me |
1 |
2 |
3 |
4 |
7 |
8 |
C19c. I yell at my [BASELINE MOTHER] |
1 |
2 |
3 |
4 |
7 |
8 |
C19d. My [BASELINE MOTHER] loses her temper with me |
1 |
2 |
3 |
4 |
7 |
8 |
In your family, do the following things happen never, sometimes, usually, or always?
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
C20a. My [BASELINE FATHER] and I argue |
1 |
2 |
3 |
4 |
7 |
8 |
C20b. My [BASELINE FATHER] screams or yells at me |
1 |
2 |
3 |
4 |
7 |
8 |
C20c. I yell at my [BASELINE FATHER] |
1 |
2 |
3 |
4 |
7 |
8 |
C20d. My [BASELINE FATHER] loses his temper with me |
1 |
2 |
3 |
4 |
7 |
8 |
[ASK ONLY IF CHILD DOES NOT LIVE WITH BASELINE MOTHER OR BASELINE FATHER] Now, thinking about your (baseline mother/baseline father)—the parent you do not live with:
NOTE: ITEMS IN THIS SECTION SHOULD BE ASKED OF AGES 11-17 ONLY
|
Every day or almost every day |
A few times a week |
A few times this past month |
Never |
REF |
DK |
C18a. In the past month, how often do you talk, email, text, phone, mail, or meet face to face with [BASELINE MOTHER]? |
1 |
2 |
3 |
4 |
7 |
8 |
C18b. In the past month, how often do you talk, email, text, phone, mail, or meet face to face with [BASELINE FATHER]? |
1 |
2 |
3 |
4 |
7 |
8 |
Please describe how your [BASELINE MOTHER] acts toward your [BASELINE FATHER]…
Very friendly 1
Somewhat friendly 2
Somewhat unfriendly 3
Very unfriendly 4
REFUSED 7
DON’T KNOW 8
Please describe how your [BASELINE FATHER] acts toward your [BASELINE MOTHER]…
Very friendly 1
Somewhat friendly 2
Somewhat unfriendly 3
Very unfriendly 4
REFUSED 7
DON’T KNOW 8
The next couple of questions refer to activities you may do each week…
In a typical week, how many days from 0 to 7 do you eat a meal with your family?
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
REFUSED 97
DON’T KNOW 98
A good night’s sleep leaves you feeling rested and alert when you wake up. During the past seven nights, on how many nights did you get a good night’s sleep?
0 1
1 2
2 3
3 4
4 5
5 6
6 7
7 8
REFUSED 97
DON’T KNOW 98
NOTE: SKIP ALL ITEMS RELATED TO SIBLING RELATIONSHIPS, IF CHILD DOES NOT HAVE SIBLINGS.
Next I’d like to ask you some questions about your relationships with your brothers, sisters, and friends. [READ CATEGORIES]
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
E1a. How often do you and your [brothers or sisters] argue with each other? |
1 |
2 |
3 |
4 |
7 |
8 |
E1b. How often do you and your [brothers or sisters] pick on or call each other names? |
1 |
2 |
3 |
4 |
7 |
8 |
E1c. How often do you and your siblings do fun things together? |
1 |
2 |
3 |
4 |
7 |
8 |
E1d. How often do you have friends over to your home? |
1 |
2 |
3 |
4 |
7 |
8 |
E1e. How often do you and your friends argue with each other? |
1 |
2 |
3 |
4 |
7 |
8 |
E1f. How often do you and your friends pick on or call each other names? |
1 |
2 |
3 |
4 |
7 |
8 |
NOTE: ITEMS IN THIS SECTION SHOULD BE ASKED OF AGES 14-17 ONLY
Are you currently seeing or dating someone, or is there someone you think of as a boyfriend/girlfriend?
Yes q 1
No q 2
REFUSED q 97
DON’T KNOW q 98
F1a. IF YES: How old is he/she?
_________YEARS OLD
REFUSED q -1
DON’T KNOW q -2
IF NO: SKIP TO D
F1b. Have your parents met your boyfriend/girlfriend?
Yes q 1
No q 2
REFUSED q 97
DON’T KNOW q 98
Thinking about your relationship with your boyfriend/girlfriend, how often do the following things happen? [READ CATEGORIES]
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
F2a. Small issues suddenly become big arguments |
1 |
2 |
3 |
4 |
7 |
8 |
F2b. My [boyfriend/girlfriend] and I stay mad at one another after an argument. |
1 |
2 |
3 |
4 |
7 |
8 |
F2c. I scream or yell at my [boyfriend/girlfriend] when I am angry. |
1 |
2 |
3 |
4 |
7 |
8 |
F2d. I blame my [boyfriend/girlfriend] for my problems. |
1 |
2 |
3 |
4 |
7 |
8 |
F2e. My [boyfriend/girlfriend] is honest and truthful with me. |
1 |
2 |
3 |
4 |
7 |
8 |
F2f. My [boyfriend/girlfriend] and I are good at working out our differences |
1 |
2 |
3 |
4 |
7 |
8 |
F2g. My [boyfriend/girlfriend] is rude and mean to me when we disagree |
1 |
2 |
3 |
4 |
7 |
8 |
F2h. When I have a serious disagreement with my [boyfriend/girlfriend], we discuss our disagreements respectfully |
1 |
2 |
3 |
4 |
7 |
8 |
F2i. I am able to talk about anything with my [boyfriend/girlfriend] |
1 |
2 |
3 |
4 |
7 |
8 |
Some teenagers have sexual intercourse and some do not. The next questions are about some experiences you may have had. The questions are very personal, just remember that all your answers are kept private.
[SKIP IF ANSWERED YES TO F1] Have you dated anyone in the last year?
Yes q 1
No q 2
REFUSED q 97
DON’T KNOW q 98
In the past year, have you ever had sexual intercourse, that is, made love, had sex, or gone all the way?
Yes q 1
No (SKIP TO SECTION G) q 2
REFUSED q 97
DON’T KNOW q 98
How many PARTNERS have you had sexual intercourse with in the last year?
__________PARTNERS
REFUSED q -1
DON’T KNOW q -2
How well are you currently doing in school?
INTERVIEWER: If respondent is currently not in school, ask her/him to think about the last three months that they were in school.
Very well 1
Well 2
Somewhat well 3
Not well at all 4
Focal child dropped out of school 5
REFUSED 7
DON’T KNOW 7
In the last month that you were in school, how often did you have trouble getting along with a teacher?
Never q 1
Once or twice q 2
Two or more times q 3
REFUSED q 7
DON’T KNOW q 8
NOTE TO REVIEWERS: The survey firm will work with us to determine how the skip patterns will work in this section, but for the purpose of this review note that all questions will be asked about both the baseline mother and the baseline father, regardless of whether or not the child is living with both parents at the time of the survey.
NOTE: QUESTION H1 WILL BE ASKED ABOUT RESIDENTIAL AND NONRESIDENTIAL BASELINE PARENTS AND ONLY IF CHILD HAS WITNESSED BASELINE PARENTS INTERACTING IN THE LAST THREE MONTHS.
Now I would like to read you a list of issues that parents may have disagreements about. For each one, please tell me how often [BASELINE MOTHER and BASELINE FATHER] disagree about it—never, sometimes, usually, or always. [READ ITEM]…Would you say they disagree never, sometimes, usually, or always?
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
H1a. Setting rules for or disciplining you |
1 |
2 |
3 |
4 |
7 |
8 |
H1b. The activities that you participate in |
1 |
2 |
3 |
4 |
7 |
8 |
H1c. How money is spent on you |
1 |
2 |
3 |
4 |
7 |
8 |
H1d. About other things? |
1 |
2 |
3 |
4 |
7 |
8 |
NOTE: ASK ITEMS H2A-H2F TO CHILDREN OF ALL AGES
ASK ITEMS H2G-H2J OF AGES 11-17 ONLY
ASK ITEMS H2K-H2O OF ALL AGES
NOTE: ITEMS H2A-H2D WILL BE ASKED ABOUT RESIDENTIAL AND NONRESIDENTIAL BASELINE PARENTS AND ONLY IF CHILD HAS WITNESSED BASELINE PARENTS INTERACT WITH EACH OTHER IN THE PAST THREE MONTHS.
ITEMS H2E-H2O WILL BE ASKED ONLY OF RESIDENTIAL PARENTS AND ONLY IF CHILD HAS WITNESSED BASELINE PARENTS INTERACT WITH EACH OTHER IN THE PAST THREE MONTHS.
Next, I will read you a few statements about how your parents interact. When I refer to “your parents,” I am talking about [BASELINE MOTHER and BASELINE FATHER]. For each one, please tell me how often they do these things. [READ CATEGORIES]
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
H2a. My parents complain about each other. |
1 |
2 |
3 |
4 |
7 |
8 |
H2b. I see my parents arguing |
1 |
2 |
3 |
4 |
7 |
8 |
H2c. My parents respect each other |
1 |
2 |
3 |
4 |
7 |
8 |
H2d. When my parents disagree, they work it out |
1 |
2 |
3 |
4 |
7 |
8 |
H2e. When my parents have an argument, they say mean things to each other |
1 |
2 |
3 |
4 |
7 |
8 |
H2f. When my parents have a disagreement, they discuss it nicely |
1 |
2 |
3 |
4 |
7 |
8 |
H2g. My parents are often mean to each other even when I'm around |
1 |
2 |
3 |
4 |
7 |
8 |
H2h. My parents have broken or thrown things during an argument |
1 |
2 |
3 |
4 |
7 |
8 |
H2i. My parents act mean after they have had an argument |
1 |
2 |
3 |
4 |
7 |
8 |
H2j. When my parents have an argument, one or both of them stomps away |
1 |
2 |
3 |
4 |
7 |
8 |
H2k. My parents have fun together |
1 |
2 |
3 |
4 |
7 |
8 |
H2l. My parents enjoy being together |
1 |
2 |
3 |
4 |
7 |
8 |
H2m. My parents like each other |
1 |
2 |
3 |
4 |
7 |
8 |
H2n. [SKIP IF BASELINE PARENTS ARE SEPARATED OR DIVORCED] My parents make each other happy |
1 |
2 |
3 |
4 |
7 |
8 |
H2o. My parents work as a team |
1 |
2 |
3 |
4 |
7 |
8 |
How often do your parents behave in the following ways toward each other?
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
H3a. They scream or yell at each other when they are angry. |
1 |
2 |
3 |
4 |
7 |
8 |
H3b. One or both hits or pushes the other. |
1 |
2 |
3 |
4 |
7 |
8 |
NOTE: QUESTION H3 WILL BE ASKED IN REFERENCE TO CONFLICT BETWEEN BASELINE PARENTS
ASK H3A-H3G TO ALL CHILDREN; ASK H3H-H3N TO CHILDREN 11-17 YEARS OLD
In every family there are times when the parents don't get along. When your parents argue or disagree, do the following statements describe your feelings or actions never, sometimes, usually, or always?
When my parents argue… |
Never True |
Sometimes |
Usually |
Always |
REF |
DK |
H4a. I feel sad |
1 |
2 |
3 |
4 |
7 |
8 |
H4b. I feel scared |
1 |
2 |
3 |
4 |
7 |
8 |
H4c. I feel angry |
1 |
2 |
3 |
4 |
7 |
8 |
H4d. I feel unsafe |
1 |
2 |
3 |
4 |
7 |
8 |
H4e. I try to clown around and make them be happy |
1 |
2 |
3 |
4 |
7 |
8 |
H4f. I try to get away from them |
1 |
2 |
3 |
4 |
7 |
8 |
H4g. I try to comfort one or both of them |
1 |
2 |
3 |
4 |
7 |
8 |
H4h. I feel caught in the middle |
1 |
2 |
3 |
4 |
7 |
8 |
H4i. I yell at or say unkind things to people in my family |
1 |
2 |
3 |
4 |
7 |
8 |
H4j. I feel sorry for one or both of my parents |
1 |
2 |
3 |
4 |
7 |
8 |
H4k. I hit, kick, slap, or throw things at people in my family |
1 |
2 |
3 |
4 |
7 |
8 |
H4l. I try to clown around and distract them |
1 |
2 |
3 |
4 |
7 |
8 |
H4m. I worry that one of them will get hurt |
1 |
2 |
3 |
4 |
7 |
8 |
H4n. I worry that they might break up or get divorced |
1 |
2 |
3 |
4 |
7 |
8 |
In the next set of questions, please tell me whether you strongly agree, agree, disagree, or strongly disagree with each statement.
|
Strongly Agree |
Agree |
Disagree |
Strongly Disagree |
REF |
DK |
I1a. I think that marriage education can help a marriage. |
1 |
2 |
3 |
4 |
7 |
8 |
I1b. I think that marriage education can help a family as a whole. |
1 |
2 |
3 |
4 |
7 |
8 |
I1c. Classes that teach teens how to have better dating and couple relationships are a very good idea. |
1 |
2 |
3 |
4 |
7 |
8 |
Would you say your health in general is…
Excellent q 1
Very good q 2
Good q 3
Fair q 4
Poor q 5
REFUSED q 7
DON’T KNOW q 8
NOTE: IF RESPONDENT IS YOUNGER THAN 11 YEARS OLD, SKIP TO K6
During this past year, how many times have you skipped school, cut classes without your parents' permission, or refused to go to school? Was it …
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
Have you been a member of a gang in the past year?
Yes q 1
No q 2
REFUSED q 97
DON’T KNOW q 98
Have you run away in the last year? IF YES: How many times?
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
Have you purposely damaged or destroyed property that did not belong to you in the last year? IF YES: How many times?
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
Have you stolen something from a store, person or house, or that did not belong to you worth 50 dollars or more in the last year? IF YES: How many times?
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
NOTE: ITEMS IN THIS SECTION CAN BE ASKED OF AGES 11-17
During the past year, how many times have you been suspended from school? This includes both in-school and out-of-school suspensions.
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
NOTE: IF RESPONDENT IS YOUNGER THAN 11 YEARS OLD, SKIP TO SECTION L
Everyone has conflicts sometimes. How often have you done these things to deal with conflict with your classmates or friends over the past year? [READ CATEGORIES]
|
Never |
Sometimes |
Usually |
Always |
REF |
DK |
K7a. Getting angry and yelling |
1 |
2 |
3 |
4 |
7 |
8 |
K7b. Staying angry a long time |
1 |
2 |
3 |
4 |
7 |
8 |
K7c. Listening and trying to understand |
1 |
2 |
3 |
4 |
7 |
8 |
K7d. Trying to work out a compromise |
1 |
2 |
3 |
4 |
7 |
8 |
K7e. Getting advice from a parent |
1 |
2 |
3 |
4 |
7 |
8 |
K7f. Getting advice from a teacher or other adult |
1 |
2 |
3 |
4 |
7 |
8 |
NOTE: ITEMS IN THIS SECTION SHOULD BE ASKED OF AGES 14-17 ONLY
In the last month, how many times have you?
K8a. Had alcohol to drink, such as beer or wine or other liquor?
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
IF R ANSWERED “NEVER” TO K8A, SKIP K8B AND MOVE ON TO K8C
K8b. Had 5 or more alcoholic drinks in a row, that is, within a couple of hours
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
K8c. Smoked cigarettes OR used chewing tobacco or snuff
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
K8d. Used any of these: marijuana or hashish, cocaine, or amphetamines
Never q 1
Once or twice q 2
More than two times q 3
REFUSED q 7
DON’T KNOW q 8
File Type | application/msword |
File Title | SHM 30-month youth survey |
Author | Sherylls |
Last Modified By | DHHS |
File Modified | 2009-05-26 |
File Created | 2009-05-26 |