J - Summary of Changes

Attachment J

NISVS Questionnaire Changes

Questions Deleted from Survey
	Survey Question #
	Rc3a	Which of these Hispanic, Latino, or Spanish groups best describes you?
	RC6	Are you affiliated or enrolled with a tribe or village
	RC6a	Which tribe or village are you affiliated or enrolled with?
	RC6b	Have you ever lived within reservation boundaries or in an Alaska Native village?
	RC6c	Have you lived within reservation boundaries or in an Alaska Native village during the past 12 months, that is since {fill: date, 12 mos. ago}?
	RC6d	On what reservation did you live during the past 12 months?
	RC7_1	Are you currently employed or working a job for which you get paid?
	RC7_2	Are you currently employed full-time or part-time?
	RC7_3	Why are you currently not employed? Are you…
	RC7_4	Now please think about your employment status or work situation over the past 12 months. What were you doing for most of the past 12 months? Were you
	RC7_5	How are you generally paid for the work you do? Are you….
	RC8	Have you been without any telephone service for more than two weeks at any point since
	H10	As an adult, have you ever lived with and cared for any children under the age of 18?
	SFU2	How old were you the last time {fill: initials} did {fill: this / these things}?
	SVp	How many times has more than one person had sex with you on the same occasion?
	SVFU6	How old were you the last time {if only endorsed one behavior for this perp, fill: this; if endorsed more than one behavior for this perp, fill: any of these things} happened with {fill: initials 1}?
	SVFU7	Did {if only endorsed one behavior for this perp, fill: this; if endorsed more than one behavior for this perp, fill: any of these things} happen within reservation boundaries or within an Alaska Native village?
	R3	Do you currently know or have a relationship with {fill: initials 1}?
	R3a	What is your current relationship to {fill: initials 1}?
	R3a_2	{FAMILY MEMBER SUB-CATEGORIES}
	R3a_3	{ACQUAINTANCE SUB-CATEGORIES}
	R6	How old were you the last time {if only endorsed one behavior for this perp, fill: this; if endorsed more than one behavior for this perp, fill: any of these things} happened with {fill: initials 1}?
	R7a	Which of these Hispanic, Latino, or Spanish groups best describes {fill: initials}?
	IP3	Are you currently living with a man or a woman as a couple at least part of the time? By couple I mean romantically or sexually involved, not just roommates.
	IP4	Are you currently romantically or sexually involved with someone like a boyfriend or girlfriend? This would include someone you are seeing or dating.
	IP5	{if IP3 = 1} Is the person you are living with as a couple male or female? {if IP2 < 2} Is your spouse male or female?
	IP6	Now please think about the employment status or work situation of your partner over the past 12 months, that is since {fill date 12 months ago}. What was your partner doing for most of the past 12 months? Was he / she…
	IP7	How is your partner generally paid for the work he or she does? Is he or she….
	IP8	Do you get paid more than your partner, paid about the same amount as your partner, or paid less than your partner?

Questions Moved to Periodic Modules (asked periodically not annually)
	Survey Question #
	H3	There are many different factors that can affect a person’s health, including worry and stress. In the past 12 months, how often would you say you were worried or stressed about having enough money to pay your rent or mortgage? Would you say…
	H4	In the past 12 months, how often would you say you were worried or stressed about having enough money to buy nutritious meals? Would you say…
	H5	Was there a time in the past 12 months when you needed to see a doctor but could not because you could not afford
	PA1	How many of your current or ex romantic or sexual partners have ever…? acted very angry towards you in a way that seemed dangerous?
	PA2	told you that you were a loser, a failure, or not good enough?
	PA3	called you names like ugly, fat, crazy, or stupid?
	PA4	insulted, humiliated, or made fun of you in front of others?
	PA5	told you that no one else would want you?
	PAi	Was it {fill: 1st set of initials}?
	PAa	{if 1st time collecting ANY initials, read: I’d like for you to tell me some way that we can refer to {fill: if any PA1 – 5 =1, this person; if any PA1 – 5 > 1, these people}, such as their initials or a nickname, so that if I ask you other questions about {fill: if any PA1 – 5 =1, this person; if any PA1 – 5 > 1, these people} you’ll know who I’m talking about.} Please tell me the initials of the {fill: if any PA1 – 5 > 1, first} person who {fill: behavior}?}
	PA1a	Is {fill: initials} male or female?
	PAb	How many times did {fill: initials} ever {fill: behavior}? Would you say…
	PAf	{Fill: Has this person / Did any of these people} {fill: behavior} in the past twelve months, that is since {fill: date, 12 months ago}?
	PAg	Which people did this in the past twelve months?
	PAh	How many times did {fill: initials} {fill: behavior} in the past twelve months? Would you say…
	CCE1	tried to keep you from seeing or talking to your family or friends?
	CCE2	made decisions for you that should have been yours to make, such as the clothes you wear, things you eat, or the friends you have?
	CCE3	kept track of you by demanding to know where you were and what you were doing?
	CCE4	threatened to hurt him or herself or commit suicide when he or she was upset with you?
	CCE5	threatened to hurt a pet or threatened to take a pet away from you?
	CCE6	threatened to hurt someone you love?
	CCE7	hurt someone you love?
	CCE8	threatened to take your children away from you?
	CCE9	kept you from leaving the house when you wanted to go?
	CCE10	kept you from having money for your own use?
	CCE11	destroyed something that was important to you?
	CCE12	said things like “If I can’t have you, then no one can”?
	CCE13	{if female, fill: tried to get you pregnant when you did not want to become pregnant; if male, fill: tried to get pregnant when you did not want them to get pregnant} or tried to stop you from using birth control?
	CCE14	refused to use a condom when you wanted them to use one?
	CCEi	Was it {fill: 1st set of initials}?
	CCEa	{if 1st time collecting ANY initials, read: I’d like for you to tell me some way that we can refer to {fill: if any CCE1 – 13 =1, this person; if any CCE1 – 13 > 1, these people}, such as their initials or a nickname, so that if I ask you other questions about {fill: if any CCE1 – 13 =1, this person; if any CCE1 – 13 > 1, these people} you’ll know who I’m talking about.} Please tell me the initials of the {fill: if any CCE1 – 13 > 1, first} person who {fill: behavior}?
	CCE1a	Is {fill: initials} male or female?
	CCEb	How many times did {fill: initials} ever {fill: behavior}? Would you say…
	CCEf	{Fill: Has this person / Did any of these people} {fill: behavior} in the past twelve months, that is since {fill: date, 12 months ago}?
	CCEg	Which people did this in the past twelve months
	CCEh	How many times did {fill: initials} {fill: behavior} in the past twelve months? Would you say…
	SV1	exposed their sexual body parts to you, flashed you, or masturbated in front of you?
	SV2	made you show your sexual body parts to them when you didn’t want it to happen?
	SV3	made you look at or participate in sexual photos or movies?
	SV4	verbally harassed you while you were in a public place in a way that made you feel unsafe?
	SVo	Did any of these things ever involve more than one person having sex with you on the same occasion?
	SVq	How many people were involved {if SVp > 1, fill: the first time this happened, the second time this happened, etc.}?
	FU3a	Had {fill: {initials}/ any of these people} been using alcohol, drugs, or both at the time when {fill: this / any of these things} happened?
	Fu3a_1	Which of these people used alcohol, drugs, or both when {fill: this / any of these things} happened?
	FU3a_2	Would you say that {fill: 1st set of initials from FU3a_1, etc.} used alcohol, drugs, or both always, almost always, sometimes, or never when {fill: this / any of these things} happened?
	Fu5_3	Have you ever talked to a psychologist or counselor about what {fill: {initials} / any of these people} did
	FU5_5	Have you ever talked to a friend about what {fill: {initials} / any of these people} did?
	FU5_6	Have you ever talked to a family member about what {fill: {initials} / any of these people} did
	FU5_7	Have you ever talked to a romantic or sexual partner about what {fill: {initials} / any of these people} did?
	FU5_8	Have you ever talked to anyone else about what {fill: {initials} / any of these people} did?
	FU5a	Which people did you talk to {fill: type, i.e. the police} about?
	FU5b	When you spoke to {fill: type, i.e. the police} about {fill: initials}, how helpful was it to you? Was it…
	FU5_2	Have you ever talked to a medical doctor or nurse about what {fill: {initials} / any of these people} did?