SAMPLE VARIABLES:
CALLTYPE (1= Landline, 2= Cell phone)
Script for answering machines: CATI DISPLAY ON 1st and 4th ATTEMPT:/
experimental group 1
Hello, this is NAME from ICF Macro, an independent research firm. We are conducting a brief survey of the American public about the 2010 Census. Your number was chosen randomly from all numbers in the United States to participate in this important evaluation. We intend to protect your anonymity by not asking for your name, address, or other personal information that could easily identify you. Please call ////////// to participate.
experimental group 2
Hello, this is NAME from ICF Macro, an independent research firm. We are conducting a brief survey of the American public about the 2010 Census. The results of this important evaluation will influence how the next Census is conducted. We intend to protect your anonymity by not asking for your name, address, or other personal information that could easily identify you. Please call ////////// to participate.
Ask of landlines
INTRO1. Hello, this is NAME from ICF Macro, an independent research firm. We are conducting a brief survey of the American public about the 2010 Census.
IF NECESSARY: Your number was chosen randomly from all numbers in the United States to participate in this important evaluation. Your answers are completely anonymous.
IF NECESSARY: The results of this important evaluation will be given to United States policy makers and will influence how the next Census is conducted.
Is this (phone number) ?
IF ASKED: We are conducting this survey for the U.S. Census Bureau. We intend to protect your anonymity by not asking for your name, address, or other personal information that could easily identify you.
01 Correct Number (proceed to next question)
05 SELECTED RESPONDENT ON THE LINE (proceed to next question)
07 Termination Screen
14 CONTINUE IN SPANISH
/ask if intro1 in (01, 05)/
HS1. Is this a private residence?
01 Yes
02 No
/read If HS1 in (02) terminate dispo 22/
X2 Thank you very much, but we are only interviewing private residences
. STOP//TERM//
/ASK IF HS1 in (01)
ADULTS I need to randomly select one adult who lives in your household to be interviewed. How many members of your household, including yourself, are 18 years of age or older?
__ Number of adults [RANGE 0-18]
ask if adults=0/
ADULT0 You are saying there are NO adults 18 or over in your household.
Is that correct?
1 Yes, correct: NO adults 18 or over in household
2 No, incorrect ///RESET TO ADULTS///
/if adult0 in (1)
X3 Thanks very much, but we are only interviewing adults 18 or over//TERM//
/ASK IF ADULTS=1/
ONEADULT Are you the adult?
21 Yes and the respondent is Male
22 Yes and the respondent is Female
03 No
/ASK IF ONEADULT in (03)/
GETADULT May I speak with him or her?
[INTERVIEWER NOTE: Type “suspend” if respondent does not want to continue]
1 Yes, Adult coming to the phone.[GO TO NEWADULT]
2 No, not here (interview will terminate) [INTERVIEWER SET APPOINTMENT FOR BEST TIME TO REACH ADULT]
//IF GETADULT = 1//
NEWADULT
Hello, this is NAME from ICF Macro, an independent research firm. We are conducting a brief survey of the American public about the 2010 Census.
IF NECESSARY: Your number was chosen randomly from all numbers in the United States to participate in this important evaluation. Your answers are completely anonymous.
IF NECESSARY: The results of this important evaluation will be given to United States policy makers and will influence how the next Census is conducted.
IF ASKED: We are conducting this survey for the U.S. Census Bureau. We intend to protect your anonymity by not asking for your name, address, or other personal information that could easily identify you.
001 Person Interested, continue.
104 Selected requested to set appointment for interview at a later time.
173 Selected person unable to complete - language barrier
174 Selected person unable to complete – impairment
175 Selected person refuses – Before Intro
176 Selected person refuses - After Intro
002 Go back to Adults question. WARNING: A NEW RESPONDENT WILL BE SELECTED AND YOU NEED A SUPERVISOR’S PASSWORD TO CONTINUE.
ask if adults=2
randomly select an integer 1 or 2 with a rectangular distribution seloftwo
TWOADLT1. Are you an adult?
IF NECESSARY: I mean are you at least 18 years old?
1 yes
2 no
/ASK IF twoadlt1 in (01)/
GETADLT2 May I speak with one of the adults?
[INTERVIEWER NOTE: Type “suspend” if respondent does not want to continue]
001 Yes, Adult coming to the phone.[GO TO NEWADULT]
ask if twoadlt1=1;
TWOADLT2. The person in your household that I need to speak with is the other adult. May I speak to that person?
1 yes ///RESET TO NEWADULT///
2 no
update programming details for newadult
if oneadult in (03) or twoadlt1=2 and getadult is blank (interviewer typed suspend)/
NOTHERE
INTERVIEWER: This interview will terminate. Please, select a reason:
170 Respondent refuses to transfer to selected person
171 Selected person not available
172 Selected person not available during time period
173 Selected person unable to complete-language barrier
174 Selected person unable to complete-impairment
/ASK IF ADULTS >2/
MEN How many of these adults are men?
0 None
1 One
2 Two
3 Three
4 four
5 Five
6 Six
7 Seven
8 Eight
9 Nine
/ASK IF ADULTS >1/
WOMEN How many of these adults are women?
0 None
1 One
2 Two
3 Three
4 four
5 Five
6 Six
7 Seven
8 Eight
9 Nine
RANDOMLY SELECT ADULT; Assign Selected Value:
01 Oldest Female
02 2nd Oldest Female
03 3rd Oldest Female
04 4th Oldest Female
05 5th Oldest Female
06 6th Oldest Female
07 7th Oldest Female
08 8th Oldest Female
09 9th Oldest Female
11 Oldest Male
12 2nd Oldest Male
13 3rd Oldest Male
14 4th Oldest Male
15 5th Oldest Male
16 6th Oldest Male
17 7th Oldest Male
18 8th Oldest Male
19 9th Oldest Male
20 No respondent selected
21 ="21-ONE PERSON HH - MALE"
22 ="22-ONE PERSON HH - FEMALE"
/ask if total number of men plus women is less than number recorded in adults/
SHOWTOT
I'm sorry, something is not right.
Number of Men - [INSERT NUMBER MEN]
Number of Women - [INSERT NUMBER WOMEN]
------
Number of Adults - [INSERT NUMBER OF ADULTS]
1 Correct the number of men
2 Correct the number of women
3 Correct the number of adults
/ASK IF ADULTS >2/
ASKFOR The person in your household that I need to speak with is the
[INSERT SELECTED]
Are you the person?
01 Yes
02 No ///RESET TO NEWADULT///
Ask of cell phones
CINTRO. Hello, this is NAME from ICF Macro, an independent research firm. We are conducting a brief survey of the American public about the 2010 Census.
IF NECESSARY: Your number was chosen randomly from all numbers in the United States to participate in this important evaluation. Your answers are completely anonymous.
IF NECESSARY: The results of this important evaluation will be given to United States policy makers and will influence how the next Census is conducted.
Is this (phone number) ?
IF ASKED: We are conducting this survey for the U.S. Census Bureau. We intend to protect your anonymity by not asking for your name, address, or other personal information that could easily identify you.
01 Correct Number (proceed to next question)
06 NUMBer is not the same
05 SELECTED RESPONDENT ON THE LINE (proceed to next question)
07 Termination Screen
14 CONTINUE IN SPANISH
Ask of cell phones
S1.Your safety is important. Are you driving in a car, walking down the street, in a public place or other location where talking on the phone might distract you or jeopardize your safety?
1 Yes /Thank and schedule callback/
2 No
97 DK /thank and terminate/
99 Refused /Thank and terminate/
ask of if s1=2
ask of cell phones
Sage. Are you at least 18 years old?
1 Yes
2 No /Thank and terminate/
97 DK /thank and terminate/
99 Refused /Thank and terminate/
ask if NEWADULT=1 or (ASKFOR in (01) or oneadult in (21,22))
Programmer: again, not sure what question codes we should use. Please advise.
CONSENT Great, before we start, I want to tell you a few things about the survey. Your participation in this survey is voluntary, but your responses are important. You can choose not to answer any question and you can end the interview at any time. We intend to protect your anonymity by not asking for your name, address, or other personal information that could easily identify you. We will only ask for your opinions. The survey takes approximately 20 to 25 minutes to complete. You can validate that this survey is a legitimate federally-approved information collection using the U.S. Office of Management and Budget approval number ////, expiring on /////. Federal agencies may not sponsor surveys and respondents are not required to respond without a valid control number.
If you have any questions or comments about this survey you may send them to an address and telephone number I will provide at the conclusion. This call may be recorded or monitored for quality assurance.
[IF RESPONDENT IS NOT AVAILABLE/REFUSES - TYPE SUSPEND]
1 respondent wants to continue survey
2 respondent refuses
ask if consent=1
A1. Have you ever heard of the Census of the United States?
1 Yes
2 No
97 Don’t Know
99 Refused
ask If A1=2,97,99
A3. The Census is the count of all the people who live in the United States. Have you ever heard of that before?
1 Yes
2 No
97 Don’t Know
99 Refused
ask if consent=1/
C3r. In general, how familiar are you with the way Census data impacts you and your community. Would you say…?
4 Very familiar
3 Somewhat familiar
2 Not very familiar
1 Not familiar at all
97 Don’t know
99 Refused
ask if consent=1/
People have different ideas about what the Census is used for. I am going to read some of them to you. As I read each one, please tell me by indicating yes or no whether you think that the Census is used for that purpose. Is the Census used…?
ROTATE LIST
C4ar. To decide how much money communities will get from the government?
C4br. To decide how many representatives each state will have in Congress?
C4cr. To see what changes have taken place in the size, location and characteristics of the people in the United States?
C4dr. To determine property taxes?
C4er. To help the police and FBI keep track of people who break the law?
C4fr. To help businesses and governments plan for the future?
C4gr. To locate people living in the country illegally?
C4hr. To determine state income tax rates?
C4ir. To count both citizens and non–citizens?
C4jr. To determine the rate of unemployment?
1 Yes
2 No
97 Don’t Know
99 Refused
ask if consent=1
D1r. As far as you know, does the law require you to answer the Census questions?
1 Yes, it’s required
2 No, it is not required
97 Don’t know
99 Refused
ask if consent=1
D2r. As far as you know, is the Census Bureau required by law to keep information confidential?
1 Yes, it’s required
2 No, it is not required
97 Don’t know
99 Refused
ask if consent=1
B1r. If the Census were held today, how likely would you be to participate? By participate, we mean fill out and mail in a Census form. Would you say you…?
5 Definitely would
4 Probably would
3 Might or might not
2 Probably would not
1 Definitely would not
97 Don’t know
99 Refused
ask if consent=1/
B5r. Thinking about the Census overall, how important do you feel it is for you to participate in the Census? Would you say it is…?
4 Very important
3 Somewhat important
2 Not too important
1 Not at all important
97 Don’t know
99 Refused
ask if consent=1/
C2r. Overall, how would you describe your general feelings about the Census? Do you feel…?
5 Highly favorable
4 Moderately favorable
3 Neutral
2 Not too favorable
1 Rather unfavorable
97 Don’t know
99 Refused
Ask if consent=1
ZIP. What is your zip code?
IF NECESSARY: To make sure that the survey represents the whole US, we need to collect some information about your location.
IF NECESSARY: This survey is completely anonymous. We only report all the results combined together, not any one person’s answers.
___ record response /range 00000-99996/
9999699997 don’t KNOW
99999 REFUSED
ask if consent=1
Next I’m going to read some opinions that some people may have about the Census. As I read each one please tell me if you strongly agree, agree, disagree, or strongly disagree.
ROTATE LIST
E1ar. The Census is an invasion of privacy.
E1br. It is important for everyone to be counted in the Census.
E1er. Taking part in the Census shows I am proud of who I am.
E1fr. Filling out the Census form will let the government know what my community needs.
E1gr. I just don’t see that it matters much if I personally fill out the Census form or not.
E1hr. It is my civic responsibility to fill out the Census form.
E1ir. The Census Bureau’s promise of confidentiality can be trusted.
E1jr. I am concerned that the information I provide will be misused.
E1lr. The government already has my personal information, like my tax returns, so I don’t need to fill out a Census form.
E1mr. I’ll never see results from the Census in my neighborhood.
E1nr. It takes too long to fill out the Census information, I don’t have time.
BELIEF1. The Census should only ask for the number of people living in the household and nothing else.
BELIEF2. Refusing to fill out the Census is a way for people to show that they don't like what the government is doing.
4 Strongly agree
3 Agree
2 Disagree
1 Strongly disagree
97 Neither agree nor disagree/No opinion
97 DK
99 Refused
benharmexperiment BHEXPER=random integer from (1,2)
ask if consent=1 and BHEXPER benharmexperiment=1
BENHARM. Do you believe that answering and sending back your census form could personally benefit you in any way, personally harm you, or neither benefit nor harm?
1. Neither harm nor benefit
2. Personally harm
3. Personally benefit
4. Both benefit and harm
97 DK
99 refused
ask if consent=1 and BHEXPER benharmexperiment=2
BENEFIT. Do you believe that answering and sending back your census form could harm you?
1 yes
2 no
97 dk
99 ref
ask if consent=1 and BHEXPER benharmexperiment=2
HARM. Do you believe that answering and sending back your census form could benefit you?
1 yes
2 no
97 dk
99 ref
ask if consent=1
Care for the elderly
Daycare for children
Fire and police stations
Hospitals and healthcare
Job training programs
Mental health care
Political representation in Congress
Public transportation
Roads and highways
Schools and the education system
PREMOT Your participation in Census surveys helps determine funding for a number of programs and services. I am going to read you several lists of these services. For each list, please tell me which one is the most important to you and which one is least important.
ask if consent=1
The first list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Daycare for children
2 Political representation in Congress
3 Schools and the education system
97 DK
99 REF
MOT1A. Of those, which is most important to you?
show list again
remove answer from MOT1A
MOT1B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Care for the elderly
2 Daycare for children
3 Public transportation
97 DK
99 REF
MOT2A. Of those, which is most important to you?
show list again
remove answer from MOT2A
MOT2B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Care for the elderly
2 Hospitals and healthcare
3 Job training programs
97 DK
99 REF
MOT3A. Of those, which is most important to you?
show list again
remove answer from MOT3A
MOT3B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Hospitals and healthcare
2 Mental health care
3 Roads and highways
97 DK
99 REF
MOT4A. Of those, which is most important to you?
show list again
remove answer from MOT4A
MOT4B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Care for the elderly
2 Political representation in Congress
3 Roads and highways
97 DK
99 REF
MOT5A. Of those, which is most important to you?
show list again
remove answer from MOT5A
MOT5B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Fire and police stations
2 Hospitals and healthcare
3 Schools and the education system
97 DK
99 REF
MOT6A. Of those, which is most important to you?
show list again
remove answer from MOT6A
MOT6B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Fire and police stations
2 Job training programs
3 Public transportation
97 DK
99 REF
MOT7A. Of those, which is most important to you?
show list again
remove answer from MOT7A
MOT7B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Daycare for children
2 Fire and police stations
3 Roads and highways
97 DK
99 REF
MOT8A. Of those, which is most important to you?
show list again
remove answer from MOT8A
MOT8B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Mental health care
2 Public transportation
3 Schools and the education system
97 DK
99 REF
MOT9A. Of those, which is most important to you?
show list again
remove answer from MOT9A
MOT9B. Which is next most important? [READ LIST IF NECESSARY]
ask if consent=1
The next list is…
IF Necessary: All of these programs and services may be important, but we want to get your view of what is most important to you and least important to you.
1 Job training programs
2 Mental health care
3 Political representation in Congress
97 DK
99 REF
MOT10A. Of those, which is most important to you?
show list again
remove answer from MOT10A
MOT10B. Which is next most important? [READ LIST IF NECESSARY]
Ask if consent=1
CE1. Did you receive a Census form in the mail this year?
1 Yes
2 No
97 Don’t Know
99 Refused
ask if ce1=1
CE2. Did you or someone else in your household fill out and return the form?
1 Yes
2 No
97 Don’t Know
99 Refused
Ask if CE2 = 1
CE3 Did you personally fill out the form or did someone else in your household fill out the form?
1 I filled out the form
2 Someone else filled out the form
3 We worked on it together
97 DK
99 Ref
Ask if CE2 = 1
CE4 Did you personally return the form or did someone else in your household return the form?
1 myself
2 someone else
97 Don’t Know
99 Refused
ask if ce3=1
CE5. When you filled out the form, did you answer all the questions completely?
1 Yes
2 No
97 Don’t Know
99 Refused
ask if consent=1
Programmer: confirm that yes and no were unread in cbams 1
C6r. Are you aware that if you don’t mail back the Census form that a Census Bureau interviewer tries to visit your home to gather the necessary information?
1 Yes
2 No
97 DK
99 Refused
ask if consent=1
CE6. Did a Census interviewer visit your home?
1 Yes
2 No
97 DK
99 Refused
ask if ce6=1
CE7. Did you or someone else from your household complete the Census with the interviewer?
1 Yes
2 No
97 DK
99 Refused
ask if consent=1
CE8 If you had a choice, would you prefer to answer the census by
rotate answer choices
1 Telephone
2 In-person
3 Internet
4 Mail
96 Some other way (volunteered)
97 DK
99 Refused
For each of the next statements, please tell me to what extent you agree that the statement describes you.
rotate questions tog1-PRIV7
TOG1 The government in Washington can be trusted to use my information responsibly
Would you say you
5 Strongly agree
4 Somewhat agree
3 Neither agree nor disagree
2 Somewhat disagree, or
1 Strongly disagree
97 DON’T KNOW
99 REFUSED
TOG2 I trust the government in Washington to keep my best interests in mind
TOG3 When I give information to the government in Washington, I know it will be kept safe
TOG4 The government in Washington should collect information about the population so that it can make the right decisions
TOG5. I trust my state government more than the government in Washington.
TOG6. I trust my city, town, and county government more than the government in Washington.
TOG7. The Census Bureau is more trustworthy than most other parts of the government in Washington.
from jpsm.
Q32b: I don't think public officials care much what people like me think.
Q32c: People's rights to privacy are well protected.
Q32d: People have lost all control over how personal information about them is used.
Q32f: The government knows more about me than it needs to.
PRIV7. Businesses and private industry have too much information about me.
Compliance with Required Paperwork
Different people approach paperwork like bills and forms differently. The next questions are about how you deal with the paperwork you have to do in your life. For these questions, think about how you do things like paying bills, renewing memberships and subscriptions, or completing your pet registration.
For each of the statements below, please tell me to what extent you agree that the statement describes you.
rotate QUESTIONS COMP1 - COMP8
[READ SCALE THE FIRST TIME; AS NECESSARY THEREAFTER]
COMP1. I usually wait to complete paperwork until it is due.
Would you say you
5 Strongly agree
4 Somewhat agree
3 Neither agree nor disagree
2 Somewhat disagree, or
1 Strongly disagree
97 DONT KNOW
99 REFUSED
COMP2. I usually take care of paperwork as soon as I receive it.
COMP3. Completing paperwork on time makes me feel good.
COMP4. I usually start and stop paperwork, rather than completing it in one sitting
COMP5. I usually put paperwork I receive in a stack of things I need to complete at some point.
COMP6. I sometimes miss deadlines for paperwork, especially when it’s not a bill.
COMP7. I try to set aside a special time in the week to take care of paperwork.
COMP8. I prioritize paperwork in terms of when it is due.
COST FRAME
ask all cOST FRAME
AMCost1: The 2010 Census cost over $10 billion. The Census Bureau is looking at saving money next time by getting sex, age, date of birth, and race information from government records for people who don’t mail back their Census forms.
Suppose you didn’t send back your Census form for one reason or another. On a scale from 1 to 5 where 1 is completely negative and 5 is completely positive, how do you feel about the Census saving money by getting your information from other government records?
5 = Completely Positive
4 =
3=
2=
1= Completely negative
97 = DK
99 = REF
ask all cOST FRAME
AMCost2: And on the same scale, how do you feel about the Census spending more by sending an interviewer to your home to ask you for the information?
5 = Completely Positive
4 =
3=
2=
1= Completely negative
97 = DK
99= REF
ask all cOST FRAME
AMCost3: On a scale of 1 to 5 where 1 is completely willing and 5 is completely unwilling, how willing would you be to give your Social Security Number to the Census in order to make it less costly for them to get information from other government agencies?
5 = Completely WILLING
4 =
3=
2=
1= Completely unWILLING
97 = DK
99= REF
ask all cOST FRAME
AMCost4: In order to save money, would you approve or disapprove the Census Bureau getting sex, age, date of birth and race information for your household from [FILL ITEM]?
<randomize order of statements>
A= Your most recent income tax returns.
B= A credit bureau
C= Your employment history
D= Medical records from your doctor
E= Information about your health insurance coverage
F= Information on your government benefits such as unemployment or Social
Security
G= [IF 65 OR OVER]Your Medicare records
1 = Approve
2 = Disapprove
97 = DK
99 = REF
ask all cOST FRAME
AMCost5: Finally, if you had to choose, would you prefer that the Census save money by getting your household’s information from other government records or would you prefer that the Census spend more to send an interviewer to your home to ask you for it?
1= Prefer to get information from records
2= Prefer to get information at home
97= dk
99= ref
BURDEN FRAME
ASK ALL BURDEN FRAME
AMBrd1: Some people think that filling out and mailing back a Census form is too much trouble. The Census Bureau is looking at ways to make the Census easier next time by getting sex, age, date of birth, and race information from government records for people who don’t mail back their Census forms.
Suppose you didn’t send back your Census form for one reason or another. On a scale from 1 to 5 where 1 is completely negative and 5 is completely positive, how do you feel about the Census making things easier by getting your information from other government records?
5 = Completely Positive
4 =
3=
2=
1= Completely negative
97 = DK
99 = REF
ASK ALL BURDEN FRAME
AMBrd2: And on the same scale, how do you feel about the Census sending an interviewer to your home to ask you for the information?
5 = Completely Positive
4 =
3=
2=
1= Completely negative
97 = DK
99 = REF
ASK ALL BURDEN FRAME
AMBrd3: On a scale of 1 to 5 where 1 is completely willing and 5 is completely unwilling, how willing would you be to give your Social Security Number to the Census in order to make it easier for them to get information from other government agencies?
5 = Completely WILLING
4 =
3=
2=
1= Completely unWILLING
97 = DK
99= REF
ASK ALL BURDEN FRAME
AMBrd4: In order to make it easier to do the Census, would you approve or disapprove the Census Bureau getting sex, age, date of birth and race information for your household from [FILL ITEM]?
<randomize order of statements>
A= Your most recent income tax returns.
B= A credit bureau
C= Your employment history
D= Medical records from your doctor
E= Information about your health insurance coverage
F= Information on your government benefits such as unemployment or Social
Security
G= [IF 65 OR OVER] Your Medicare records
1 = Approve
2 = Disapprove
97 = DK
99 = REF
ASK ALL BURDEN FRAME
AMBrd5: Finally, if you had to choose, would you prefer that the Census make things easier by getting your household’s information from other government records or would you prefer that the Census send an interviewer to your home to ask you for it?
1= Prefer to get information from records
2= Prefer to get information at home
97= dk
99= ref
CONTROL FRAME
ASK ALL CONTROL FRAME
AMCtrl1: The
Census Bureau is thinking about getting sex, age, date of birth, and
race information from government records for people who don’t
mail back their Census forms next time.
Suppose
you didn’t send back your Census form for one reason or
another. On a scale from 1 to 5 where 1 is completely negative
and 5 is completely positive, how do you feel about the Census
getting your information from other government records?
5 = Completely Positive
4 =
3=
2=
1= Completely negative
97 = DK
99 = REF
ask all control frame
AMCtrl2: And
on the same scale, how do you feel about the Census sending an
interviewer to your home to ask you for the information?
5 = Completely Positive
4 =
3=
2=
1= Completely negative
97 = DK
99 = REF
ask all control frame
AMCtrl3: On
a scale of 1 to 5 where 1 is completely willing and 5 is completely
unwilling, how willing would you be to give your Social Security
Number to the Census in order to make it easier for them to get
information from other government agencies?
5 = Completely WILLING
4 =
3=
2=
1= Completely unWILLING
97 = DK
99= REF
ask
all control frame
AMCtrl4: In
order to make it easier to do the Census, would you approve or
disapprove the Census Bureau getting sex, age, date of birth and race
information for your household from [FILL ITEM]?
<randomize
order of statements>
A=
Your most recent income tax returns.
B= A credit bureau
C=
Your employment history
D= Medical records from your doctor
E= Information about your health insurance coverage
F=
Information on your government benefits such as unemployment or
Social
Security
G= [IF 65 OR OVER] Your Medicare
records
1 = Approve
2 = Disapprove
97 = DK
99
= REF
AMCtrl5: Finally, if you had to choose, would
you prefer that the Census gets your household’s information
from other government records or would you prefer that the Census
send an interviewer to your home to ask you for it?
1= Prefer to get information from records
2= Prefer to get information at home
97= dk
99= ref
Now I’m going to ask some questions about technology.
ask if cell phone and sage=1
L2. In addition to your cell phone, is there at least one telephone inside your home that is currently working and is not a cell phone? Do not include telephones only used for business or telephones only used for computers or fax machines.
1 Yes
2 No
97 Don’t know
99 Refused
ASK IF L2=1
L2a. How many?
IF NECESSARY: Telephone lines inside your home.
__ Telephones /RANGE=1-6/
97 Don’t know
99 Refused
ask if landline and sage=1
L3. In addition to your residential landline telephone, do you also use one or more cell phone numbers?
1 Yes
2 No
97 Don’t know
99 Refused
ASK IF L3=1
L3a. How many?
IF NECESSARY: Cell phones do you use.
__ Cell phones /RANGE=1-6/
97 Don’t know
99 Refused
ask IF L2=01,99 or L3=01,99
L6. Of all the telephone calls that you receive, are …
01 All or almost all calls received on a cell phone?
02 Some received on a cell phone and some on a regular landline phone?
03 Very few or none received on a cell phone?
87 Don’t have a regular landline phone
88 Don’t have a cell phone
89 Don’t have any phone
97 DK
99 Refused
ask if cell phone or l3=1
INT1. Do you ever use your cell phone to access the internet?
1 Yes
2 No
97 DK
99 Refused
ask if consent=1
INT2. Do you ever use the internet on a laptop or desktop computer?
1 Yes
2 No
97 DK
99 Refused
ask if INT1=1 OR INT2=1
J8r. On an average day, about how many hours do you use the Internet at home, work or somewhere else?
IF NECESSARY: Please include time you use the internet on your phone or on a regular computer.
0 None or less than one [Interviewer: 0 = Respondent does not use Internet or does not have Internet]
1 Hour
2 Hours
3 Hours
4 Hours
5 Hours
6 Hours
7 Hours
8 Hours
9 Hours
10 Hours
11 More than 10 hours
97 Don’t know
99 Refused
ASK F INT1=1 OR INT2=1
On the internet, do you
rotate list
IntSite1. Pay bills, manage bank accounts, or trade stocks
IntSite2. Visit social networking sites such as Facebook, Myspace, or Linkedin
IntSite3. Shop or buy things on sites like amazon or expedia.com.
IntSite4. Create accounts to get personalized information (like review your cell phone bill or read special content at a magazine)
IntSite5. Read news sites or blogs
IntSite6. Post things about yourself like pictures, status, or blog entries.
IntSite7. Prepare and file state or federal income taxes
1 Yes
2 No
97 DK
99 Refused
ASK FOR EACH OF INTSITE1-INTSITE4 FOR WHICH THE ANSWER=1 if int1=1 and int2=1
INTSRC1-INTSRC4 You said that you [pop in from intsite1-intsite4] on the web. To do that, do you use your
1 computer,
2 phone, or
3 both
97 DK
99 ref
The next questions are about you. We use this information to group the survey data in analysis. It helps us ensure that everyone’s opinion is represented.
ask if consent=1
ASKGENDR [ask IF NECESSARY] I’m sorry, I am required to ask, what is your gender?
1 Male
2 Female
97 don’t KNOW
99 REFUSED
ask if consent=1
M1. Including yourself, how many people live in your household?
__ record answer /range 1-20/
97 don’t KNOW
99 REFUSED
ask if m1>1 OR M1 IN (97, 99)
this modification is recommended by the in person team, which notes that the original phrasing will be confusing in multi-family households
M2. Are there children living at home with you who are under 18 and go to school?
1 Yes
2 No
97 Don’t know
99 Refused
ask if m2=1
CIS1: In the past two years, have the children living at home with you brought home any materials about the Census?
1 Yes
2 No
97 Don’t know
99 Refused
ask if m2=1
CIS2: In the past two years, have the children living at home talked about the Census with you?
1. Yes
2. No
97. Don’t know
99. Refused
ask if CIS2=1
CIS3: When you talked with them about the Census, was it about things they had learned about the Census at school?
1. Yes
2. No
97. Don’t know
99. Refused
ask if consent=1
M3. What is your marital status?
1 Now married
2 Widowed
3 Divorced
4 Separated
5 Never married
97 Don’t Know
99 Refused
ask if consent=1
M4. What is the highest grade or year of regular school you completed?
1 Less than grade school
2 Less than high school graduate
3 High school graduate
4 Some college
5 College graduate
6 Postgraduate
97 Don’t Know
99 Refused
ask if consent=1
M5. Are you Hispanic or Latino?
1 Yes
2 No
97 Don’t know
99 Refused
ask if consent=1
multipunch
programmer: please update with variable names from cbams i
M6. Which of these categories best describes your race?
[READ LIST, SELECT ALL THAT APPLY]
1 American Indian or Alaska Native
2 Asian
3 Native Hawaiian or other Pacific Islander
4 Black or African-American
5 White
6 Other
97 Don’t Know
99 Refused
ask if consent=1
M7. What language is spoken most often in this household?
1 English
2 Spanish
3 An Asian or Pacific Islander language such as Chinese, Japanese, Tagalog, or Vietnamese
4 Other
97 Don’t Know
99 Refused
ask if consent=1
M8. Were you born in the United States?
1 Yes
2 No
97 Don’t know
99 Refused
ask if consent=1
M9. Do you rent or own your house or apartment?
1 Rent
2 Own
3 Other
97 DK
99 Refused
ask if consent=1
the before taxes modification comes from the in person team, which notes that this language was used in cbams I
M10a. Is your total household income before taxes less than $50,000?
IF NECESSARY: I am required to ask because we have to make sure that the survey represents people with all levels of income.
IF NECESSARY: Your responses are completely anonymous.
1 yes
2 no
97 DK
99 ref
ask if m10a=1
M10b. Is it less than $25,000?
IF NECESSARY: I am required to ask because we have to make sure that the survey represents people with all levels of income.
IF NECESSARY: Your responses are completely anonymous.
1 yes
2 no
97 DK
99 ref
ask if m10a=2
M10c. Is it more than $75,000?
IF NECESSARY: I am required to ask because we have to make sure that the survey represents people with all levels of income.
IF NECESSARY: Your responses are completely anonymous.
1 yes
2 no
97 DK
99 ref
ask if m10c=1
M10d. Is it more than $100,000?
IF NECESSARY: I am required to ask because we have to make sure that the survey represents people with all levels of income.
IF NECESSARY: Your responses are completely anonymous.
1 yes
2 no
97 DK
99 ref
ask if m10d=1
M10e. Is it more than $150,000?
IF NECESSARY: I am required to ask because we have to make sure that the survey represents people with all levels of income.
IF NECESSARY: Your responses are completely anonymous.
1 yes
2 no
97 DK
99 ref
ask if consent=1
programmer, this is now asked of landline and cell
M11r. What is your age?
__ years old /range 18-90/ [INTERVIEWER: 90 = 90 or more]
97 Don’t know
99 Refused
ask IF M11r=97, 99
M11a. In which of these age categories do you belong?
1 18-24
2 25-34
3 35-44
4 45-54
5 55-64
6 65 or older
97 dk
99 Refused
ask if consent=1
LANG. DO NOT ASK: WAS THIS INTERVIEW CONDUCTED IN
ENGLISH
SPANISH
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Riki Conrey |
| File Modified | 0000-00-00 |
| File Created | 2021-02-01 |