Post Soft Launch Version to OMB, 4/15/2013
Attachment A:
Revised NSCNC Questionnaire
nATIONAL Survey of CHILDREN IN nONPARENTAL CARE (NSCNC)
The following public burden estimate statement will be available as a CATI screen:
According to the Paperwork Reduction Act (PRA) of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 0920-0406. The time required to complete this information collection is estimated to average 30 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments about the accuracy of the time estimate(s) or suggestions for improving this form please write to: CDC Reports Clearance Officer, 1600 Clifton Road, MS-D74, Atlanta, GA 30333; call 404-639-4794; or send an email to omb@cdc.gov.
Data collection conducted under contract to the CDC by NORC at the University of Chicago.
Form approved
OMB No. 0920-0406
Exp. Date 04/30/14
Assurance of Confidentiality. All information which would permit identification of any individual, a practice, or an establishment will be held confidential, will be used for statistical purposes only by NCHS staff, contractors, and agents only when required and with necessary controls, and will not be disclosed or released to other persons without the consent of the individual or the establishment in accordance with section 308(d) of the Public Health Service Act (42 USC 242m) and the Confidential Information Protection and Statistical Efficiency Act (PL-107-347).
nOTE: ALL QUESTIONS HAVE DON’T KNOW (DK) AND REFUSED (RF) AS ANSWER OPTIONS, WHETHER OR NOT THOSE CHOICES ARE SPECIFICALLY INCLUDED IN THIS QUESTIONNAIRE.
NOTE: When filling [interview date] in intro_1 and intro_2, use month and year only
INTRO_1 Hello, my name is _________________. I’m calling on behalf of the CDC's National Center for Health Statistics (IF RECEIVED ADVANCE LETTER (ADVLTR=1), “to follow up on a letter that was sent to your home”/ ELSE NO FILL). In [INTERVIEW DATE], we conducted a telephone survey on children’s health with an adult at this phone number about a [Male/Female] child who would now be about [ESTIMATED AGE] years old. The person we spoke with told us [he was/she was/they were] the child's [RELATION]. We are interested in speaking with this child’s [RELATION] again, or with a parent or guardian who is currently living with the child. Is this person available?
HELP TEXT: COMPLETE THE INTERVIEW WITH THE ORIGINAL NSCH RESPONDENT ONLY IF HE/SHE IS THE CURRENT CAREGIVER OF SC. IF NOT, THEN ONLY ASK THE ORIGINAL RESPONDENT THE LOCATING QUESTIONS AND THE 9 QUESTIONS IN THE NLNPCG SECTION BUT COMPLETE THE FULL INTERVIEW WITH THE CURRENT PARENT/GUARDIAN/CAREGIVER OF SC.
(1) YES, SPEAKING WITH THAT PERSON <IF RDD_NCCELL_CCELL=1 THEN GO TO INTRO3; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(2) YES, NEW PERSON COMES TO PHONE <GO TO INTRO_2>
(3) NO, NOT AVAILABLE NOW <SET GCB AND TERMINATE>
(4) TERMINATE THE INTERVIEW <GO TO T1>
(5) NO, PERSON HAS MOVED OR HAS NEW PHONE NUMBER <IF RDD_NCCELL_CCELL=1 THEN GO TO LOC_A; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(6) DO NOT KNOW THIS PERSON <GO TO UNKNOWN>
(7) NO, PERSON IS DECEASED <GO TO DECEASEDP>
(8) NO, CHILD IS DECEASED <GO TO DECEASED>
(9) CHILD NO LONGER LIVES IN HOUSE WITH R <IF RDD_NCCELL_CCELL=1 THEN GO TO MOVED; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(11) CONFIRM BUSINESS <GO TO SALZ >
(12) ANSWERING MACHINE < IF MESSAGE IS TO BE LEFT THEN GO TO SASERV, ELSE HANG UP AND SET ITS =35>
(15) SUPERVISOR REVIEW (RAISE YOUR HAND TO GET PERMISSION BEFORE USING THIS CODE) <SET ITS =31>
R_TYPE IF INTRO_1=1 OR INTRO_1=2 AND INTRO_2=1 THEN DISPLAY,
INTERVIEWER INSTRUCTION: DID THE RESPONDENT INDICATE HIS/HER RELATIONSHIP TO S.C.? IF NOT, ASK RESPONDENT: Are you the child’s [RELATION]?
(1) YES - CHILD'S [RELATION] (NSCH RESPONDENT)
(2) NO - OTHER PARENT OR GUARDIAN CURRENTLY LIVING WITH S.C.
S_WARM If you are currently driving a car or doing any activity that requires your full attention I need to call you back at a later time.
(1) CONTINUE <IF INTRO_1 = 1 THEN GO TO INTRO_3; ELSE IF INTRO_1 = 5 THEN GO TO LOC_A; ELSE IF INTRO_1=9 THEN GO TO MOVED>
(2) R UNABLE TO CONTINUE <GO TO S_ATTN>
(3) NOT A CELL PHONE <IF INTRO_1 = 1 THEN GO TO INTRO_3; ELSE IF INTRO_1 = 5 THEN GO TO LOC_A; ELSE IF INTRO_1=9 THEN GO TO MOVED>
S_ATTN For your safety, we will call you back at another time.
INTERVIEWER INSTRUCTION: EVEN IF THE RESPONDENT IS USING A HANDS-FREE DEVICE WHILE DRIVING, YOU MUST END THE CALL.
CALL BACK ANOTHER TIME <GO TO CB1>
CALL BACK AT ANOTHER NUMBER REQUESTED <GO TO CB1N_WARNING>
WRONG TIME ZONE FOR CELL PHONE <GO TO CELL_TZ_1>
GO BACK TO S_WARM
UNKNOWN Do you know anyone who would be able to tell us how to get in contact with this child’s current caregiver or guardian?
INTERVIEWER INSTRUCTION: IF INFORMATION IS PROVIDED, ENTER IT IN A DETAILED CALL NOTE.
(1) YES <GO TO UNKNOWN_EXIT>
(2) NO <GO TO UNKNOWN_EXIT>
UNKNOWN_EXIT Thank you for your time. Have a nice day.
TERMINATE AND SET ITS=71
LOC_A What is their new telephone number?
(1) CONTINUE – R CAN PROVIDE A NEW NUMBER
(2) NONE
(77) DON’T KNOW
(99) REFUSED
SKIP TO LOC_F IF NONE/DK/RF.
LOC_AA RECORD NUMBER ___-___-_____
IF NUMBER RECORDED, SET NEWPHONE1_FLAG=1.
LOC_B Is that a landline or cell phone number?
(1) LANDLINE
(2) CELLULAR
(77) DON’T KNOW
(99) REFUSED
LOC_C Does this person have any other number where they might be reached?
(1) YES <GO TO LOC_D>
(2) NO <GO TO LOC_F>
(77) DON’T KNOW <GO TO LOC_F>
(99) REFUSED <GO TO LOC_F>
LOC_D What is that telephone number?
(1) CONTINUE - R CAN PROVIDE A NEW NUMBER
(2) NONE
(77) DON’T KNOW
(99) REFUSED
SKIP TO LOC_F IF NONE/DK/RF.
LOC_DD RECORD NUMBER ___-___-_____
IF NUMBER RECORDED, SET NEWPHONE2_FLAG=1
LOC_E Is that a landline or cellular telephone number?
(1) LANDLINE
(2) CELLULAR
(77) DON’T KNOW
(99) REFUSED
LOC_F What is their name?
(1) CONTINUE - R CAN PROVIDE A NAME
(77) DON’T KNOW [GO TO LOC_TYPE]
(99) REFUSED [GO TO LOC_TYPE]
LOC_FF RECORD VERBATIM RESPONSE __________________
LOC_TYPE IF INTRO_1= 7 OR INTRO_2=7, OR R_TYPE=1, AUTOMATICALLY FILL LOC_TYPE=2 AND SKIP LOC_TYPE.
IF LOC_A IN (2,77,99) AND LOC_F IN (77,99) THEN SKIP TO LOC_G; ELSE, DISPLAY
Is the contact information you are providing for the child's [RELATION] or for a different caregiver or guardian?
CHILD'S [RELATION]
NEW CAREGIVER/ GUARDIAN
(77) DON’T KNOW
(99) REFUSED
LOC_G What is your name?
INTERVIEWER INSTRUCTION: IF R ASKS WHY THEIR NAME IS
NEEDED, INDICATE THAT WE WILL PROBABLY NEED TO EXPLAIN WHO REFERRED US TO THE CHILD’S CURRENT CAREGIVER. IF R IS UNCOMFORTABLE, GET FIRST NAME ONLY.
(1) CONTINUE - R CAN PROVIDE A NAME
(77) DON’T KNOW <GO TO LOC_EXIT>
(99) REFUSED <GO TO LOC_EXIT>
LOC_GG RECORD VERBATIM RESPONSE __________________
LOC_EXIT IF (LOC_A NOT IN (2,77,99) OR LOC_D NOT IN (2,77,99) OR LOC_F NOT IN (2,77,99)) THEN DISPLAY,
Thank you for providing contact information for [S.C.]’s caregiver. We will attempt to contact this person as soon as possible to discuss this important survey.
ELSE, IF (LOC_A IN (2,77,99) AND LOC_F IN (2,77,99)) AND (INTRO_1=9 OR INTRO_2=9 OR ELIG_ = 2, 77, 99) DO NOT DISPLAY AND GO TO NLNPCG
ELSE, IF (LOC_A IN (2,77,99) AND LOC_F IN (2,77,99)) AND (INTRO_1=5 OR INTRO_2=5 ) DO NOT DISPLAY AND GO TO LOC_EXIT2
LOC_EXIT2 Thank you for your time and have a nice day.
IF PHONE NUMBER PROVIDED (i.e., LOC_AA NE MISSING OR LOC_DD NE MISSING), SET ITS=73.
SET CALLING RULES TO IMMEDIATELY DIAL THE NUMBER ENTERED AT LOC_AA; SET RDD_NCCELL_CCELL=(1 OR 2 BASED ON LOC_B); ON NEXT DIAL, IF LOC_TYPE=1 THEN GO TO INTRO_1; ELSE IF LOC_TYPE=2, 77 OR 99 THEN GO TO NEWINTRO_1.
IF NO PHONE NUMBER PROVIDED (i.e., LOC_A IN (2,77,99)), BUT NAME PROVIDED (LOC_FF NE MISSING) , TERMINATE AND SET ITS=71.
NEWINTRO_1 Hello, my name is _________________. I’m calling on behalf of the CDC's National Center for Health Statistics. We are trying to reach a current parent or guardian of [FILL: [CHILD NAME] IF AVAILABLE, “a [male/female] child” IF NAME NOT AVAILABLE] who is now approximately [ESTIMATED AGE] years old. [FILL: [ORIGINAL RESPONDENT NAME] IF AVAILABLE, “[His/Her] previous caregiver” IF NAME NOT AVAILABLE] told us that [FILL: [NEW CAREGIVER NAME] (IF NAME AVAILABLE) OR “this person” IF NAME NOT AVAILABLE] could be reached at this telephone number. Is [FILL: [NEW CAREGIVER NAME] IF NAME AVAILABLE OR “this child’s current parent or guardian” IF NAME NOT AVAILABLE] available?
(1) YES, SPEAKING WITH THAT PERSON <GO TO NEWINTRO_2>
(2) YES, NEW PERSON COMES TO PHONE <REPEAT NEWINTRO_1>
(3) NO, NOT AVAILABLE NOW <SET GCB AND TERMINATE>
(4) HOW DID yOU GET MY NUMBER? <GO TO NEWINTRO_2>
(5) NO, PERSON HAS MOVED OR HAS NEW PHONE NUMBER <IF RDD_NCCELL_CCELL=1 THEN GO TO LOC_A; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(6) DO NOT KNOW THIS PERSON <GO TO UNKNOWN>
(7) NO, PERSON IS DECEASED <GO TO DECEASEDP>
(8) NO, CHILD IS DECEASED <GO TO DECEASED>
(9) CHILD NO LONGER LIVES IN HOUSE WITH R < IF RDD_NCCELL_CCELL=1 THEN GO TO MOVED; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(11) CONFIRM BUSINESS <GO TO SALZ >
(12) ANSWERING MACHINE < IF MESSAGE IS TO BE LEFT THEN GO TO SASERV, ELSE HANG UP AND SET ITS =35>
(15) SUPERVISOR REVIEW (RAISE YOUR HAND TO GET PERMISSION BEFORE USING THIS CODE) <SET ITS =31>
NEWINTRO_2 In [INTERVIEW DATE], we conducted a telephone survey on children’s health with an adult about [FILL CHILD’S NAME, OR: a [Male/Female] child who would now be about [ESTIMATED AGE] years old]. The person we spoke with told us [he was/she was/they were] the child's caregiver. We recently recontacted that person’s household and were told that someone at this telephone number is now providing care for the child. We are interested in speaking with the child’s current caregiver. Is this person available?
(1) YES, SPEAKING WITH THAT PERSON <GO TO NEWINTRO_3>
(2) YES, NEW PERSON COMES TO PHONE <REPEAT NEWINTRO_1>
(3) NO, NOT AVAILABLE NOW <SET GCB AND TERMINATE>
(5) NO, PERSON HAS MOVED OR HAS NEW PHONE NUMBER <IF RDD_NCCELL_CCELL=1 THEN GO TO LOC_A; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(6) DO NOT KNOW THIS PERSON <GO TO UNKNOWN>
(7) NO, PERSON IS DECEASED <GO TO DECEASEDP>
(8) NO, CHILD IS DECEASED <GO TO DECEASED>
(9) CHILD NO LONGER LIVES IN HOUSE WITH R <IF RDD_NCCELL_CCELL=1 THEN GO TO MOVED; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(11) CONFIRM BUSINESS <GO TO SALZ >
(12) ANSWERING MACHINE < IF MESSAGE IS TO BE LEFT THEN GO TO SASERV, ELSE HANG UP AND SET ITS =35>
(15) SUPERVISOR REVIEW (RAISE YOUR HAND TO GET PERMISSION BEFORE USING THIS CODE) <SET ITS =31>
DECEASED I’m sorry to hear that. I do not need to continue. Thank you, and please accept my condolences. Goodbye.
[TERMINATE AND SET ITS=82]
DECEASEDP I’m sorry to hear that, please accept my condolences. Would you be able to tell us how to get in contact with this child’s current caregiver or guardian?
INTERVIEWER INSTRUCTION: IF R ANSWERS “NO” SAY “Thank you for your time. Have a nice day.”
(1) YES <GO TO LOC_A>
(2) NO <TERMINATE AND SET ITS=74>
(3) I AM THAT PERSON <GO TO NEWINTRO_3>
MOVED We are interested in speaking with a parent or guardian of the child who is currently living with the child. Would you be able to tell us how to get in contact with this person?
(1) YES <GO TO LOC_A>
(2) NO <GO TO NLNPCG>
MOVED2 Would you be able to tell us how to get in contact with a parent or guardian of the child who is currently living with the child?
(1) YES <GO TO LOC_A>
(2) NO <GO TO NLNPCG>
INTRO_2 Hello, my name is _________________. I’m calling on behalf of the CDC's National Center for Health Statistics (IF RECEIVED ADVANCE LETTER (ADVLTR=1), “to follow up on a letter that was sent to your home”/ ELSE NO FILL). In [INTERVIEW DATE], we conducted a telephone survey on children’s health with an adult at this phone number about a [Male/Female] child who would now be about [ESTIMATED AGE] years old. The person we spoke with told us [he was/she was/they were] the child’s [RELATION]. We are interested in speaking with this person again, or with a parent or guardian who is currently living with the child. Is this person available?
(1) YES, SPEAKING WITH THAT PERSON <IF RDD_NCCELL_CCELL=1 THEN GO TO INTRO_3; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(2) YES, NEW PERSON COMES TO PHONE <REPEAT INTRO_2>
(3) NO, NOT AVAILABLE NOW <SET GCB AND TERMINATE>
(5) NO, PERSON HAS MOVED OR HAS NEW PHONE NUMBER <IF RDD_NCCELL_CCELL=1 THEN GO TO LOC_A; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(6) DO NOT KNOW THIS PERSON <GO TO UNKNOWN>
(7) NO, PERSON IS DECEASED <GO TO DECEASEDP>
(8) NO, CHILD IS DECEASED <GO TO DECEASED>
(9) CHILD NO LONGER LIVES IN HOUSE WITH R <IF RDD_NCCELL_CCELL=1 THEN GO TO MOVED; IF RDD_NCCELL_CCELL=2, 3 THEN GO TO S_WARM>
(11) CONFIRM BUSINESS <GO TO SALZ >
(12) ANSWERING MACHINE < IF MESSAGE IS TO BE LEFT THEN GO TO SASERV, ELSE HANG UP AND SET ITS =35>
NEWINTRO_3 The CDC’s National Center for Health Statistics is re-contacting caregivers and guardians of children who were living apart from their parents. This survey will help researchers to understand the living situations of these children and the problems they and their caregivers may have receiving needed services. If you qualify for and complete this survey, as a token of appreciation we will send you $[MONEY_1/MONEY_2] for your time.
CONTINUE <GO TO ELIG_>
INTRO_3 Thank you for previously completing the National Survey of Children’s Health. We appreciate your household’s participation in this important survey.
The CDC’s National Center for Health Statistics is re-contacting caregivers and guardians of children who were living apart from their parents. This survey will help researchers to understand the living situations of these children and the problems they and their caregivers may have receiving needed services. If you qualify for and complete this survey, as a token of appreciation we will send you $[MONEY_1/MONEY_2] for your time.
CONTINUE <GO TO ELIG_>
ELIG_ We are interested in speaking with a parent or guardian of the child who is currently living with the child. Does the child live with you now?
(1) YES <GO TO AGE>
(2) NO <GO TO MOVED2>
(77) DON'T KNOW <GO TO MOVED2>
(99) REFUSED <GO TO MOVED2>
AGE When we last spoke, your child was [AGEYR_CHILD]. How old is [he/she] now?
ENTER AGE IN YEARS: _____
ENTER 77 FOR DON’T KNOW AND 99 FOR REFUSED
CURRENT AGE CANNOT BE LESS THAN EST_AGE.
IF AGE LE 17 OR AGE IN (77, 99) GO TO CONSENT; ELSE, GO TO AGE_EXIT
AGE_EXIT We are only interviewing parents or guardians whose child is less than 18 years old. I’d like to thank you on behalf of the CDC's National Center for Health Statistics for the time and effort you’ve spent answering these questions. Have a good day.
TERMINATE AND SET ITS=76
nlnpcg I only have a few additional questions for you.
READ IF NECESSARY: You do not qualify for the full survey today because you are no longer caring for [S.C.]. We would, however, like to ask you a few questions about being a former caregiver of [S.C.].
CONTINUE
CONSENT Before we continue, I'd like you to know that taking part in this research is voluntary. You may choose not to answer any question you don't wish to answer, or end the interview at any time with no impact on the benefits you may receive. We are required by Federal law to develop and follow strict procedures to protect the confidentiality of your information and use your answers only for statistical research. I can describe these laws if you wish. [FILL: IF INTRO1=9 OR INTRO2=9 OR ELIG NE 1, LEAVE BLANK; ELSE FILL: In appreciation for your time, we will send you $[MONEY_1/MONEY_2]. The survey will take about a half hour.] In order to review my work, this call will be recorded and my supervisor may listen as I ask the questions. I'd like to continue now unless you have any questions.
READ IF NECESSARY: If you are receiving government benefits, your participation in this survey will not change whether or not you receive the benefits. If you are not receiving benefits, participation will not change your eligibility for any benefits.
READ IF
NECESSARY: The Public Health Service Act is Title 42 of the
US Code, Section 242k. The collection of information in this survey
is authorized by Section 306 of this Act. Through the National
Center for Health Statistics, the confidentiality of your responses
is assured by Section 308d of this Act and by the Confidential
Information Protection and Statistical Efficiency Act. Would you
like me to read the Confidential Information Protection provisions
to you?
IF RESPONDENT WOULD LIKE TO
HEAR PROVISIONS, READ: The information you provide will be
used for statistical purposes only. In accordance with the
Confidential Information Protection provisions of Title V, Subtitle
A, Public Law 107-347 and other applicable Federal laws, your
responses will be kept confidential and will not be disclosed in
identifiable form to anyone other than NCHS employees or agents. By
law, every employee of the National Center for Health Statistics,
N-O-R-C at the University of Chicago, and their agents and
contractors who works on this survey has taken an oath and is
subject to a jail term of up to 5 years, a fine of up to $250,000,
or both, if he or she willingly discloses ANY identifiable
information about you or your household members.
(1) CONTINUE, RECORDING ACCEPTABLE
(2) CONTINUE, DO NOT RECORD
IF INTRO_1=9 OR INTRO_2=9 OR ELIG NE 1 THEN GO TO NLNPCGSTART, ELSE GO TO H1.
NLNPCGSTART
(THESE 9 QUESTIONS ARE ASKED OF FORMER CAREGIVERS NO LONGER CARING FOR THE CHILD AND THE INTERVIEW THEN TERMINATES)
N_L1 Just before coming to live with you, where did [S.C.] live? [SELECT ONLY ONE]
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [S.C.]’S HOUSEHOLD, RATHER THAN [S.C.] COMING TO LIVE WITH THEM, CODE “RESPONDENT MOVED INTO [S.C.]’S HOUSEHOLD.”
INTERVIEWER INSTRUCTION: IF [S.C.] HAS LIVED WITH RESPONDENT SINCE BIRTH, CODE “[S.C.] HAS LIVED WITH RESPONDENT SINCE BIRTH”
(1) WITH [HIS/HER] BIRTH PARENT(S)
(2) WITH [HIS/HER] ADOPTIVE PARENT(S)
(3) WITH OTHER MEMBERS OF [HIS/HER] BIRTH FAMILY, ANOTHER RELATIVE
(4) WITH ANOTHER FOSTER PARENT
(5) IN A GROUP HOME IN FOSTER CARE SYSTEM, THAT IS, A HOME WITH 4 FOSTER CHILDREN OR MORE
(6) IN A RESIDENTIAL TREATMENT FACILITY, THAT IS, A FACILITY WHERE A NUMBER OF CHILDREN AND YOUTH LIVE
(7) SOMEONE ELSE NOT MENTIONED (SPECIFY) [SKIP TO N_L1_VERBATIM]
(8) RESPONDENT MOVED INTO [S.C.]’S HOUSEHOLD
(9) [S.C.] HAS LIVED WITH RESPONDENT SINCE BIRTH
(77) DON'T KNOW
(99) REFUSED
ALL EXCEPT 7 SKIP TO N_H14
N_L1_VERBATIM RECORD VERBATIM RESPONSE _______________________
N_H14 When did [S.C.] start living with you on a regular basis, without [his/her] parent or parents?
READ IF NECESSARY: Do you know the year?
READ IF NECESSARY: Do you know the month?
RECORD DATE __/__/_____
ENTER 55/55/5555 FOR SINCE BIRTH [SKIP TO N_H16]
ENTER 66/66/6666 TO RECORD LENGTH OF TIME (MONTHS OR YEARS) [SKIP TO N_H14_1]
ENTER 77/77/7777 FOR DON’T KNOW [SKIP TO N_H16]
ENTER 99/99/9999 FOR REFUSED [SKIP TO N_H16]
N_H14_1 RECORD VALUE ____________________
ENTER 77 FOR DON’T KNOW
ENTER 99 FOR REFUSED
N_H14_2 (1) YEARS
(2) MONTHS
IF N_H14_2 = 1 AND N_H14_1 > [AGE*12], OR
IF N_H14_2 = 2 AND N_H14_1 > [AGE],
THEN [DISPLAY WARNING TEXT]
ELSE, [SKIP TO N_H16]
WARNING: ANSWER IS GREATER THAN CURRENT AGE OF CHILD. PLEASE CORRECT.
N_H16 Did anyone from child protective services or a foster care agency help arrange for you to care for [S.C.]?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
N1 How many months ago did [S.C.] stop living with you?
INTERVIEWER INSTRUCTION: IF LESS THAN A MONTH, ENTER ZERO.
RECORD VALUE __________
ENTER 77 FOR DON'T KNOW
ENTER 99 FOR REFUSED
N2 What is the reason [S.C.] is no longer living with you? [MARK ALL THAT APPLY]
CUSTODY
(1) YOU HAD LEGAL CUSTODY AGREEMENT THAT THE CHILD WOULD LIVE ELSEWHERE
(2) YOU VOLUNTARILY GAVE UP CUSTODY
(3) YOU HAD AN INFORMAL AGREEMENT THAT SOMEONE ELSE WOULD TAKE CARE OF THE CHILD
(4) CHILD PROTECTIVE SERVICES, ANOTHER AGENCY, OR THE COURT REMOVED THE CHILD FROM YOUR HOME
CURRENT LIVING ARRANGEMENT
(5) TOO MUCH CONFLICT BETWEEN THE CHILD AND OTHER CHILDREN IN THE HOUSEHOLD
(6) SPOUSE/PARTNER WANTED THE CHILD TO MOVE
(7) COULD NOT HANDLE/MANAGE THE CHILD
(8) CHILD WENT TO LIVE WITH PARENT/REUNIFIED
HEALTH AND SAFETY
(9) YOU HAD HEALTH PROBLEMS
(10) THE CHILD HAD HEALTH PROBLEMS
(11) FELT CHILD WAS UNSAFE IN YOUR NEIGHBORHOOD
(12) FAMILY EMERGENCY
CHILD’S DECISION
(13) THE CHILD CHOSE TO LIVE WITH DIFFERENT CAREGIVERS
(14) CHILD WANTED TO LIVE BY HIM/HERSELF
(15) CHILD WANTED TO LIVE WITH GIRLFRIEND/BOYFRIEND OR ROOMMATES/ FRIENDS
(16) CHILD RAN AWAY
OTHER
(17) CHILD WENT AWAY TO SCHOOL
(18) FINANCIAL PROBLEMS/COULD NOT AFFORD THE COST OF CARING FOR THE CHILD
(19) CHILD WAS PLACED IN JUVENILE DETENTION CENTER/INCARCERATED
(20) OTHER (SPECIFY) [SKIP TO N2_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
N2_VERBATIM RECORD VERBATIM RESPONSE _______________________
N3 With whom did [S.C.] live immediately after leaving your household?
(1) WITH [HIS/HER] BIRTH PARENTS
(2) WITH [HIS/HER] ADOPTIVE PARENTS
(3) WITH OTHER MEMBERS OF [HIS/HER] BIRTH OR ADOPTIVE FAMILY, ANOTHER RELATIVE
(4) WITH A FOSTER PARENT
(5) IN A GROUP HOME IN FOSTER CARE SYSTEM, THAT IS, A HOME WITH 4 FOSTER CHILDREN OR MORE
(6) IN A RESIDENTIAL TREATMENT FACILITY, THAT IS, A FACILITY WHERE A NUMBER OF CHILDREN AND YOUTH LIVE
(7) IN A JUVENILE DETENTION CENTER OR PRISON
(8) ON HIS/HER OWN
(9) WITH GIRLFRIEND/BOYFRIEND, OR WITH ROOMMATES/FRIENDS
(10) SOMEONE ELSE NOT MENTIONED (SPECIFY) [SKIP TO N3_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
N3_VERBATIM RECORD VERBATIM RESPONSE _______________________
N4 Did you agree with the decision to change [SC]’s living arrangement?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
N_P5 When you were caring for [S.C.] and [S.C.] was living with you, why didn’t [he/she] live with [her/his] mother? [MARK ALL THAT APPLY]
(1) MOTHER IN JAIL
(2) MOTHER DETAINED/DEPORTED FOR IMMIGRATION VIOLATIONS
(3) MOTHER WAS NOT A GOOD MOTHER/WAS ABUSIVE/MISTREATED CHILD
(4) CHILD REMOVED BY CHILD PROTECTIVE SERVICES
(5) MOTHER IS SICK
(6) MOTHER TOO BUSY/WORK SCHEDULE TOO DEMANDING
(7) MOTHER HAS PROBLEMS WITH HUSBAND/BOYFRIEND
(8) MOTHER HAS FINANCIAL PROBLEMS/CAN’T AFFORD TO KEEP CHILD
(9) MOTHER HAS DRUG/ALCOHOL PROBLEMS
(10) MOTHER DOESN’T WANT TO CARE FOR CHILD/GAVE CHILD UP
(11) MOTHER THINKS CURRENT CARETAKER CAN DO A BETTER JOB
(12) MOTHER’S NEIGHBORHOOD NOT GOOD FOR RAISING CHILDREN
(13) MOTHER DECEASED
(14) OTHER (SPECIFY) [SKIP TO N_P5_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
N_P5_VERBATIM RECORD VERBATIM RESPONSE _______________________
N_P23 When you were caring for [S.C.] and [S.C.] was living with you, why didn’t [he/she] live with [her/his] father? [MARK ALL THAT APPLY]
(1) FATHER IN JAIL
(2) FATHER DETAINED/DEPORTED FOR IMMIGRATION VIOLATIONS
(3) FATHER WAS NOT A GOOD FATHER/WAS ABUSIVE/MISTREATED CHILD
(4) CHILD REMOVED BY CHILD PROTECTIVE SERVICES
(5) FATHER IS SICK
(6) FATHER TOO BUSY/WORK SCHEDULE TOO DEMANDING
(7) FATHER HAS PROBLEMS WITH WIFE/GIRLFRIEND
(8) FATHER HAS FINANCIAL PROBLEMS/CAN’T AFFORD TO KEEP CHILD
(9) FATHER HAS DRUG/ALCOHOL PROBLEMS
(10) FATHER DOESN’T WANT TO CARE FOR CHILD/GAVE CHILD UP
(11) FATHER THINKS CURRENT CARETAKER CAN DO A BETTER JOB
(12) FATHER’S NEIGHBORHOOD NOT GOOD FOR RAISING CHILDREN
(13) FATHER DECEASED
(14) OTHER (SPECIFY) [SKIP TO N_P23_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
N_P23_VERBATIM RECORD VERBATIM RESPONSE _______________________
NLNPCG END Those are all the questions I have. I’d like to thank you on behalf of the CDC's National Center for Health Statistics for the time and effort you’ve spent answering these questions. If you have any questions about this survey, you may call my supervisor toll-free at 1-877-346-9982. If you have questions about your rights as a survey participant, you may call the chairman of the Research Ethics Review Board at 1-800-223-8118. We would like to send you $10 in appreciation for your time. I will need to collect your name and address information so that we can mail it to you.
[INTERVIEWER INSTRUCTION: COLLECT NAME AND FULL ADDRESS IN FOOTPRINTS BEFORE HITTING ENTER]
Thank you again and have a nice day.
IF NLNPCG MODULE COMPLETE AND NO LOCATING INFORMATION WAS COLLECTED AT LOC_A (2,77,99) AND LOC_D (2,77,99) AND LOC_F IN (2,77,99) OR MOVED/MOVED2 = 2 THEN TERMINATE AND SET ITS=65
IF NLNPCG MODULE COMPLETE AND LOCATING INFORMATION WAS COLLECTED AT LOC_A=1 OR LOC_D=1 OR LOC_F=1 OR MOVED/MOVED2 = 1 THEN TERMINATE AND SET ITS=66
IF ITS=66 THEN SET CALLING RULES TO IMMEDIATELY DIAL THE NUMBER ENTERED AT LOC_AA; SET RDD_NCCELL_CCELL=(1 OR 2 BASED ON LOC_B) AND GO TO NEWINTRO_1.
SET CALLING RULES TO TRY THE NUMBER ENTERED AT LOC_DD IF LOC_AA IS NOT SUCCESSFUL AND GO TO NEWINTRO_1.
IF BREAKOFF OCCURS IN NLNPCG MODULE AND NO LOCATING INFORMATION WAS COLLECTED AT LOC_A (2,77,99) AND LOC_D (2,77,99) AND LOC_F IN (2,77,99) OR MOVED/MOVED2 = 2 THEN TERMINATE AND SET ITS=54. DO NOT SEND CASE FOR LOCATING.
IF BREAKOFF OCCURS IN NLNPCG MODULE AND LOCATING INFORMATION WAS COLLECTED AT LOC_A=1 OR LOC_D=1 OR LOC_F=1 OR MOVED/MOVED2 = 1 THEN TERMINATE AND SET ITS=56. SEND CASE FOR LOCATING.
H1_INTRO I can continue to refer to your child as [your N year old] for the rest of the interview, or if you prefer, you could give me a first name or initials.
(01) CONTINUE TO USE AGE REFERENCE [GO TO H1]
(02) USE NAME [GO TO SC_NAME]
[SKIP TO H1 IF NAME OF S.C. ALREADY GATHERED AT SCNAME OR SELECTION1_NAME_A]
SC_NAME ENTER NAME/INITIALS: ____________ [GO TO H1]
H1
Universe: All
How many adults age 18 or older live in this household?
INTERVIEWER INSTRUCTION: EACH PERSON IN THE HOUSEHOLD MUST BE A CURRENT RESIDENT OF THE HOUSEHOLD. CHILDREN WHO ONLY LIVE PART-TIME IN THE HOUSEHOLD BECAUSE OF CUSTODY ISSUES SHOULD BE INCLUDED IF THEY ARE STAYING THERE WHEN CONTACT WITH THE HOUSEHOLD IS MADE.
A CURRENT RESIDENCE IS DEFINED AS A PLACE WHERE THE PERSON IS STAYING FOR MORE THAN TWO MONTHS AT THE TIME OF THE SURVEY CONTACT. IF A PERSON HAS NO PLACE WHERE HE OR SHE USUALLY STAYS, THE PERSON SHOULD BE CONSIDERED A CURRENT RESIDENT REGARDLESS OF THE LENGTH OF THE CURRENT STAY.
PERSONS AWAY FROM THEIR RESIDENCE FOR TWO MONTHS OR LESS, WHETHER TRAVELING OR IN THE HOSPITAL, ARE CONSIDERED “IN RESIDENCE.” PERSONS AWAY FROM THEIR RESIDENCE FOR MORE THAN TWO MONTHS ARE CONSIDERED “NOT IN RESIDENCE” UNLESS THE PERSON IS AWAY AT SCHOOL (I.E., BOARDING SCHOOL, MILITARY ACADEMY, PREP SCHOOL, ETC.).
RECORD NUMBER OF PEOPLE:_______
RESPONSE MUST BE GREATER THAN 0
ENTER 77 FOR DON'T KNOW
ENTER 99 FOR REFUSED
H2
Universe: All
How many children age 17 or younger live in this household?
INTERVIEWER INSTRUCTION: EACH PERSON IN THE HOUSEHOLD MUST BE A CURRENT RESIDENT OF THE HOUSEHOLD. CHILDREN WHO ONLY LIVE PART-TIME IN THE HOUSEHOLD BECAUSE OF CUSTODY ISSUES SHOULD BE INCLUDED IF THEY ARE STAYING THERE WHEN CONTACT WITH THE HOUSEHOLD IS MADE.
A CURRENT RESIDENCE IS DEFINED AS A PLACE WHERE THE PERSON IS STAYING FOR MORE THAN TWO MONTHS AT THE TIME OF THE SURVEY CONTACT. IF A PERSON HAS NO PLACE WHERE HE OR SHE USUALLY STAYS, THE PERSON SHOULD BE CONSIDERED A CURRENT RESIDENT REGARDLESS OF THE LENGTH OF THE CURRENT STAY.
PERSONS AWAY FROM THEIR RESIDENCE FOR TWO MONTHS OR LESS, WHETHER TRAVELING OR IN THE HOSPITAL, ARE CONSIDERED “IN RESIDENCE.” PERSONS AWAY FROM THEIR RESIDENCE FOR MORE THAN TWO MONTHS ARE CONSIDERED “NOT IN RESIDENCE” UNLESS THE PERSON IS AWAY AT SCHOOL (I.E., BOARDING SCHOOL, MILITARY ACADEMY, PREP SCHOOL, ETC.).
RECORD NUMBER OF PEOPLE:_______
RESPONSE MUST BE GREATER THAN 0
ENTER 77 FOR DON'T KNOW
ENTER 99 FOR REFUSED
H4
Universe: All
IF INTRO_1=1, FILL= “when we last spoke with you.” ELSE FILL “When we last spoke with someone in your household.”
[When we last spoke with you/When we last spoke with someone in your household], [S.C.] did not have any parents living in the household with [him/her]. Does [S.C.] have any parents living in your household now?
READ IF NECESSARY: During the NSCH interview, the respondent reported that [S.C.] did not have a mother or father of any type living in the household with [S.C.].
(1) NO [GO TO H6]
(2) YES, RESPONDENT IS THE CHILD’S PARENT (BIOLOGICAL, STEP, OR ADOPTIVE PARENT WHO ADOPTED THE CHILD BEFORE THE NSCH SURVEY) (3) RESPONDENT IS NOT A BIOLOGICAL OR ADOPTIVE PARENT, BUT A BIOLOGICAL OR ADOPTIVE PARENT LIVES IN THE HOUSEHOLD [GO TO H6]
(4) RESPONDENT IS CAREGIVER WHO ADOPTED THE CHILD SINCE THE NSCH SURVEY [GO TO H6]
(77) DON'T KNOW [GO TO H6]
(99) REFUSED [GO TO H6]
H5
Universe: Respondents who are parents
INTERVIEWER INSTRUCTION: IF NOT OBVIOUS, ASK WHETHER THE PARENT IS THE CHILD’S MOTHER OR FATHER. ELSE, CODE THE APPROPRIATE RESPONSE WITHOUT ASKING.
(1) MOTHER
(2) FATHER
(77) DON'T KNOW
(99) REFUSED
H6
Universe: All
Are you married, widowed, divorced, separated or never married?
(1) MARRIED
(2) WIDOWED [GO TO H8]
(3) DIVORCED [GO TO H8]
(4) SEPARATED [GO TO H8]
(5) NEVER MARRIED [GO TO H8]
(77) DON’T KNOW [GO TO H8]
(99) REFUSED [GO TO H8]
H7
Universe: All married Rs
Does your spouse currently live with you?
(1) YES [GO TO H9]
(2) NO [GO TO H9]
(77) DON'T KNOW [GO TO H9]
(99) REFUSED [GO TO H9]
H8
Universe: Rs who are not married and not currently living with spouse
Are you currently living with a boyfriend, girlfriend, or partner?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
H9_1
Universe: All except parents
IF H4=2, THEN GO TO H13
What is your relationship to [S.C.]? [MARK ALL THAT APPLY]
READ IF NECESSARY: Are you related on the mother’s side of [S.C.’s] family or on the father’s side of the family? If not related, how do you know [S.C.]?
INTERVIEWER INSTRUCTION: IF CARETAKER IS BOTH A RELATIVE AND A FOSTER PARENT, CODE BOTH. IF CARETAKER IS BOTH A FRIEND OF THE FAMILY AND A FOSTER PARENT, CODE BOTH.
INTERVIEWER INSTRUCTION: IF R IS ADOPTIVE PARENT, PROBE FOR ANOTHER PREVIOUS RELATIONSHIP AND CODE BOTH.
(1) MATERNAL GRANDPARENT
(2) PATERNAL GRANDPARENT
(3) GREAT GRANDPARENT
(4) AUNT/UNCLE
(5) SIBLING
(6) OTHER RELATIVE
(7) STEP-PARENT
(8) FOSTER PARENT
(9) FRIEND OF CHILD’S MOTHER OR FATHER
(10) OTHER FAMILY FRIEND, INCLUDING THOSE NOT SURE IF FRIEND OF MOTHER OR FATHER
(11) ADOPTIVE PARENT (MUST CODE ANOTHER)
(12) OTHER (SPECIFY) [SKIP TO H9_1_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
H9_1_VERBATIM RECORD VERBATIM RESPONSE _______________________
H9_2
Universe: All except parents
IF H6=1 OR H8=1 ASK H9_2; ELSE GO TO H10
IF H6=1 THEN ASK: What is your spouse's relationship to [S.C.]? [MARK ALL THAT APPLY]
IF H6 NE 1 AND H8=1 What is your partner's relationship to [S.C.]? [MARK ALL THAT APPLY]
READ IF NECESSARY: Is your [IF H6=1 THEN FILL "spouse"; IF H6 NE 1 AND H8=1 THEN FILL "partner"] related on the mother’s side of [S.C.]’s family or on the father’s side of the family? If not related, how does he/she know [S.C.]?
INTERVIEWER INSTRUCTION: IF CARETAKER IS BOTH A RELATIVE AND A FOSTER PARENT, CODE BOTH. IF CARETAKER IS BOTH A FRIEND OF THE FAMILY AND A FOSTER PARENT, CODE BOTH.
INTERVIEWER INSTRUCTION: IF SPOUSE/PARTNER IS ADOPTIVE PARENT, PROBE FOR ANOTHER PREVIOUS RELATIONSHIP AND CODE BOTH.
(1) MATERNAL GRANDPARENT
(2) PATERNAL GRANDPARENT
(3) GREAT GRANDPARENT
(4) AUNT/UNCLE
(5) SIBLING
(6) OTHER RELATIVE
(7) STEP-PARENT
(8) FOSTER PARENT
(9) FRIEND OF CHILD’S MOTHER OR FATHER
(10) OTHER FAMILY FRIEND, INCLUDING THOSE NOT SURE IF FRIEND OF MOTHER OR FATHER
(11) ADOPTIVE PARENT (MUST CODE ANOTHER)
(12) OTHER (SPECIFY) [SKIP TO H9_2_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
H9_2_VERBATIM RECORD VERBATIM RESPONSE _______________________
H10
Universe: All except parents
IF H4=2 SKIP TO H13
IF H4 NE 2, AND H6=1 THEN ASK: Have you and/or your spouse legally adopted [S.C.]?
IF H4 NE 2, AND H6 NE 1 and H8=1 THEN ASK: Have you and/or your partner legally adopted [S.C.]?
IF H4 NE 2, AND H6 NE 1 and H8 NE 1 THEN ASK: Have you legally adopted [S.C.]?
INTERVIEWER INSTRUCTION: IF RESPONDENT IS PARENT AND ANSWERS HE/SHE IS THE BIOLOGICAL PARENT CODE ‘2’.
(1) YES (R AND/OR SPOUSE/PARTNER IS LEGAL ADOPTIVE PARENT) [GO TO H13]
(2) NO (NEITHER R NOR SPOUSE/PARTNER IS LEGAL ADOPTIVE PARENT)
(77) DON'T KNOW
(99) REFUSED
H11
Universe: All except parents
IF H6=1 THEN ASK: Did you or your spouse know [S.C.] before you began caring for [him/her]?
IF H6 NE 1 and H8=1 THEN ASK: Did you or your partner know [S.C.] before you began caring for [him/her]?
IF H6 NE 1 and H8 NE 1 THEN ASK: Did you know [S.C.] before you began caring for [him/her]?
(1) YES (R OR SPOUSE/PARTNER KNEW CHILD PREVIOUSLY)
(2) NO (NEITHER R NOR SPOUSE/PARTNER KNEW CHILD)
(77) DON'T KNOW
(99) REFUSED
H12
Universe: All except parents
IF H6=1 THEN ASK: Since [S.C.] has been living in your household, have you or your spouse ever been officially a foster parent to [him/her]?
IF H6 NE 1 and H8=1 THEN ASK: Since [S.C.] has been living in your household, have you or your partner ever been officially a foster parent to [him/her]?
IF H6 NE 1 and H8 NE 1 THEN ASK: Since [S.C.] has been living in your household, have you ever been officially a foster parent to [him/her]?
READ IF NECESSARY: IF R ASKS WHAT WE MEAN BY “OFFICALLY A FOSTER PARENT” SAY: Foster parents have to complete an application process called a home study, including a home inspection by the child protective services agency. Often to become a foster parent, you also have to participate and complete training.
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
H13
Universe: All
What is your current housing situation? Please stop me when I read the statement that describes your situation. Do you own your own home, rent your own apartment or house, live with family or friends who rent and you contribute part of the rent, live with family or friends who rent but you do not pay rent, or live in a house or condo owned by another family member? [SELECT ONLY ONE]
(1) OWN YOUR OWN HOME
(2) RENT YOUR OWN APARTMENT OR HOUSE
(3) LIVE WITH FAMILY OR FRIENDS WHO RENT AND YOU CONTRIBUTE PART OF THE RENT
(4) LIVE WITH FAMILY OR FRIENDS WHO RENT BUT YOU DO NOT PAY RENT
(5) LIVE IN A HOUSE OR CONDO OWNED BY ANOTHER FAMILY MEMBER
(6) OTHER
(77) DON'T KNOW
(99) REFUSED
H14
Universe: All
H14_MDY IF RESPONDENT IS A PARENT (H4=2), ASK: Now, I’d like to ask you some questions about [S.C.]. Thinking about the time when you and [S.C.] weren’t living together, when was it that [S.C.] stopped living with you on a regular basis?
ELSE, ASK: Now, I’d like to ask you some questions about [S.C.]. When did [S.C.] start living with you on a regular basis, without [his/her] parent or parents?
READ IF NECESSARY: Do you know the year?
READ IF NECESSARY: Do you know the month?
RECORD DATE __/__/_____
ENTER 55/55/5555 FOR SINCE BIRTH [SKIP TO H16]
ENTER 66/66/6666 TO RECORD LENGTH OF TIME (MONTHS OR YEARS) [SKIP TO H14_1]
ENTER 77/77/7777 FOR DON’T KNOW [SKIP TO H15]
ENTER 99/99/9999 FOR REFUSED [SKIP TO H15]
H14_1 RECORD VALUE ____________________
ENTER 77 FOR DON’T KNOW
ENTER 99 FOR REFUSED
H14_2 (1) YEARS
(2) MONTHS
IF H14_2 = 1 AND H14_1 > [AGE*12], OR
IF H14_2 = 2 AND H14_1 > [AGE],
THEN [DISPLAY WARNING TEXT]
ELSE, [SKIP TO H16]
WARNING: ANSWER IS GREATER THAN CURRENT AGE OF CHILD. PLEASE CORRECT.
H15
Universe: All respondents who don’t know the year and month in H14
IF AGE < 4 THEN ASK: About how long ago do you think it was? Was it a year ago or less, or two or three years ago?
IF AGE >= 4 THEN ASK: About how long ago do you think it was? Was it a year ago or less, or two or three years ago, or four or five years ago?
IF AGE >= 6 THEN ASK: About how long ago do you think it was? Was it a year ago or less, or two or three years ago, or four or five years ago, or six or seven years ago?
IF AGE >= 8 THEN ASK: About how long ago do you think it was? Was it a year ago or less, or two or three years ago, or four or five years ago, or six or seven years ago, or eight or nine years ago?
IF AGE >= 10 THEN ASK: About how long ago do you think it was? Was it a year ago or less, or two or three years ago, or four or five years ago, or six or seven years ago, or eight or nine years ago, or 10 or more years ago?
(0) A YEAR AGO OR LESS
(1) A YEAR AGO
(2) TWO OR THREE YEARS AGO
(3) FOUR OR FIVE YEARS AGO
(4) SIX OR SEVEN YEARS AGO
(5) EIGHT OR NINE YEARS AGO
(6) 10 MORE YEARS AGO
(77) DON'T KNOW
(99) REFUSED
H16
Universe: All except parents
IF H4=2, THEN GO TO H18
Did anyone from child protective services or a foster care agency help arrange for you to care for [S.C.]?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
H17
Universe: All except parents
When the arrangement was made for you to care for [S.C.], did a court or judge make you responsible for the care of [S.C.]?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
H18
Universe: All
To your knowledge, has [S.C.] ever had an open child protective services case?
READ IF NECESSARY: Has a child protective services or social services worker ever visited [S.C.] on a regular basis?
READ IF NECESSARY: Child protective services is the agency designated (in most States) to receive and investigate reports that a child has been abused or neglected. This agency may be part of the larger social services agency. When the agency finds that abuse or neglect has occurred or is at risk of occurring, it will typically open a case and provide intervention and treatment services to the child and family involved.
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
H19
Universe: All except parents
IF H4=2, THEN GO TO N5
As part of the process of [S.C.] coming to live with you, did someone from the child protective services agency visit your home?
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [S.C.]’S HOUSEHOLD, RATHER THAN [S.C.] COMING TO LIVE WITH THEM, READ: Please think about the process of you coming to live with [S.C.].
READ IF NECESSARY: It may have been someone from your state or county’s child welfare agency, department of social services, or department of human resources.
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
H20
Universe: All except parents
GO TO L1_1
As part of the process of [S.C.] coming to live with you, were you required to undergo a local, state, or federal criminal background check?
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [S.C.]’S HOUSEHOLD, RATHER THAN [S.C.] COMING TO LIVE WITH THEM, READ: Please think about the process of you coming to live with [S.C.].
READ IF NECESSARY: Did you have to get fingerprinted?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
N5
Universe: Fathers
IF H5=1, THEN GO TO N6; ELSE IF H5 IN [6,7] THEN GO TO L1
Does [S.C.]'s mother live with you and [S.C.] in this household, or somewhere else?
READ IF NECESSARY: If [S.C.] has had more than one person who has been a legal mother, please consider the individual who was the child’s legal guardian, either biological or adoptive, when we last interviewed someone in your household on [INTERVIEW DATE].
(1) IN THIS HOUSEHOLD [GO TO L1_1]
(2) SOMEWHERE ELSE [GO TO L1_1]
(3) DON’T KNOW WHO MOTHER IS, OR DON’T KNOW ANYTHING ABOUT THE MOTHER [GO TO L1_1]
(4) MOTHER IS DECEASED
(77) DON’T KNOW [GO TO L1_1]
(99) REFUSED [GO TO L1_1]
N6
Universe: Mothers
Does [S.C.]'s father live with you and [S.C.] in this household, or somewhere else?
READ IF NECESSARY: If [S.C.] has had more than one person who has been a legal father, please consider the individual who was the child’s legal guardian, either biological or adoptive, when we last interviewed someone in your household on [INTERVIEW DATE].
(1) IN THIS HOUSEHOLD
(2) SOMEWHERE ELSE
(3) DON’T KNOW WHO FATHER IS, OR DON’T KNOW ANYTHING ABOUT FATHER
(4) FATHER IS DECEASED
(77) DON'T KNOW
(99) REFUSED
L1_1
Universe: All except parents
IF H4=2, THEN GO TO L2
Just before coming to live with you, where did [S.C.] live? [SELECT ONLY ONE]
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [S.C.]’S HOUSEHOLD, RATHER THAN [S.C.] COMING TO LIVE WITH THEM, CODE “RESPONDENT MOVED INTO [S.C.]’S HOUSEHOLD.”
INTERVIEWER INSTRUCTION: IF [S.C.] HAS LIVED WITH RESPONDENT SINCE BIRTH, CODE “[S.C.] HAS LIVED WITH RESPONDENT SINCE BIRTH”
(1) WITH [HIS/HER] BIRTH PARENT(S)
(2) WITH [HIS/HER] ADOPTIVE PARENT(S)
(3) WITH OTHER MEMBERS OF [HIS/HER] BIRTH FAMILY, ANOTHER RELATIVE
(4) WITH ANOTHER FOSTER PARENT
(5) IN A GROUP HOME IN FOSTER CARE SYSTEM, THAT IS, A HOME WITH 4 FOSTER CHILDREN OR MORE
(6) IN A RESIDENTIAL TREATMENT FACILITY, THAT IS, A FACILITY WHERE A NUMBER OF CHILDREN AND YOUTH LIVE
(7) SOMEONE ELSE NOT MENTIONED (SPECIFY) [SKIP TO L1_VERBATIM]
(8) RESPONDENT MOVED INTO [S.C.]’S HOUSEHOLD
(9) [S.C.] HAS LIVED WITH RESPONDENT SINCE BIRTH
(77) DON'T KNOW
(99) REFUSED
L1_VERBATIM RECORD VERBATIM RESPONSE _______________________
L2
Universe: All
How much of the time does [S.C.] live with you? Is it all or most of the time, weekdays only, about half of the time, weekends only, or less than all of these?
(1) ALL OR MOST OF THE TIME
(2) WEEKDAYS ONLY
(3) ABOUT HALF OF THE TIME
(4) WEEKENDS ONLY
(5) LESS THAN OTHER OPTIONS GIVEN
(77) DON'T KNOW
(99) REFUSED
L3
Universe: All except parents
IF H4=2 THEN GO TO L5
Since [S.C.] began living with you, has there been any time lasting a month or more when [S.C.] did not live with you?
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [S.C.]’S HOUSEHOLD, RATHER THAN [S.C.] COMING TO LIVE WITH THEM, READ: “Please think about when you came to live with [S.C.].”
(1) YES
(2) NO [GO TO L5]
(77) DON'T KNOW [GO TO L5]
(99) REFUSED [GO TO L5]
L4
Universe: All except parents; where R has lived apart from [SC] for one month or more since [SC] came to live with them
IF H4=2 THEN GO TO L5
When [S.C.] was not living with you for a month or more, did [he/she] ever spend time living with [his/her] mother, [his/her] father, [his/her] grandparent(s), an aunt or uncle, other relatives, a foster home, a group home, or a residential treatment center or hospital? [MARK ALL THAT APPLY]
(1) [HIS/HER] MOTHER
(2) [HIS/HER] FATHER
(3) [HIS/HER] GRANDPARENT(S)
(4) [HIS/HER] AUNT/UNCLE
(5) OTHER RELATIVES
(6) FOSTER HOME
(7) GROUP HOME
(8) RESIDENTIAL TREATMENT CENTER OR HOSPITAL
(9) OTHER (SPECIFY) [SKIP TO L4_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
L4_VERBATIM RECORD VERBATIM RESPONSE _______________________
L5
Universe: All
IF L5=0, THEN GO TO P1_1
How many biological or adoptive brother or sisters does [S.C.] have?
INTERVIEWER INSTRUCTION: INCLUDE STEP AND HALF BROTHERS AND SISTERS.
ENTER NUMBER OF SIBLINGS: _______________
(66) [S.C.] HAS SIBLING(S), BUT DON’T KNOW HOW MANY
(77) DON’T KNOW IF [S.C.] HAS ANY SIBLINGS [GO TO P1_1]
(99) REFUSED [GO TO P1_1]
L5_CONF Just to confirm, I entered that [S.C.] has [fill response from L5] siblings. Is this correct?
(1) CONFIRMED - CHILD HAS [fill response from L5] SIBLINGS
(2) NOT CORRECT - CHILD DOES NOT HAVE [fill response from L5] SIBLINGS – RETURN TO L5 AND ENTER CORRECT RESPONSE
L6
Universe: [SC] has any siblings
IF L6 > L5 AND L6 NOT = [77, 99] GO TO L6_CONF ELSE SKIP TO L7
How many of these siblings are living with you now?
ENTER NUMBER OF CHILDREN: _______________
(77) DON'T KNOW
(99) REFUSED
L6_CONF Just to confirm, I entered that [fill response from L6] siblings are living with you now. Is this correct?
(1) CONFIRMED - CHILD HAS [fill response from L6] SIBLINGS
(2) NOT CORRECT - CHILD DOES NOT HAVE [fill response from L6] SIBLINGS – RETURN TO L6 AND ENTER CORRECT RESPONSE
L7
Universe: All except parents; where [SC] has non-residential siblings
IF L5=L6 OR H4=2, THEN GO TO P1_1
During the past 12 months, about how often did [S.C.] have contact with [his/her] siblings that don’t live with you , either in person or by talking on the telephone, texting, email, or connecting on Facebook or other social media?
INTERVIEWER INSTRUCTION: READ RESPONSE OPTIONS IF NECESSARY
(1) NOT AT ALL
(2) ONCE OR TWICE A YEAR
(3) SEVERAL TIMES A YEAR
(4) 1-3 TIMES A MONTH
(5) ABOUT ONCE A WEEK
(6) SEVERAL TIMES A WEEK/EVERYDAY
(77) DON'T KNOW
(99) REFUSED
P1_1
Universe: All except parents
IF H4=2 THEN GO TO P4
I'd like to ask you a few questions about [S.C.]’s mother.
IF RESPONDENT HAS ADOPTED CHILD SINCE THE TIME OF THE NSCH INTERVIEW (H10=1), ASK: Is [S.C.]'s previous legal mother currently living?
READ IF NECESSARY: By previous legal mother, we mean [S.C.]’s legal guardian, either biological or adoptive, before you adopted [him/her].
ELSE ASK: Is [S.C.]'s mother currently living?
READ IF NECESSARY: By mother, we mean the child’s most recent legal guardian, either biological or adoptive.
(1) YES
(2) NO
(3) DON’T KNOW WHO MOTHER IS, OR DON’T KNOW ANYTHING ABOUT THE MOTHER [GO TO P5]
(77) DON'T KNOW
(99) REFUSED
P4
Universe: All except Rs who don’t know who mother is or don’t know anything about her
IF R IS CHILD’S PARENT WHO IS MOTHER (H5=1), ASK: What is the highest grade or year of school you completed?
ELSE ASK: What is the highest grade or year of school [S.C.]’s mother completed?
(1) 8th GRADE OR LESS
(2) 9th-12th GRADE NO DIPLOMA
(3) HIGH SCHOOL GRADUATE OR GED COMPLETED
(4) COMPLETED A VOCATIONAL, TRADE, OR BUSINESS SCHOOL PROGRAM
(5) SOME COLLEGE CREDIT BUT NO DEGREE
(6) ASSOCIATE DEGREE (AA, AS)
(7) BACHELOR’S DEGREE (BA, BS, AB)
(8) MASTER’S DEGREE (MA, MS, MSW, MBA)
(9) DOCTORATE (PhD, EdD) or PROFESSIONAL DEGREE (MD, DDS, DVM, JD)
(77) DON'T KNOW
(99) REFUSED
P5
Universe: All except current non-parental caregivers who reported that mother is deceased
IF P1_1=2 THEN GO TO P6_NEW1
IF R IS CHILD’S MOTHER (H5=1), ASK: Why weren’t you living with [S.C.] previously? [MARK ALL THAT APPLY]
ELSE, IF R IS CHILD’S FATHER (H5=2), ASK: Why wasn’t [S.C.] living with [his/her] mother previously? [MARK ALL THAT APPLY]
ELSE, IF MOTHER IS NOT DECEASED (P1_1 = 1,3,77,99) ASK: Why doesn’t [S.C.] live with [his/her] mother now? [MARK ALL THAT APPLY]
(1) MOTHER IN JAIL
(2) MOTHER DETAINED/DEPORTED FOR IMMIGRATION VIOLATIONS
(3) MOTHER WAS NOT A GOOD MOTHER/WAS ABUSIVE/MISTREATED CHILD
(4) CHILD REMOVED BY CHILD PROTECTIVE SERVICES
(5) MOTHER IS SICK OR MENTALLY ILL
(6) MOTHER TOO BUSY/WORK SCHEDULE TOO DEMANDING
(7) MOTHER HAS PROBLEMS WITH HUSBAND/BOYFRIEND
(8) MOTHER HAS FINANCIAL PROBLEMS/CAN’T AFFORD TO KEEP CHILD
(9) MOTHER HAS DRUG/ALCOHOL PROBLEMS
(10) MOTHER DOESN’T WANT TO CARE FOR CHILD/GAVE CHILD UP
(11) MOTHER THINKS CURRENT CARETAKER CAN DO A BETTER JOB
(12) MOTHER’S NEIGHBORHOOD NOT GOOD FOR RAISING CHILDREN
(14) OTHER [SKIP TO P5_VERBATIM]
(15) MOTHER DOES LIVE WITH [S.C.] NOW
(77) DON'T KNOW
(99) REFUSED
P5_VERBATIM RECORD VERBATIM RESPONSE _______________________
P6_NEW1
Universe: All except parents
IF H4=2 THEN GO TO P18
P6_NEW1 Was there a different reason why [S.C.] didn’t live with [his/her] mother originally?
(1) YES - THERE WAS A DIFFERENT REASON [GO TO P6]
(2) NO - THE SAME REASON [GO TO P7]
(77) DON'T KNOW [GO TO P7]
(99) REFUSED [GO TO P7]
P6 Why didn’t [S.C.] live with [his/her] mother originally? [MARK ALL THAT APPLY]
(1) MOTHER IN JAIL
(2) MOTHER DETAINED/DEPORTED FOR IMMIGRATION VIOLATIONS
(3) MOTHER WAS NOT A GOOD MOTHER/WAS ABUSIVE/MISTREATED CHILD
(4) CHILD REMOVED BY CHILD PROTECTIVE SERVICES
(5) MOTHER WAS SICK OR MENTALLY ILL
(6) MOTHER TOO BUSY/WORK SCHEDULE TOO DEMANDING
(7) MOTHER HAS PROBLEMS WITH HUSBAND/BOYFRIEND
(8) MOTHER HAS FINANCIAL PROBLEMS/CAN’T AFFORD TO KEEP CHILD
(9) MOTHER HAS DRUG/ALCOHOL PROBLEMS
(10) MOTHER DOESN’T WANT TO CARE FOR CHILD/GAVE CHILD UP
(11) MOTHER THINKS CURRENT CARETAKER CAN DO A BETTER JOB
(12) MOTHER’S NEIGHBORHOOD NOT GOOD FOR RAISING CHILDREN
(13) MOTHER DECEASED
(15) OTHER (SPECIFY) [SKIP TO P6_ VERBATIM]
(77) DON'T KNOW
(99) REFUSED
P6_ VERBATIM RECORD VERBATIM RESPONSE _______________________
P7
Universe: All except parents, Rs who do not know who mother is or don’t know anything about her, and [S.C.]’s mother is deceased or mother is in jail
IF P5=1 THEN GO TO P8
IF P1 IN [1, 99] AND P5=15 THEN GO TO P11
Is [S.C.]’s mother currently living in a hospital, in an institution or residential treatment facility, or in jail, prison or a detention center, or none of these?
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS 'REHAB' CODE ‘2’.
(1) IN THE HOSPITAL
(2) IN AN INSTITUTION OR RESIDENTIAL TREATMENT FACILITY
(3) IN JAIL, PRISON OR DETENTION CENTER
(4) NONE OF THE ABOVE
(77) DON'T KNOW
(99) REFUSED
P8
Universe: All except parents, Rs who do not know who mother is or don’t know anything about her, and [S.C.]’s mother is deceased
During the past 12 months how often has [S.C.] seen [his/her] mother?
(1) NOT AT ALL
(2) ONCE OR TWICE A YEAR
(3) SEVERAL TIMES A YEAR
(4) 1-3 TIMES A MONTH
(5) ABOUT ONCE A WEEK
(6) SEVERAL TIMES A WEEK
(77) DON'T KNOW
(99) REFUSED
P9
Universe: All except parents, Rs who do not know who mother is or don’t know anything about her, and [S.C.]’s mother is deceased; where [S.C.] is at least 3 years old
During the past 12 months, about how often did [S.C.] have contact with [his/her] mother by talking on the telephone, texting, email, connecting on Facebook or other social media, or by receiving a card, letter or package from [his/her] mother?
(1) NOT AT ALL
(2) ONCE OR TWICE A YEAR
(3) SEVERAL TIMES A YEAR
(4) 1-3 TIMES A MONTH
(5) ABOUT ONCE A WEEK
(6) SEVERAL TIMES A WEEK
(7) DON’T KNOW EXACT FREQUENCY BUT KNOW [S.C.] AND MOTHER CONNECT
(77) DON'T KNOW
(99) REFUSED
P11
Universe: All except parents, Rs who do not know who mother is or don’t know anything about her, and [S.C.]’s mother is deceased
During the past 12 months, has [S.C.]’s mother ever cared for [him/her] during the day or overnight?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
P14
Universe: All except parents, Rs who do not know who mother is or don’t know anything about her, and [S.C.]’s mother is deceased
When there are decisions to make about [S.C.]’s school or day care arrangements, how often do you talk it over with [S.C.]’s mother first? Is it all the time, most of the time, about half the time, sometimes, or never?
(1) ALL THE TIME
(2) MOST OF THE TIME
(3) ABOUT HALF THE TIME
(4) SOMETIMES
(5) NEVER
(77) DON'T KNOW
(99) REFUSED
P15
Universe: All except parents, Rs who do not know who mother is or don’t know anything about her, and [S.C.]’s mother is deceased
When there are decisions to make about [S.C.]’s health or health care, how often do you talk it over with [S.C.]’s mother first? Is it all the time, most of the time, about half the time, sometimes, or never?
(1) ALL THE TIME
(2) MOST OF THE TIME
(3) ABOUT HALF THE TIME
(4) SOMETIMES
(5) NEVER
(77) DON'T KNOW
(99) REFUSED
END MOTHER SERIES
START FATHER SERIES
P18
Universe: All except parents
IF H4=2, THEN GO TO P21
I'd like to ask you a few questions about [S.C.]’s father.
IF RESPONDENT HAS ADOPTED CHILD SINCE THE TIME OF THE NSCH INTERVIEW (H10=1), ASK: Is [S.C.]'s previous legal father currently living?
READ IF NECESSARY: By previous legal father, we mean the child’s most recent legal guardian, either biological or adoptive, before you adopted [him/her].
ELSE ASK: Is [S.C.]'s father currently living?
READ IF NECESSARY: By father, we mean [S.C.]’s most recent legal guardian, either biological or adoptive.
(1) YES
(2) NO
(3) DON’T KNOW WHO FATHER IS, OR DON’T KNOW ANYTHING ABOUT FATHER [GO TO P23]
(77) DON'T KNOW
(99) REFUSED
P21
Universe: All except Rs who don’t know who father is or don’t know anything about him
IF R IS [S.C.]’S PARENT WHO IS FATHER, ASK: What is the highest grade or year of school you completed?
ELSE ASK: What is the highest grade or year of school [S.C.]’s father completed?
(1) 8th GRADE OR LESS
(2) 9th-12th GRADE NO DIPLOMA
(3) HIGH SCHOOL GRADUATE OR GED COMPLETED
(4) COMPLETED A VOCATIONAL, TRADE, OR BUSINESS SCHOOL PROGRAM
(5) SOME COLLEGE CREDIT BUT NO DEGREE
(6) ASSOCIATE DEGREE (AA, AS)
(7) BACHELOR’S DEGREE (BA, BS, AB)
(8) MASTER’S DEGREE (MA, MS, MSW, MBA)
(9) DOCTORATE (PhD, EdD) or PROFESSIONAL DEGREE (MD, DDS, DVM, JD)
(77) DON'T KNOW
(99) REFUSED
P22
Universe: All except fathers and Rs who don’t know who father is or don’t know anything about him
IF H5=2 THEN GO TO P23
IF FATHER IS DECEASED (P18 =1) THEN ASK: Had legal paternity been established? That is, had the father signed a document identifying himself as [S.C.]’s father or had a court or administrative agency, such as the child support agency, established the child’s father as his legal father?
ELSE ASK: Has legal paternity been established? That is, has the father signed a document identifying himself as [S.C.]’s father or has a court or administrative agency, such as the child support agency, established the child’s father as his legal father?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
P23
Universe: All except current non-parental caregivers who reported that father is deceased
IF P18=2 THEN GO TO P24_NEW1
IF R IS CHILD’S FATHER (H5=2), ASK: Why weren’t you living with [S.C.] previously? [MARK ALL THAT APPLY]
ELSE, IF R IS CHILD’S MOTHER (H5=1), ASK: Why wasn’t [S.C.] living with [his/her] father previously? [MARK ALL THAT APPLY]
ELSE, IF FATHER IS NOT DECEASED (P18 = 1,3,77,99) ASK: Why doesn’t [S.C.] live with [his/her] father now? [MARK ALL THAT APPLY]
(1) FATHER IN JAIL
(2) FATHER DETAINED/DEPORTED FOR IMMIGRATION VIOLATIONS
(3) FATHER WAS NOT A GOOD FATHER/WAS ABUSIVE/MISTREATED CHILD
(4) CHILD REMOVED BY CHILD PROTECTIVE SERVICES
(5) FATHER IS SICK OR MENTALLY ILL
(6) FATHER TOO BUSY/WORK SCHEDULE TOO DEMANDING
(7) FATHER HAS PROBLEMS WITH WIFE/GIRLFRIEND
(8) FATHER HAS FINANCIAL PROBLEMS/CAN’T AFFORD TO KEEP CHILD
(9) FATHER HAS DRUG/ALCOHOL PROBLEMS
(10) FATHER DOESN’T WANT TO CARE FOR CHILD/GAVE CHILD UP
(11) FATHER THINKS CURRENT CARETAKER CAN DO A BETTER JOB
(12) FATHER’S NEIGHBORHOOD NOT GOOD FOR RAISING CHILDREN
(14) OTHER (SPECIFY) [SKIP TO P23_VERBATIM]
(15) FATHER DOES LIVE WITH [S.C.] NOW
(77) DON'T KNOW
(99) REFUSED
P23_VERBATIM RECORD VERBATIM RESPONSE _______________________
P24_NEW1
Universe: All except parents
IF H4=2 THEN GO TO C3
P24_NEW1 Was there a different reason why [S.C.] didn’t live with [his/her] father originally?
(1) YES - THERE WAS A DIFFERENT REASON [GO TO P24]
(2) NO - THE SAME REASON [GO TO P25]
(77) DON'T KNOW [GO TO P25]
(99) REFUSED [GO TO P25]
P24 Why didn’t [S.C.] live with [his/her] father originally? [MARK ALL THAT APPLY]
(1) FATHER IN JAIL
(2) FATHER DETAINED/DEPORTED FOR IMMIGRATION VIOLATIONS
(3) FATHER WAS NOT A GOOD FATHER/WAS ABUSIVE/MISTREATED CHILD
(4) CHILD REMOVED BY CHILD PROTECTIVE SERVICES
(5) FATHER WAS SICK OR MENTALLY ILL
(6) FATHER TOO BUSY/WORK SCHEDULE TOO DEMANDING
(7) FATHER HAS PROBLEMS WITH WIFE/GIRLFRIEND
(8) FATHER HAS FINANCIAL PROBLEMS/CAN’T AFFORD TO KEEP CHILD
(9) FATHER HAS DRUG/ALCOHOL PROBLEMS
(10) FATHER DOESN’T WANT TO CARE FOR CHILD/GAVE CHILD UP
(11) FATHER THINKS CURRENT CARETAKER CAN DO A BETTER JOB
(12) FATHER’S NEIGHBORHOOD NOT GOOD FOR RAISING CHILDREN
(13) SAME REASON THAT CHILD DOESN’T LIVE WITH FATHER NOW
(14) OTHER (SPECIFY) [SKIP TO P24_ VERBATIM]
(77) DON'T KNOW
(99) REFUSED
P24_ VERBATIM RECORD VERBATIM RESPONSE _______________________
P25
Universe: All except parents, Rs who do not know who father is or don’t know anything about him, [SC]’s father is deceased, or father is in jail.
IF P18 IN [1, 99] AND P23=15 THEN GO TO P29
IF P23=1 THEN GO TO P26
Is [S.C.]’s father currently living in a hospital, in an institution or residential treatment facility, or in jail, prison or a detention center, none of these?
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS 'REHAB' CODE ‘2’.
(1) IN THE HOSPITAL
(2) IN AN INSTITUTION OR RESIDENTIAL TREATMENT FACILITY
(3) IN JAIL, PRISON OR DETENTION CENTER
(4) NONE OF THE ABOVE
(77) DON'T KNOW
(99) REFUSED
P26
Universe: All except parents, Rs who do not know who father is or don’t know anything about him, and [S.C.]’s father is deceased
During the past 12 months how often has [S.C.] seen [his/her] father?
(1) NOT AT ALL
(2) ONCE OR TWICE A YEAR
(3) SEVERAL TIMES A YEAR
(4) 1-3 TIMES A MONTH
(5) ABOUT ONCE A WEEK
(6) SEVERAL TIMES A WEEK/EVERYDAY
(77) DON'T KNOW
(99) REFUSED
P27
Universe: All except parents, Rs who do not know who father is or don’t know anything about him, and [S.C.]’s father is deceased; where [S.C.] at least 3 years old
During the past 12 months, about how often did [S.C.] have contact with [his/her] father by talking on the telephone, texting, email, connecting on Facebook or other social media, or by receiving a card, letter or package from [his/her] father?
(1) NOT AT ALL
(2) ONCE OR TWICE A YEAR
(3) SEVERAL TIMES A YEAR
(4) 1-3 TIMES A MONTH
(5) ABOUT ONCE A WEEK
(6) SEVERAL TIMES A WEEK/EVERYDAY
(7) DON’T KNOW EXACT FREQUENCY BUT KNOW [S.C.] AND FATHER CONNECT
(77) DON'T KNOW
(99) REFUSED
P29
Universe: All except parents, Rs who do not know who father is or don’t know anything about him, and [S.C.]’s father is deceased
During the past 12 months, has [S.C.]’s father ever cared for [him/her] during the day or overnight?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
P32
Universe: All except parents, Rs who do not know who father is or don’t know anything about him, and [S.C.]’s father is deceased
When there are decisions to make about [S.C.]’s school or day care arrangements, how often do you talk it over with [S.C.]’s father first? Is it all the time, most of the time, about half the time, sometimes, or never?
(1) ALL THE TIME
(2) MOST OF THE TIME
(3) ABOUT HALF THE TIME
(4) SOMETIMES
(5) NEVER
(77) DON'T KNOW
(99) REFUSED
P33
Universe: All except parents, Rs who do not know who father is or don’t know anything about him, and [S.C.]’s father is deceased
When there are decisions to make about [S.C.]’s health or health care, how often do you talk it over with [S.C.]’s father first? Is it all the time, most of the time, about half the time, sometimes, or never?
(1) ALL THE TIME
(2) MOST OF THE TIME
(3) ABOUT HALF THE TIME
(4) SOMETIMES
(5) NEVER
(77) DON'T KNOW
(99) REFUSED
P36
Universe: All except parents, Rs who do not know who parents are or don’t know anything about them, and [S.C.]’s father is deceased
ONLY ASK IF AT LEAST ONE PARENT IS LIVING (IF P1_1=1 OR P18=1)
IF P1_1 NE 1 AND P18=1 THEN ASK: “How well do you get along with [S.C.]'s father? Would you say get along very well, get along somewhat well, don’t get along very well, or don’t get along at all?
IF P1_1=1 AND P18 NE 1 THEN ASK: “How well do you get along with [S.C.]'s mother? Would you say get along very well, get along somewhat well, don’t get along very well, or don’t get along at all?
ELSE IF P1_1 AND P18=1 ASK: How well do you get along with [S.C.]'s parents? Would you say get along very well, get along somewhat well, don’t get along very well, or don’t get along at all?
END FATHER SERIES
F1
Universe: All except parents
Next, I'd like to ask some questions about child support from [S.C.]’s parent or parents. Have child support payments for [S.C.] ever been agreed to informally, agreed to in writing, awarded to you by a court or judge, or do you not have an agreement of any kind? [MARK ALL THAT APPLY]
INTERVIEWER INSTRUCTION: CODE 4 CANNOT BE CODED WITH ANY OTHER.
(1) YES, AGREED TO INFORMALLY
(2) YES, AGREED TO IN WRITING
(3) YES, AWARDED BY A COURT OR JUDGE
(4) NO AGREEMENT [GO TO F3]
(77) DON'T KNOW [GO TO F3]
(99) REFUSED [GO TO F3]
F3
Universe: All except parents; where there is no child support agreement
Have you ever contacted a child support enforcement office, a department of social services, welfare office, or any government agency to find out about child support for [S.C.]?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
F4
Universe: All except parents
In the past 12 months, did you receive any payment for taking care of [S.C.]? Please include foster care or adoption assistance payments, social security survivor benefits, payments from Temporary Assistance for Needy Families (TANF) or welfare, as well as child support payments from a parent.
(1) YES
(2) NO [GO TO F10]
(77) DON'T KNOW [GO TO F10]
(99) REFUSED [GO TO F10]
F5
Universe: All except parents; where any payment is received for caring for [S.C.]
From whom do you receive payments? [MARK ALL THAT APPLY]
(1) CHILD’S MOTHER
(2) CHILD’S FATHER
(3) FOSTER CARE OR ADOPTION PAYMENT/STIPEND
(4) TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) / WELFARE
(5) SOCIAL SECURITY FOR CHILD
(6) UNSPECIFIED GOVERNMENT SOURCE
(7) FRIENDS OR RELATIVES
(8) OTHER (SPECIFY) [SKIP TO F5_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
F5_VERBATIM RECORD VERBATIM RESPONSE _______________________
F10
Universe: All except parents; where R receives child support payments from [S.C.]’s mother and/or father
IF F5 NE [1, 2], THEN GO TO F11
IF F5 = 1 AND 2, THEN ASK: Do [S.C.]’s parents give you a regular amount of money each month or just money once in a while to help out?
IF F5 = 1, THEN ASK: Does [S.C.]’s mother give you a regular amount of money each month or just money once in a while to help out?
IF F5 = 2, THEN ASK: Does [S.C.]’s father give you a regular amount of money each month or just money once in a while to help out?
(1) REGULAR AMOUNT
(2) MONEY ONCE IN A WHILE
(77) DON'T KNOW
(99) REFUSED
F11
Universe: All except parents
Do you receive any non-monetary support from [S.C.]’s parents or your friends or other relatives for taking care of [S.C.]? Non-monetary support may include diapers, formula, food, clothes, or bedding.
READ IF NECESSARY: Relatives could include relatives of the child or your own relatives.
(1) YES
(2) NO [GO TO F6]
(77) DON'T KNOW [GO TO F6]
(99) REFUSED [GO TO F6]
F12
Universe: All except parents; where R receives non-monetary support from [S.C.]’s parents or friends or other relatives
Who do you receive the non-monetary supports from? [MARK ALL THAT APPLY]
(1) CHILD’S MOTHER
(2) CHILD’S FATHER
(3) FRIENDS OR RELATIVES
(4) CHURCH OR OTHER GROUP
(77) DON'T KNOW
(99) REFUSED
F6
Universe: All except parents
IF F5=4, THEN ASK: Did you apply for the TANF or welfare payments for [S.C.]?
IF F5 NE 4, THEN ASK: Have you ever applied for TANF or welfare payments on behalf of [S.C.]?
(1) YES
(2) NO [GO TO F9]
(77) DON'T KNOW [GO TO F9]
(99) REFUSED [GO TO F9]
F7
Universe: All except parents; where R does not receive TANF
IF F5=4, THEN GO TO F9
Why didn’t you receive Temporary Assistance for Needy Families (TANF), that is, welfare payments, for [S.C.]? [MARK ALL THAT APPLY]
INTERVIEWER INSTRUCTION: PROBE "Any other reason?"
HELP TEXT: "NOT ELIGIBLE" CAN BE DUE TO INCOME, RELATIONSHIP TO CHILD, OR OTHER REASONS.
(1) NOT ELIGIBLE
(2) ASSISTANCE NOT AVAILABLE
(3) PUT ON WAITLIST
(4) DISCOURAGED/GAVEUP/ TOO MUCH HASSLE
(5) DECIDED DIDN’T WANT/NEED HELP FROM GOVERNMENT
(6) DIDN’T KNOW ASSISTANCE WAS AVAILABLE
(7) OTHER (SPECIFY) [SKIP TO F7_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
F7_VERBATIM RECORD VERBATIM RESPONSE _______________________
F9
Universe: All except parents; where R received TANF/welfare payments and R did not apply for TANF/welfare payments
IF F5 NE 4, THEN GO TO C1
Was [S.C.] already receiving TANF or welfare benefits before coming to live with you?
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [S.C.]’S HOUSEHOLD, RATHER THAN [S.C.] COMING TO LIVE WITH THEM, READ: Please think about when you came to live with [S.C.].
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
C1
Universe: All except parents
Now I’d like to ask some questions about how prepared you were to care for [S.C.] and any plans you may have for the future.
Overall, how well prepared were you to care for [S.C.] when [he/she] first came to live with you? Would you say you were very well prepared, somewhat prepared, not very well prepared, or not at all prepared?
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [S.C.]’S HOUSEHOLD, RATHER THAN [S.C.] COMING TO LIVE WITH THEM, READ: Please think about when you came to live with [S.C.].
(1) VERY WELL PREPARED
(2) SOMEWHAT PREPARED
(3) NOT VERY WELL PREPARED
(4) NOT AT ALL PREPARED
(77) DON'T KNOW
(99) REFUSED
C2
Universe: All except parents
I am going to ask you about specific services or items you may have needed at the time [S.C.] first came to live with you. I’d like you to tell me how easy or difficult each item or service was to obtain.
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [S.C.]’S HOUSEHOLD, RATHER THAN [S.C.] COMING TO LIVE WITH THEM, READ: Please think about when you came to live with [S.C.].\
CONTINUE
C2A Please tell me how easy or difficult it was to obtain…
Child care for [S.C.]
Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2B Please tell me how easy or difficult it was to obtain…
Clothing for [S.C.]?
Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2C Please tell me how easy or difficult it was to obtain…
A bed or other furniture for [S.C.]
Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2D (READ IF NECESSARY: Please tell me how easy or difficult it was to obtain…)
Legal assistance
READ IF NECESSARY: Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
HELP TEXT: LEGAL ASSISTANCE IS HELP OR ADVICE PROVIDED BY AN ATTORNEY.
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2E (READ IF NECESSARY: Please tell me how easy or difficult it was to obtain…)
Food from a pantry or food bank
READ IF NECESSARY: Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2F (READ IF NECESSARY: Please tell me how easy or difficult it was to find …)
A parent or grandparent support group
READ IF NECESSARY: Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
INTERVIEWER INSTRUCTION: A GRANDPARENT SUPPORT GROUP IS A GROUP OF GRANDPARENTS WHO MEET TOGETHER TO SHARE THEIR EXPERIENCES AND ADVICE ABOUT RAISING THEIR GRANDCHILDREN.
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2G (READ IF NECESSARY: Please tell me how easy or difficult it was to obtain…)
Transportation assistance
READ IF NECESSARY: Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2H (READ IF NECESSARY: Please tell me how easy or difficult it was to obtain…)
Help obtaining public assistance such as food stamps, Medicaid, Social Security, or TANF
READ IF NECESSARY: Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
HELP TEXT: TANF stands for Temporary Assistance for Needy Families.
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2K (READ IF NECESSARY: Please tell me how easy or difficult it was to obtain…)
Information about the school system
READ IF NECESSARY: Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C2L (READ IF NECESSARY: Please tell me how easy or difficult it was to obtain…)
Information about adoption, guardianship, or custody
READ IF NECESSARY: Would you say it was very easy, somewhat easy, somewhat difficult, very difficult, or you never needed it for [S.C.]?
(1) VERY EASY
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NEVER NEEDED FOR [S.C.]
(6) DIDN’T KNOW ABOUT THIS SERVICE OR NEVER TRIED TO GET IT
(77) DON'T KNOW
(99) REFUSED
C5
Universe: All
Do you think that [S.C.] will live with you until [he/she] grows up?
(1) YES [GO TO C8]
(2) NO
(77) DON'T KNOW
(99) REFUSED
C6
Universe: All; where R thinks [S.C.] won’t live with R until [S.C.] grows up or R doesn’t know or refuses to answer if [S.C.] will live with R until [S.C.] grows up
How much longer do you think [S.C.] will stay with you?
READ IF NECESSARY: Your best estimate is fine.
INTERVIEWER INSTRUCTION: CODE ONE OF TWO WAYS: MONTHS OR YEARS
_________ ENTER NUMBER
ENTER 77 FOR DON'T KNOW
ENTER 99 FOR REFUSED
C6_1 CHOOSE MONTHS OR YEARS
(1) GAVE NUMBER OF MONTHS
(2) GAVE NUMBER OF YEARS
C7
Universe: All; where R thinks [S.C.] won’t live with R until [S.C.] grows up or R doesn’t know or refuses to answer if [S.C.] will live with R until [S.C.] grows up
Who do you think [S.C.] will live with after you? [MARK ALL THAT APPLY]
(1) MOTHER
(2) FATHER
(3) MOTHER AND FATHER
(4) OTHER RELATIVE OF CHILD
(5) FRIEND
(6) FOSTER PARENT/FAMILY
(7) ADOPTIVE PARENT/FAMILY
(8) INDEPENDENTLY BY [HIMSELF/HERSELF] OR WITH ROOMMATES OR SPOUSE/PARTNER
(9) OTHER (SPECIFY) [SKIP TO C7_VERBATIM]
(77) DON'T KNOW
(99) REFUSED
C7_VERBATIM RECORD VERBATIM RESPONSE _______________________
C8
Universe: All except parents, and Rs who have adopted [S.C.]
IF H4 = 2 OR H10 = 1, THEN GO TO CC1
Do you have a formal or legal agreement about custody or guardianship for [S.C.]?
READ IF NECESSARY: Custody refers to the legal right to make decisions about children, including where they live. Parents have legal custody of their children unless they voluntarily give custody to someone else or a court takes this right away and gives it to someone else. For instance, a court may give legal custody to a relative or to a child welfare agency.
(1) YES [GO TO C11]
(2) NO
(77) DON'T KNOW
(99) REFUSED
C9
Universe: All except parents, and Rs who have adopted [S.C.]; where R does not have custody/guardianship of [S.C.]
Are you currently trying or planning to seek legal custody of [S.C.] or become [S.C.]’s legal guardian?
READ IF NECESSARY: Legal custody or guardianship means that the parental responsibility and legal authority for [S.C.] have been transferred to you, with the intention that you plan to provide permanent care for [S.C.]. This can be done without terminating the parental rights of the child's parents. If [S.C.] was in foster care, then establishing custody or guardianship would have ended [his/her] involvement in the child welfare system, allowing you to make important decisions on the child's behalf, and establishing you as a long-term caregiver for the child.
(1) YES [GO TO C11]
(2) NO
(77) DON'T KNOW [GO TO C11]
(99) REFUSED [GO TO C11]
C10
Universe: All except parents, and Rs who have adopted [S.C.]; where R is not seeking or not planning to seek custody or guardianship of [S.C.]
What discouraged you from seeking custody or guardianship of [S.C.] or prevented you from making such a plan? [MARK ALL THAT APPLY]
(1) CHILD HAS DISABILITIES/HEALTH PROBLEMS THAT RESPONDENT MAY NOT BE ABLE TO HANDLE IN A LONG-TERM SITUATION
(2) PROBLEMS BETWEEN CHILD AND OTHER FAMILY MEMBERS
(3) PROCESS SEEMED TOO COMPLICATED/DIFFICULT
(4) FINANCIAL CONCERNS
(5) RESPONDENT’S HEALTH OR AGE
(6) CHILD’S PARENTS DISCOURAGED IT
(7) COURT REFUSED TO GRANT CUSTODY/GUARDIANSHIP
(8) ATTORNEY OR SOCIAL WORKER RECOMMENDED AGAINST
(9) CHILD’S AGE/CHILD TOO OLD
(10) CHILD’S BEHAVIOR PROBLEMS OR JUVENILE JUSTICE SYSTEM INVOLVEMENT
(11) NO DISCOURAGING FACTORS
(12) OTHER, SPECIFY [SKIP TO C10_VERBATIM]
(77) DON’T KNOW
(99) REFUSED
C10_VERBATIM RECORD VERBATIM RESPONSE _______________________
C11
Universe: All except parents, and Rs who have adopted [S.C.]
IF H4=3 THEN GO TO CC1
Have you ever considered legally adopting [S.C.] if [he/she] cannot return to [his/her] parents?
READ IF NECESSARY: By adoption, I mean the court process through which a child would become a full and permanent legal member of your family. Although a child could maintain contact with their birth family, the parents’ rights have to be terminated or relinquished for an adoption to be finalized.
(1) YES
(2) NO [GO TO C13]
(77) DON'T KNOW
(99) REFUSED
C12
Universe: All except parents, and Rs who have adopted [S.C.]
Are you currently planning to adopt [S.C.]?
(1) YES [GO TO CC1]
(2) NO
(77) DON'T KNOW
(99) REFUSED
C13
Universe: All except parents; where R has not adopted [S.C.] and is not currently planning to adopt [S.C.]
What discouraged you from wanting to adopt [S.C.] or prevented you from making such a plan? [MARK ALL THAT APPLY]
BIOLOGICAL FAMILY ISSUES:
(1) CHILD STILL EMOTIONALLY ATTACHED TO BIOLOGICAL PARENT(S)
(2) BIOLOGICAL PARENT HAS NOT RELINQUISHED RIGHTS, OR RIGHTS HAVE NOT BEEN TERMINATED BY COURT
(3) CHILD’S PARENTS DISCOURAGED IT
(4) PROBLEMS BETWEEN CHILD AND OTHER MEMBERS OF RESPONDENT’S FAMILY
CHILD ISSUES:
(5) CHILD’S RACE/ETHNICITY DIFFERS FROM RESPONDENT’S FAMILY
(6) CHILD’S AGE/CHILD TOO OLD
HEALTH ISSUES:
(7) CHILD HAS DISABILITIES/HEALTH PROBLEMS THAT RESPONDENT MAY NOT BE ABLE TO HANDLE IN A LONG-TERM SITUATION
(8) RESPONDENT’S HEALTH OR AGE
(9) CHILD’S BEHAVIOR PROBLEMS/JUVENILE JUSTICE SYSTEM INVOLVEMENT
FINANCIAL ISSUES:
(10) FINANCIAL CONCERNS
OTHER:
(11) PROCESS SEEMED TOO COMPLICATED/DIFFICULT
(12) NO DISCOURAGING FACTORS
(13) OTHER, SPECIFY [SKIP TO C13_VERBATIM]
(77) DON’T KNOW
(99) REFUSED
C13_VERBATIM RECORD VERBATIM RESPONSE _______________________
CC1
Universe: All
How would you describe your relationship to [S.C.]? Would you say very warm and close, somewhat warm and close, somewhat distant, or very distant? Please describe your relationship as it exists now.
(1) VERY WARM AND CLOSE
(2) SOMEWHAT WARM AND CLOSE
(3) SOMEWHAT DISTANT
(4) VERY DISTANT
(77) DON’T KNOW
(99) REFUSED
WB2
Universe: All
Now I want to ask about mental health care [S.C.] may have received during the last 12 months. Mental health professionals include psychiatrists, psychologists, psychiatric nurses, and clinical social workers. During the past 12 months, has [S.C.] received any treatment or counseling from a mental health professional?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB3
Universe: All where [S.C.] is age 5 or older
IF AGE <5, THEN GO TO WB8
How easy or difficult was it to enroll [S.C.] in school? Would you say it was very easy, somewhat easy, somewhat difficult, or very difficult?
(1) VERY EASY [GO TO WB5]
(2) SOMEWHAT EASY
(3) SOMEWHAT DIFFICULT
(4) VERY DIFFICULT
(5) NOT EVER HAD TO ENROLL IN SCHOOL [GO TO WB5]
(77) DON’T KNOW
(99) REFUSED
WB4
Universe: All where [S.C.] is age 5 or older and respondent ever enrolled child in school but did not report that doing so was very easy
What difficulties did you face in enrolling [S.C.] in school? [MARK ALL THAT APPLY]
(1) LACK OF TRANSPORTATION
(2) LACK OF IMMUNIZATION AND MEDICAL RECORDS
(3) LACK OF SCHOOL RECORDS
(4) LACK OF GUARDIANSHIP OR CUSTODY OF CHILD
(5) LACK OF PROOF OF CHILD'S RESIDENCY
(6) LACK OF BIRTH CERTIFICATE
(7) SCHOOL FEES
(8) CHILD'S LEARNING OR BEHAVIORAL ISSUES
(9) DID NOT KNOW WHOM TO CALL OR WHERE TO GO TO ENROLL CHILD
(10) SCHOOL CREDIT ACCRUAL/COURSEWORK NOT CONSISTENT IN DIFFERENT SCHOOLS CHILD HAS ATTENDED
(11) OTHER (SPECIFY) [SKIP TO WB4_VERBATIM]
(12) NO DIFFICULTIES
(77) DON’T KNOW
(99) REFUSED
WB4_VERBATIM RECORD VERBATIM RESPONSE _______________________
WB6
Universe: All; where child is age 5 or older and was enrolled in school (or homeschooled) during last school year
How would you describe [S.C.]’s school performance in reading and writing? Would you say that it is excellent, very good, good, fair, or poor?
(1) EXCELLENT
(2) VERY GOOD
(3) GOOD
(4) FAIR
(5) POOR
(6) CHILD NOT ENROLLED IN SCHOOL/HOMESCHOOLED
(77) DON’T KNOW
(99) REFUSED
WB7
Universe: All; where child is age 5 or older and was enrolled in school (or homeschooled) at during last school year
How would you describe [S.C.]’s school performance in math? Would you say that it is excellent, very good, good, fair, or poor?
(1) EXCELLENT
(2) VERY GOOD
(3) GOOD
(4) FAIR
(5) POOR
(6) CHILD NOT ENROLLED IN SCHOOL/HOMESCHOOLED
(77) DON’T KNOW
(99) REFUSED
WB6.2
Universe: All; where child age is 5 or more
How well does [S.C.] speak English?
(1) VERY WELL
(2) WELL
(3) NOT WELL
(4) NOT AT ALL
(77) DON’T KNOW
(99) REFUSED
WB8
Universe: All; where child age is 0 to 12
IF AGE >12, THEN GO TO WB9
We’d like to know how [S.C.] spent [his/her] time when [he/she] was not with you during the last month. I’m going to read a list of different kinds of programs children attend and different kinds of people who care for children. I’d like you to tell me which ones you used for [S.C.], at least once a week during the last month.
INTERVIEWER INSTRUCTION: TYPE OF CHILD CARE USED FOR [S.C.] AT LEAST ONCE A WEEK DURING THE LAST MONTH.
<ENTER>
WB8A [IF AGE > 5, GO TO WB8C]
First, did [S.C.] attend Head Start?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB8B Other than Head Start, what about a nursery school, a preschool, a pre-kindergarten, or a day care center? Please do not include child care or babysitting in someone else’s home.
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB8C [IF AGE < 2 THEN GO TO WB8D]
IF S.C. IS 2 TO 5 YEARS OLD ASK: A program that provided before- or after-school care?
IF S.C. IS 6 TO 12 YEARS OLD ASK: First, did [S.C.] attend a program that provided before- or after-school care?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB8D Did [S.C.] have child care or babysitting in your home by someone other than [you/you or your spouse/partner]?
(1) YES
(2) NO [GO TO WB8H]
(77) DON'T KNOW [GO TO WB8H]
(99) REFUSED [GO TO WB8H]
WB8H What about child care or babysitting in someone else’s home?
(1) YES
(2) NO [GO TO WB9]
(77) DON'T KNOW [GO TO WB9]
(99) REFUSED [GO TO WB9]
WB9
Universe: All except parents; where [S.C.] age 5 or older at time R began caring for [S.C.]
IF [CHILD AGE – (LENGTH OF TIME IN YEARS BETWEEN CURRENT DATE AND DATE WHEN [S.C.] BEGAN LIVING WITH R) < 5 YEARS] OR H4=2, THEN GO TO R1.
Did [S.C.] change schools as a result of coming to live with you?
INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS THEY MOVED INTO [SC]’S HOUSEHOLD, RATHER THAN [SC] COMING TO LIVE WITH THEM, READ: Please think about the time when you came to live with SC.
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB10
Universe: All
Is [S.C.] deaf or does [he/she] have serious difficulty hearing?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB11
Universe: All
Is [S.C.] blind or does [he/she] have serious difficulty seeing, even when wearing glasses?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB12
Universe: All; where child age is 5 or more
Because of a physical, mental or emotional condition, does [S.C.] have serious difficulty concentrating, remembering, or making decisions?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB13
Universe: All; where child age is 5 or more
Does [S.C.] have serious difficulty walking or climbing stairs?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB14
Universe: All; where child age is 5 or more
Does [S.C.] have difficulty dressing or bathing?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
WB15
Universe: All; where child age is 15 or more
Because of a physical, mental or emotional condition, does [S.C.] have difficulty doing errands alone such as visiting a doctor’s office or shopping?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
R1_1
Universe: All
Now I’m going to ask you some questions about your health and supports you may receive.
Would you say that, in general, your health is excellent, very good, good, fair, or poor?
(1) EXCELLENT
(2) VERY GOOD
(3) GOOD
(4) FAIR
(5) POOR
(77) DON’T KNOW
(99) REFUSED
R2_1
Universe: Married or cohabiting Rs
IF H6 NE 1 AND H8 NE 1, THEN GO TO R3_1
Would you say that, in general, your [spouse’s/partner’s] health is excellent, very good, good, fair, or poor?
(1) EXCELLENT
(2) VERY GOOD
(3) GOOD
(4) FAIR
(5) POOR
(77) DON’T KNOW
(99) REFUSED
R3_1
Universe: All
Would you say that, in general, your mental and emotional health is excellent, very good, good, fair, or poor?
(1) EXCELLENT
(2) VERY GOOD
(3) GOOD
(4) FAIR
(5) POOR
(77) DON’T KNOW
(99) REFUSED
R4_1
Universe: Married or cohabiting Rs
IF H6 NE 1 AND H8 NE 1, THEN GO TO R5
Would you say that, in general, your [spouse’s/partner’s] mental and emotional health is excellent, very good, good, fair, or poor?
(1) EXCELLENT
(2) VERY GOOD
(3) GOOD
(4) FAIR
(5) POOR
(77) DON’T KNOW
(99) REFUSED
R5
Universe: All
Do you have a physical health condition that limits the amount or kind of work or activities that you can do in or outside the household?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
R6
Universe: Married or cohabiting Rs
IF H6 NE 1 AND H8 NE 1, THEN GO TO R11
Does your [spouse/partner] have a physical health condition that limits the amount or kind of work or activities that they can do in or outside the household?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
R14_INTRO
Universe: All
Now I will read you a number of statements. Some of the statements describe how a parent or caregiver may feel about parenting, raising children, or their family life more generally. Other statements describe how a parent or caregiver who is receiving services or considering receiving services may feel about his or her situation. For each statement, please tell me whether you strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, or strongly disagree.
R11
Universe: All
I often feel tired, worn out, or exhausted from raising a family.
Would you say you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?
(1) STRONGLY AGREE
(2) SOMEWHAT AGREE
(3) SOMEWHAT DISAGREE
(4) STRONGLY DISAGREE
(77) DON’T KNOW
(99) REFUSED
R14A When problems arise with [S.C.], I handle them pretty well.
Would you say you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?
(1) STRONGLY AGREE
(2) SOMEWHAT AGREE
(3) SOMEWHAT DISAGREE
(4) STRONGLY DISAGREE
(77) DON’T KNOW
(99) REFUSED
R14F When I need help with problems in my family, I am able to ask for help from others.
READ IF NECESSARY: Would you say you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?
(1) STRONGLY AGREE
(2) SOMEWHAT AGREE
(3) SOMEWHAT DISAGREE
(4) STRONGLY DISAGREE
(77) DON’T KNOW
(99) REFUSED
R14I I have a good understanding of [S.C.]’s feelings and problems.
READ IF NECESSARY: Would you say you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?
(1) STRONGLY AGREE
(2) SOMEWHAT AGREE
(3) SOMEWHAT DISAGREE
(4) STRONGLY DISAGREE
(77) DON’T KNOW
(99) REFUSED
R14J I have a good understanding of the services available in my community to help my family.
READ IF NECESSARY: Would you say you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?
(1) STRONGLY AGREE
(2) SOMEWHAT AGREE
(3) SOMEWHAT DISAGREE
(4) STRONGLY DISAGREE
(77) DON’T KNOW
(99) REFUSED
R13NEW_1
Universe: All
Over the past two weeks, how often have you been bothered by any of the following problems?
Little interest or pleasure in doing things
Would you say not at all, several days, more than half the days or nearly every day?
(1) NOT AT ALL
(2) SEVERAL DAYS
(3) MORE THAN HALF THE DAYS
(4) NEARLY EVERY DAY
(77) DON’T KNOW
(99) REFUSED
R13NEW_2
Universe: All
READ IF NECESSARY: Over the past two weeks, how often have you been bothered by any of the following problems?
Feeling down, depressed, or hopeless
Would you say not at all, several days, more than half the days or nearly every day?
(1) NOT AT ALL
(2) SEVERAL DAYS
(3) MORE THAN HALF THE DAYS
(4) NEARLY EVERY DAY
(77) DON’T KNOW
(99) REFUSED
S3_1
Universe: All
Now I have some questions about health insurance and other services and supports. Does [S.C.] have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicaid?
(1) YES [GO TO S5]
(2) NO
(77) DON’T KNOW [GO TO S5]
(99) REFUSED [GO TO S5]
S4
Universe: All; where R indicates [S.C.] has no health coverage
Just to confirm, I entered that [S.C.] is not covered by any type of health insurance. Is this correct?
(1) CONFIRMED - CHILD IS NOT COVERED BY ANY TYPE OF HEALTH INSURANCE [GO TO S7]
(2) NOT CORRECT - CHILD HAS INSURANCE - RETURN TO S3 AND ENTER CORRECT RESPONSE
(77) DON' KNOW [GO TO S5]
S5
Universe: All; where R indicates [S.C.] has health coverage or R doesn’t know/refuses to answer whether [S.C.] has health coverage
IF S3_1 = 1 THEN FILL “Is that coverage” ELSE, fill “Is [he/she] insured by.”
[Is that coverage/Is [he/she] insured by] Medicaid or the Children’s Health Insurance Program, CHIP? In [FILL NAME OF STATE FROM NSCH PRELOAD], the program is sometimes called [FILL MEDICAID NAME, CHIP NAME].
READ IF NECESSARY: CHIP, also known as S-CHIP, is a type of state-sponsored health insurance coverage that a child may have. The name of the plan varies from state-to-state.
(1) YES [GO TO S6]
(2) NO [GO TO S6]
(3) R DOESN’T LIVE IN THE STATE MENTIONED IN THE QUESTION
(77) DON'T KNOW [GO TO S6]
(99) REFUSED [GO TO S6]
S6
Universe: All; where R indicates that [S.C.] has health coverage
IF S3_1 NE 1, THEN GO TO S7
During the past 12 months, was there any time when [S.C.] was not covered by ANY health insurance?
(1) YES [GO TO S8]
(2) NO [GO TO S1_1]
(77) DON'T KNOW [GO TO S1_1]
(99) REFUSED [GO TO S1_1]
S7
Universe: All; where R indicates that [S.C.] does not have health coverage
IF S3_1 NE 2, THEN GO TO S1_1
During the past 12 months, was there any time when [S.C.] had health care coverage?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
S8
Universe: All; where R indicates that [S.C.] does not currently have health coverage or lacked coverage at any point in prior 12 months
IF S3_1=2, FILL “is.” ELSE IF S6=1 FILL “was.”
What are the reasons why [S.C.] [is/was] not covered by insurance? [MARK ALL THAT APPLY]
COST
(1) COST IS TOO HIGH
ELIGIBILITY
(2) INSURER REFUSES TO COVER / PREEXISTING CONDITION
(3) CHILD NOT ELIGIBLE FOR INSURANCE THROUGH R OR R’S SPOUSE/PARTNER’S EMPLOYER PROVIDED INSURANCE BECAUSE OF CUSTODY ISSUES
(4) R IS NOT ELIGIBLE FOR COVERAGE THROUGH OWN EMPLOYMENT OR THAT OF SPOUSE/PARTNER’S EMPLOYMENT
(5) CHILD NOT ELIGIBLE FOR SOME OTHER REASON
APPLICATION PROCESS
(6) HAVE APPLIED – NOW JUST WAITING
(7) INTEND TO APPLY BUT JUST HAVEN’T DONE SO
(8) DON'T KNOW WHERE OR HOW TO APPLY
(9) APPLICATION PROCESS TOO DIFFICULT, TAKES TOO MUCH TIME
OTHER
(10) R’S EMPLOYER AND SPOUSE/PARTNER’S EMPLOYER DO NOT OFFER INSURANCE
(11) DO NOT LIKE DOCTORS / MEDICAL STAFF / CLINIC IN HEALTH PLAN AVAILABLE TO CHILD
(12) CHILD DOES NOT NEED INSURANCE / DOES NOT GET SICK
(13) EXPECT TO HAVE INSURANCE FROM ANOTHER SOURCE SOON
(14) OTHER
(77) DON’T KNOW
(99) REFUSED
S1_1
Universe: All
At this time, do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicaid or Medicare?
(1) YES
(2) NO [GO TO S9]
(77) DON’T KNOW [GO TO S9]
(99) REFUSED [GO TO S9]
S2_1
Universe: Rs with health coverage
Is that health insurance provided through your current employer, former employer, union, Medicare, Medicaid, or some other source? [MARK ALL THAT APPLY]
READ IF NECESSARY: Please think about your insurance or your spouse's insurance.
(1) CURRENT EMPLOYER
(2) FORMER EMPLOYER
(3) UNION
(4) MEDICARE
(5) MEDICAID
(6) SOME OTHER SOURCE [SPECIFY] [SKIP TO S2_1_VERBATIM]
(77) DON’T KNOW
(99) REFUSED
S2_1_VERBATIM RECORD VERBATIM RESPONSE _______________________
S9
Universe: All
In addition to earnings from work, families often receive other sources of income and supports, from the government, from private institutions or from their own savings. I would like to ask you a few questions about all sources of income and supports currently received by members of your household other than earnings from work.
Does anybody in your household receive Social Security retirement benefits or payments to survivors from the U.S. government?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
S10
Universe: All
Does anybody in your household receive Social Security disability benefits, or SSDI?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
S11
Universe: All
Does anybody in your household receive veterans’ benefits?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
S12
Universe: All
How about Food Stamps?
(1) YES
(2) NO [GO TO S14]
(77) DON'T KNOW [GO TO S14]
(99) REFUSED [GO TO S14]
S13
Universe: All except parents; where R’s household receives food stamps
IF H4=2, THEN GO TO S14
Are the Food Stamps received as a result of your caring for [S.C.]?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
S14
Universe: All; where child is 6 years old or younger
IF AGE > 6, THEN GO TO S15
Does [S.C.] receive Women, Infants, and Children (WIC) Program benefits?
HELP TEXT: WIC STANDS FOR WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM.
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
S15
Universe: All
Does [S.C.] get free or reduced price meals while at child care or in school?
READ IF NECESSARY: “Free or reduced price meals” are paid or partially paid for by a government program or agency. Do not include meals that are covered by tuition you pay for school.
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
S17
Universe: All; where child uses any form of child care
IF [IF WB8A= [2, 77, 99] AND WB8B=[2, 77, 99] AND WB8C=[2, 77, 99] AND WB8D=[2, 77, 99] AND WB8H=[2, 77, 99]], THEN GO TO S18
In addition to any child care for [S.C.] that you paid for, were any of [his/her] regular child care arrangements last month free or at a reduced fee or cost?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
S18
Universe: All
When answering this next question, please remember to include your income PLUS the income of all family members living in this household.
What is your best estimate of the total income of all family members from all sources, before taxes, in 2012?
INTERVIEWER INSTRUCTION: ENTER ‘999,995’ IF THE REPORTED INCOME IS GREATER THAN $999,995.
RECORD INCOME AMOUNT [GO TO S18_CONF]: ______________
INCOME GREATER THAN $999,995 [GO TO D1] 999995
INTERVIEWER INSTRUCTION: ENTER 77 FOR DON’T KNOW
ENTER 99 FOR REFUSED
CATI INSTRUCTION: IF S18=77,99 GO TO INCOME CASCADE (S19)
S18_CONF Just to confirm that I entered it correctly, the total income of all family members was [AMOUNT FROM S18]. Is that correct?
(1) YES > GO TO D1
(2) NO > GO TO S18
S19
Universe: Respondents who don't know or refuse to report income initially
Was your total family income from all sources less than $50,000 or $50,000 or more?
(1) LESS THAN $50,000
(2) $50,000 OR MORE [G0 TO S22]
(77) DON’T KNOW [G0 TO D1]
(99) REFUSED [G0 TO D1]
S20
Universe: Respondents who don’t know or refuse to report income initially, then report income of less than $50,000
Was your total family income from all sources less than $35,000 or $35,000 or more?
(1) LESS THAN $35,000
(2) $35,000 OR MORE [IF H1 + H2 = (8, 9) GO TO S21; ELSE GO TO D1]
(77) DON’T KNOW [GO TO D1]
(99) REFUSED [GO TO D1]
S21
Universe: Respondents who don’t know or refuse to report income initially, then report income of less than $35,000 or report an income of $35,000-$50,000 for a family with 8-9 family members
Was your total family income from all sources less than [FILL: Poverty threshold for household of size H1 + H2] or [FILL: Poverty threshold for household of size H1 + H2] or more?
(1) LESS THAN [FILL: Poverty threshold for household of size H1 + H2] [GO TO D1]
(2) [FILL: Poverty threshold for household of size H1 + H2] OR MORE [GO TO D1]
(77) DON’T KNOW [GO TO D1]
(99) REFUSED [GO TO D1]
S22
Universe: Respondents who don’t know or refuse to report income initially, then report income of at least $50,000
Was your total family income from all sources less than $100,000 or $100,000 or more?
(1) LESS THAN $100,000
(2) $100,000 OR MORE [GO TO D1]
(77) DON’T KNOW [GO TO D1]
(99) REFUSED [GO TO D1]
S23
Universe: Respondents who don’t know or refuse to report income initially, then report income of less than $100,000
Was your total family income from all sources less than $75,000 or $75,000 or more?
(1) LESS THAN $75,000
(2) $75,000 OR MORE
(77) DON’T KNOW
(99) REFUSED
D1
Universe: All
IF H4=2, H6=1 THEN ASK: Now I’m going to ask a few final questions about you and your spouse. What year were you born?
IF H4=2, H6 NE 1 and H8=1 THEN ASK: Now I’m going to ask a few final questions about you and your partner. What year were you born?
IF H4=2, H6 NE 1 and H8 NE 1 THEN ASK: Now I’m going to ask a few final questions about you. What year were you born?
YEAR:________________________
ENTER 7777 FOR DON’T KNOW
ENTER 9999 FOR REFUSED
D2
Universe: All; where R has spouse/partner
IF H6 NE 1 AND H8 NE 1, THEN GO TO D3
What year was your [spouse/partner] born?
YEAR:________________________
ENTER 7777 FOR DON’T KNOW
ENTER 9999 FOR REFUSED
D3
Universe: All
IF H5=1 (R is mom) AND P2 NE MISSING, THEN FILL D3 WITH P2 – SKIP
Are you of Hispanic or Latino origin?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
D4
Universe: All
IF H5=1 (R is mom) AND P3 NE MISSING, THEN FILL D4 WITH P3 – SKIP
Please choose one or more of the following categories to describe your race. Are you White, Black or African American, American Indian, Alaska Native, Asian, or Native Hawaiian or other Pacific Islander? [MARK ALL THAT APPLY]
(1) WHITE
(2) BLACK/AFRICAN AMERICAN
(3) AMERICAN INDIAN/NATIVE AMERICAN
(4) ALASKA NATIVE
(5) ASIAN
(6) NATIVE HAWAIIAN
(7) PACIFIC ISLANDER
(8) OTHER (SPECIFY) [SKIP TO D4_VERBATIM]
(77) DON’T KNOW
(99) REFUSED
D4_VERBATIM RECORD VERBATIM RESPONSE _______________________
D5
Universe: All
Compared to yourself, is [S.C.] a different race or ethnicity or from a different culture?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
D9
Universe: All
What is your current employment status?
INTERVIEWER INSTRUCTIONS:
RECORD AS STUDENT ONLY IF THERE IS NO FULL- OR PART-TIME EMPLOYMENT.
‘SEMI-RETIRED’ SHOULD BE CODED AS ‘EMPLOYED PART-TIME’.
‘SELF-EMPLOYED’ SHOULD BE CODED AS ‘EMPLOYED FULL-TIME’ OR ‘EMPLOYED PART-TIME’ DEPENDING ON HOW MUCH THEY WORK.
(1) EMPLOYED FULL-TIME (MORE THAN 30 HOURS PER WEEK)
(2) EMPLOYED PART-TIME (30 HOURS PER WEEK OR LESS)
(3) NOT WORKING--ON VACATION
(4) NOT WORKING--ON TEMPORARY LAYOFF OR STRIKE
(5) NOT WORKING BUT LOOKING FOR WORK
(6) HOMEMAKER/TAKING CARE OF HOME OR FAMILY
(7) RETIRED
(8) STUDENT
(9) DISABLED
(10) OTHER (SPECIFY) [SKIP TO D9_VERBATIM]
(77) DON’T KNOW
(99) REFUSED
D9_VERBATIM RECORD VERBATIM RESPONSE _______________________
D10
Universe: All Rs with a spouse or partner
IF H6 NE 1 AND H8 NE 1, THEN GO TO D11
What is your [spouse’s/partner’s] current employment status?
INTERVIEWER INSTRUCTIONS:
RECORD AS STUDENT ONLY IF THERE IS NO FULL- OR PART-TIME EMPLOYMENT.
‘SEMI-RETIRED’ SHOULD BE CODED AS ‘EMPLOYED PART-TIME’.
‘SELF-EMPLOYED’ SHOULD BE CODED AS ‘EMPLOYED FULL-TIME’ OR ‘EMPLOYED PART-TIME’ DEPENDING ON HOW MUCH THEY WORK.
(1) EMPLOYED FULL-TIME (MORE THAN 30 HOURS PER WEEK)
(2) EMPLOYED PART-TIME (30 HOURS PER WEEK OR LESS)
(3) NOT WORKING--ON VACATION
(4) NOT WORKING--ON TEMPORARY LAYOFF OR STRIKE
(5) NOT WORKING BUT LOOKING FOR WORK
(6) HOMEMAKER/TAKING CARE OF HOME OR FAMILY
(7) RETIRED
(8) STUDENT
(9) DISABLED
(10) OTHER (SPECIFY) [SKIP TO D10_VERBATIM]
(77) DON’T KNOW
(99) REFUSED
D10_VERBATIM RECORD VERBATIM RESPONSE _______________________
D11
Universe: All
IF NSCNC RESPONDENT IS SAME PERSON WHO RESPONDED TO NSCH, FILL INFO FROM NSCH VARIABLE K11Q20 IF R WAS FOSTER MOTHER (i.e., IF NSCH VARIABLE C10Q02A=3), ELSE FROM NSCH VARIABLE K11Q21 IF R WAS FOSTER FATHER (i.e., IF NSCH VARIABLE C10Q02A=8), ELSE FROM K11Q22.
ELSE, ASK: What is the highest degree or year of school you have completed?
(1) 8th GRADE OR LESS
(2) 9th-12th GRADE NO DIPLOMA
(3) HIGH SCHOOL GRADUATE OR GED COMPLETED
(4) COMPLETED A VOCATIONAL, TRADE, OR BUSINESS SCHOOL PROGRAM
(5) SOME COLLEGE CREDIT BUT NO DEGREE
(6) ASSOCIATE DEGREE (AA, AS)
(7) BACHELOR’S DEGREE (BA, BS, AB)
(8) MASTER’S DEGREE (MA, MS, MSW, MBA)
(9) DOCTORATE (PhD, EdD) or PROFESSIONAL DEGREE (MD, DDS, DVM, JD)
(77) DON’T KNOW
(99) REFUSED
D12
Universe: All; where R has spouse/partner
IF H6 NE 1 AND H8 NE 1, THEN GO TO D13
What is the highest grade or year of school your [spouse/partner] has completed?
(1) 8th GRADE OR LESS
(2) 9th-12th GRADE NO DIPLOMA
(3) HIGH SCHOOL GRADUATE OR GED COMPLETED
(4) COMPLETED A VOCATIONAL, TRADE, OR BUSINESS SCHOOL PROGRAM
(5) SOME COLLEGE CREDIT BUT NO DEGREE
(6) ASSOCIATE DEGREE (AA, AS)
(7) BACHELOR’S DEGREE (BA, BS, AB)
(8) MASTER’S DEGREE (MA, MS, MSW, MBA)
(9) DOCTORATE (PhD, EdD) or PROFESSIONAL DEGREE (MD, DDS, DVM, JD)
(77) DON’T KNOW
(99) REFUSED
D13
Universe: All
Were you born in the United States?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
D14
Universe: All Rs with a spouse or partner
IF H6=1 OR H8=1 THEN GO TO D15
Was your [spouse/partner] born in the United States?
(1) YES
(2) NO
(77) DON'T KNOW
(99) REFUSED
ADDRESS_INTRO IF ( NSCNC_INCENT_FLAG = 2 OR NSCNC_PASSIVE in (1,2) )
AND NSCNC_LETTER_FLG = 2 THEN FILL MONEY_2 = $15; ELSE FILL MONEY_1 = $10
Those are all the questions I have. Before I go, I'll need to confirm your mailing address so we can send you $[MONEY_1/MONEY_2] as a token of our appreciation for taking the time to answer these questions.
<GET/CONFIRM ADDRESS and GO TO NSCNC_END>
NSCNC_END I’d like to thank you on behalf of the CDC's National Center for Health Statistics for the time and effort you’ve spent answering these questions. If you have any questions about this survey, you may call my supervisor toll-free at 1-877-346-9982. If you have questions about your rights as a survey participant, you may call the chairman of the Research Ethics Review Board at 1-800-223-8118. Thank you again.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | NCHS RESEARCH ETHICS REVIEW BOARD (RESEARCH ERB) |
| Author | kdo7 |
| File Modified | 0000-00-00 |
| File Created | 2021-02-01 |