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pdfYA132309CQ0014 / TO2
CE Records Study
November 8, 2010
INTERVIEW 1
1. How do you feel about the length of this survey? Would you say it was
1. Too long,
2. Too short, or
3. Just about right
2. In general, how difficult or easy was it for you to answer this survey? Would you say it was…
1. Very difficult,
2. Difficult
3. Somewhat difficult,
4. Neither easy nor difficult,
5. Somewhat easy, or
6. Easy
7. Very easy
3. In general, how certain are you that the answers you reported on this survey are accurate?
1. Extremely certain
2. Quite certain
3. Somewhat certain
4. Slightly certain
5. Not at all certain
4. How often did you have to guess when providing the costs of your expenses?
1. Never or almost never
2. Some of the time
3. About half of the time
4. Most of the time
5. Almost every time
5. Were there sections that required you to guess the cost of expenses more than others? If so,
which ones?
6. [IF HOUSEHOLD SIZE > 1] How knowledgeable would you say you are about expenditures made
by other people in your household?
1. Extremely knowledgeable
2. Quite knowledgeable
3. Somewhat knowledgeable
Debriefing Questions for Interview 1
1
4. Slightly knowledgeable
5. Not at all knowledgeable
7. [IF HOUSEHOLD SIZE > 1] If someone else in your household completed this survey instead of
you, how comfortable would you be telling that person about the expenditures you made?
1. Very comfortable
2. Comfortable
3. Somewhat comfortable
4. Neither comfortable nor uncomfortable
5. Somewhat uncomfortable
6. Uncomfortable
7. Very uncomfortable
8. What were the hardest sections for you to answer? Do you remember?
[RECORD UP TO THREE SECTIONS]
9. What were the easiest sections for you to answer?
10.
11.
12.
13.
[RECORD UP TO THREE SECTIONS]
Do you have any other thoughts or comments about the interview?
[RECORD RESPONSE]
Advance Materials
About a week ago, we sent a letter to introduce you to the study and ask you to participate in
the study. Did you receive that letter?
1. Yes, I got the letter,
2. No, I did not get the letter, or
[ASK IF Rs answer 1 to Q11] Many people do not read all materials that they get via mail. Did
you read the letter?
1. Yes
2. No
3. Skimmed it
[ASK IF Rs answer 2 to Q12] What were the reasons that you did not read the letter?
1. Did not have time
2. Unattractive look/design
3. My name was not written on it
Debriefing Questions for Interview 1
2
4.
5.
6.
7.
The sender name
It does not seem important
Somebody else in the household read the letter
Other reasons…
Now, I will show you the advance letter that we sent you earlier. Please take a few minutes to read
through this letter and then I will ask you some questions. [WAIT FOR RESPONDENT TO READ THE
LETTER.]
14. How accurate do you think the letter is in describing the survey that you just completed? Would
you say the description is…
1. Extremely accurate
2. Quite accurate
3. Somewhat accurate
4. Slightly accurate
5. Not at all accurate
15. [IF SOMEWHAT OR NOT AT ALL] What did you think was not accurate?
_______________________________
16. Do you think any parts of the letter are confusing or unclear?
1. YES (SPECIFY): _______________________________
2. NO
17. Is there any information in this letter that caused you concern or made you hesitant to
participate?
1. YES (SPECIFY WHAT): _______________________________
2. NO
18. Is there any additional information that you think we should add to this letter?
1. YES (SPECIFY WHAT): _______________________________
2. NO
19. If you received this letter in the mail without being called in advance like you were for this
interview, do you think you would participate, or would you choose not to participate?
1. PARTICIPATE GOTO #21
2. NOT PARTICIPATE
3. UNSURE
20. What changes could be made to the letter that would make you more likely to participate?
Debriefing Questions for Interview 1
3
(RECORD RESPONSES VERBATIM)
Information Booklet
21. INTERVIEWER: DID RESPONDENT USE THE INFORMATION BOOKLET DURING THE INTERVIEW?
1. YES Æ GOTO #22
2. NO Æ GOTO #25
22. [ASK IF R USED INFORMATION BOOKLET] When completing the survey, how useful was the
information booklet? Would you say it was…
1. Extremely useful
2. Quite useful
3. Somewhat useful
4. Slightly useful, or
5. Not at all useful
23. [ASK IF R USED INFORMATION BOOKLET] Still thinking about the information booklet, how
difficult or easy was it to use? Would you say it was…
1. Very difficult,
2. Difficult
3. Somewhat difficult,
4. Neither easy nor difficult,
5. Somewhat easy, or
6. Easy
7. Very easy
24. [ASK IF R USED INFORMATION BOOKLET] Do you have any suggestions for ways that we could
improve the information booklet?
(RECORD RESPONSES VERBATIM)
25. [ASK IF R DID NOT USE INFORMATION BOOKLET] Some people use the information booklet
when completing the survey, but I noticed that you did not. Why did you choose not to use the
information booklet? Select all that apply.
1. I forgot
2. It was too difficult or tedious to use
3. I did not need it
4. Some other reason, specify:
26. [IF HOUSEHOLD SIZE > 1] HOW OFTEN DID THE RESPONDENT ASK ANY OTHER HOUSEHOLD
MEMBERS ABOUT THEIR EXPENSES DURING THE INTERVIEW?
1. Never or almost never
Debriefing Questions for Interview 1
4
2.
3.
4.
5.
Some of the time
About half of the time
Most of the time
Almost every time
Debriefing Questions for Interview 1
5
File Type | application/pdf |
Author | ashrichards |
File Modified | 2011-01-07 |
File Created | 2011-01-07 |