O MB No.: 0970-0403
Expiration Date: xx/xx/xxxx
PACT
Healthy Marriage
Baseline Survey CATI
June 13, 2013
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0970-0403. 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. |
CONTENTS
Section Page
i. introduction ii
A. CONTACT INFORMATION 1 1
B. DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS 6
c. RELATIONSHIP STATUS 9
d. PARENTING 17
e. relationSHIP quality 22
F. ECONOMIC STABILITY 27
G. BACKGROUND AND WELL BEING 33
H. MOTIVATION TO PARTICIPATE IN PROGRAM 36
I. CONTACT INFORMATION 2 38
INTERVIEWER SELECT STAFF NAME AND PROGRAM NAME FROM DROP DOWN MENU.
PROGRAMMER: PRELOAD STAFF NAMES AND program NAMES. |
ALL |
INTRO1 . INTERVIEWER: WAS THIS CALL RECEIVED ON THE INTERVIEWER LINE OR THE SUPERVISOR LINE?
NOTE: YOU SHOULD NOT SELECT SUPERVISOR LINE UNLESS YOU WERE GIVEN PERMISSION TO DO SO BY YOUR SUPERVISOR.
1-888-xxx-xxxx (INTERVIEWER LINE) 1
1-xxx-xxx-xxxx (SUPERVISOR LINE) 0
ALL |
INTRO1A. Hello, could you please tell me the name of the program you are calling from?
EL PASO CENTER FOR CHILDREN 1
JEWISH FAMILY AND CHILDREN’S SERVICE (JFCS) 2
UNIVERSITY BEHAVIORAL ASSOCIATES (UBA) 3
ALL |
INTRO2. Can you please tell me your name?
PROGRAMMER: PROVIDE DROP-DOWN LIST OF STAFF NAMES
CONTINUE 1
NAME NOT IN LIST 99
IF OTHER SPECIFY (99): INTERVIEWER: ENTER STAFF MEMBER’S NAME (STRING 50) |
soft check: if intro2=99: INTERVIEWER: BEFORE RECORDING A NEW NAME, PLEASE DOUBLE-CHECK THAT YOU CODED THE PROGRAM NAME CORRECTLY. |
intro1=0 |
INTRO2a. Why is the client required to attend the program?
COURT ORDER 1
WILDCARD (SPECIFY) 99
(STRING 50)
IF OTHER SPECIFY (99): INTERVIEWER: ENTER OTHER REASON (STRING 50) |
ALL |
INTRO3. Thank you for that information. Can you please hand the phone to the client?
CONTINUE 1
PROGRAMMER:
IF INTRO1=0, GO TO 7, ELSE GO TO 1.
intro1=1 |
i1. Hello, my name is [INTERVIEWER NAME], and I work for Mathematica Policy Research. I understand that you are interested in [PROGRAM NAME] and the Parents and Children Together study. Is that correct?
YES 1 GO TO i2
NO 0 GO TO i1a
i1=00 |
i1a. Please tell me why you are not interested in participating.
(STRING 250)
i1=00 |
i1b. Your participation is important because it will help us learn about services for couples like you in the future. All information we collect will be kept strictly private, and if you are eligible for the study, you will receive $10 for completing the survey today. Will you reconsider and agree to participate in the PACT study?
YES, I WILL PARTICIPATE 1 GO TO i2
NO, I WILL NOT PARTICIPATE 0 GO TO i6b
i1=1 or i1b=1 |
i2. Great. Thanks for taking the time to talk to me today. I would like to tell you a little bit more about the study, which is called PACT for short. Please stop me at any time if you have a question.
The [PROGRAM NAME] is part of the Parents and Children Together (PACT) study, a national study being conducted by the U.S. Department of Health and Human Services. The study is being done to learn more about which services help couples build a better relationship and be better parents as well as improve their economic stability. The Department of Health and Human Services asked researchers from an organization called Mathematica to assist with the study. We invite you to be a part of the study.
The study is being done to learn how well programs like [PROGRAM NAME] work. This program aims to help couples build better relationships, have healthy interactions with their children, and get and keep good jobs. The study will determine whether the program achieves those aims, and will help us learn whether there are ways these kinds of programs can be improved.
The [PROGRAM NAME] program is for couples. If you want to be in the program, you and your partner have to agree to be a part of the PACT study. If you and your partner decide that you do not want to be a part of the study, you will not be able to participate in the [PROGRAM NAME] program. You will be given information about other services that you can receive in the community.
If you decide to be in the [PROGRAM NAME] program and the study and you are eligible for the study, I will ask you to complete a short survey on the telephone with me today. I will ask you questions about yourself, your partner and your child or children. This will take about 30 minutes. You will receive $10 once you complete the survey in appreciation of your time.
Do you have any questions about what I’ve said so far?
YES 1
NO 0 GO TO i3
i2=1 |
i2a. What is your question?
(STRING 250)
INTERVIEWER: PRESS Alt-F1 TO ACCESS FAQ
ALL |
i3. In about 12 months, the researchers will contact you again by phone and ask you about topics such as your relationships with your partner, your interactions with your child or children, your relationship with other family members, your employment, and services you receive.
At that time, you may also be asked to participate in focus groups, in-person interviews, and to complete check lists about interactions with your child. Researchers may also ask if it’s alright to interview your child. We will provide more information about these activities later, and your participation is voluntary.
The decision to participate in the survey in 12 months, the interviews, and the check lists are voluntary and will have no effect on your participation in the program. We will provide more information about these activities later, and you can decide in 12 months whether to participate in the survey, interviews, and check lists.
If you agree to be part of the study, it means you are giving permission for the [PROGRAM NAME] program to share information with the researchers about the services you receive from the program. We will ask you for your social security number. We want to assure you that it will be kept private and will only be used for research purposes. It may be used in requests to federal and state agencies for more information about your employment and earnings and child support agreements and may be used to locate you more easily for the interview in a year’s time.
Do you have any questions at this time?
YES 1
NO 0 GO TO i4
i3=1 |
i3a. What is your question?
(STRING 250)
INTERVIEWER: PRESS Alt-F1 TO ACCESS FAQ
ALL |
i4. This study will look at two groups of couples: those who receive the [PROGRAM NAME]’s program services, and those who receive referrals to other existing services in the community. The study will compare outcomes for the two groups. A computer will randomly select which group you will be in. One of the groups will receive [PROGRAM NAME] program services at no cost to them. The other group will be able to receive referrals to other organizations for services, but not the [PROGRAM NAME] program services.
The computer works like a flip of a coin; assignment to a group is completely random. This procedure makes sure that assignments to the groups are fair. Everyone who agrees to join the study has the same chance of being placed into either group. The chance of being able to receive services is not influenced by what you say to program staff or your answers to the questions on the telephone. A staff member from [PROGRAM NAME] will let you know which group you are assigned to after you and your partner complete today’s interview.
If you are not randomly assigned to participate in [PROGRAM NAME] program, you will be provided with information about other services available to you in the community, and you will be able to talk to a staff person about those other services.
Do you have any questions now?
YES 1
NO 0 GO TO i5
i4=1 |
i4a. What is your question?
(STRING 250)
INTERVIEWER: PRESS Alt-F1 TO ACCESS FAQ
ALL |
i5. At any time, after you have been randomly assigned, you can call Mathematica’s help line to say that you no longer want the program to share information about you with the Mathematica researchers, and that will have no effect on the services available to you.
Everything you tell the researchers will be used for research purposes only, unless we are required by law to release it for some other purpose. The Department of Health and Human Services may allow other researchers to use the information that you provide, and researchers may use your name and contact information to get in touch with you in the future for research purposes. Nobody will ever publish your name in connection with the information you provide. Instead, information about you will be combined with information about other people in the study, so researchers can describe the overall program effects and participants’ experiences.
Your participation in the study could help in providing services in the future to other couples like you.
You may feel uncomfortable answering some questions in interviews. You can refuse to answer those questions if you wish, and it will not change your participation in the program. Although researchers will take many steps to protect all study information, there is a small risk that non-researchers could see it, including information about your employment and earnings, child support agreements and involvement with the criminal justice system. In addition, representatives from the Department of Health and Human Services and the New England Institutional Review Board (IRB) may inspect and have access to confidential information as they ensure your rights as a study participant are protected.
Do you have any questions now?
YES 1
NO 0 GO TO i5b
i5=01 |
i5a. What is your question?
(STRING 250)
INTERVIEWER: PRESS Alt-F1 TO ACCESS FAQ
ALL |
i5b. To help us protect your privacy, we have obtained a Certificate of Confidentiality from the National Institutes of Health. With this Certificate, the researchers cannot be forced to disclose information that may identify you, even by a court subpoena, in any federal, state, local, civil, criminal, legislative, administrative, or other proceedings. The researchers will use the Certificate to resist any demands for information that would identify you, with one exception. The Certificate of Confidentiality does not prevent the researchers from disclosing information that would identify you as a participant in the research project if you tell me anything that suggests you are very likely to harm yourself, that you are planning to hurt another person or child, or that someone is likely to harm you.
You should understand that a Certificate of Confidentiality does not prevent you, or a member of your family, from voluntarily releasing information about yourself or your involvement in this research. If an insurer, employer or other person obtains your written consent to receive research information, then the researchers may not use the Certificate to withhold that information.
Do you have any questions now?
YES 1
NO 0 GO TO i5d
i5b=01 |
i5c. What is your question?
(STRING 250)
INTERVIEWER: PRESS Alt-F1 TO ACCESS FAQ
i1=01 |
i5d. We hope you will want to be in the study but your participation is strictly voluntary. However, if you do not want to be in the study, you cannot be entered into the computer system to see if you can receive services from [PROGRAM NAME]. If you agree to be in the study and later decide you do not want to answer some or all study questions or have information from the program shared with researchers, you may decline at any time. By agreeing now to be in the study, even if later you tell us you want to withdraw from the study, you are authorizing researchers to use information that was collected about you before you withdrew.
Do you have any questions now?
YES 1
NO 0 GO TO i6
i5d=1 |
i5e. What is your question?
(STRING 250)
INTERVIEWER: PRESS Alt-F1 TO ACCESS FAQ
ALL |
i6. Do you agree to be in the PACT study?
YES 1 GO TO A1
NO 0
i1=0 OR if i6=0 |
i6a. Please tell me why you are not interested in participating in the PACT study.
(STRING 250)
i1=0 OR if i6=0 |
i6b. Your participation is important because it will help us learn about services for couples like you in the future. All information we collect will be kept strictly private, and you will receive a $10 gift card once you complete the survey today. Will you reconsider and agree to participate in the PACT study?
YES, I WILL PARTICIPATE 1 GO TO i2
NO, I WILL NOT PARTICIPATE 0
i1b = 0 |
i6c. If you do not want to be part of the study, you will not be able to participate in [PROGRAM NAME] and you will be given information about other services that you can receive in the community. Will you reconsider and agree to participate in the PACT study?
YES, I WILL PARTICIPATE 1 GO TO i2
NO, I WILL NOT PARTICIPATE 0
i6c = 0 |
i6d. Thank you very much for your time. Can you please hand the phone back to the staff person at [PROGRAM NAME]?
INTERVIEWER: INFORM PROGRAM STAFF THAT RESPONDENT WILL NOT BE PART OF THE PACT STUDY AND WILL NOT BE IN THE PROGRAM BUT WILL RECEIVE INFORMATION ABOUT OTHER SERVICES IN THE COMMUNITY.
INTRO1=0 |
i7. Hello, my name is [INTERVIEWER NAME], and I work for Mathematica Policy Research. Thanks for taking the time to talk to me today. I would like to tell you a little bit more about the [PROGRAM NAME] program.
The [PROGRAM NAME] program is participating in a study being conducted by the U.S. Department of Health and Human Services, and Mathematica is assisting with the study. The study is called Parents and Children Together, or PACT, for short. Because you are required to receive services from [PROGRAM NAME], we are not asking you to participate in the PACT study. However, [PROGRAM NAME] will need to record some information about you in the PACT database in order to track your participation in their program. Everything you tell the researchers will be used for research purposes only, unless we are required by law to release it for some other purpose.
Do you have any questions?
YES 1
NO 0 GO TO i7b
i7=01 |
i7a. What is your question?
(STRING 250)
INTERVIEWER: PRESS Alt-F1 TO ACCESS FAQ
i7=00 |
i7b. Do you agree to allow [PROGRAM NAME] to record your information in the PACT database?
YES 1 GO TO A1
NO 0
i7b=00 |
FILL STAFF MEMBER NAME FROM INTRO2 ANSWER |
i7c. Thank you very much for your time. Can you please hand the phone back to [STAFF MEMBER NAME]?
INTERVIEWER: INFORM PROGRAM STAFF THAT RESPONDENT DID NOT AGREE TO HAVE THEIR INFORMATION RECORDED IN THE PACT DATABASE. DO NOT GIVE RESPONDENT A GIFT CARD.
Thank you. I would like to start by asking you some questions about yourself.
ALL |
A1. What is your full name? Please spell that for me.
INTERVIEWER: CONFIRM LAST NAME GIVEN IS THEIR FULL LEGAL NAME (i.e. ARE THERE TWO LAST NAMES OR HYPHENATED LAST NAME).
(STRING 50)
FIRST NAME
(STRING 50)
MIDDLE INITIAL/NAME
(STRING 50)
LAST NAME
ALL |
FILL FULL NAME FROM A1 |
A1a. I want to make sure that we call you by the correct name. Do you go by another name besides [FULL NAME]?
YES 1
NO 0 GO TO A2
A1a=01 |
A1b. Please spell that name for me.
(STRING 50)
NAME
ALL |
A2. What is your date of birth?
| | | / | | | / | | | | |
(01-12) (01-31) (1900-2013)
MONTH DAY YEAR
SOFT CHECK: IF OUT OF RANGE < 18 YEARS OLD; I recorded (fill A2 ANSWER). Is that correct? PROGRAMMER: IF R CONFIRMS THEY ARE <18 YEARS OLD, GO TO END2. |
all |
A3. What is your Social Security Number?
| | | | - | | | -| | | | |
(000-999) (00-99) (0000-9999)
DON’T KNOW d
REFUSED r
all |
A3a. INTERVIEWER INSTRUCTION:
RWTW
MALE 1
FEMALE 2
all |
A4. What is your address?
PROBE: Is there an apartment number?
STREET 1
STREET 2
APT. #
CITY
STATE
ZIP
all |
A5. What is your home telephone number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
NO LANDLINE AT HOME, ONLY CELL PHONE 0
DON’T KNOW d
REFUSED r
all |
A6. Do you have a cell phone?
YES 1
NO 0 GO TO A9
DON’T KNOW d GO TO A9
REFUSED r GO TO A9
a6=1 |
A6a. What is your cell phone number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
DON’T KNOW d
REFUSED r
SKIP IF INTRO1=0 |
A
Youthbuild
|
|
|||
|
YES |
NO |
DK |
REF |
a. Do you have a contract? |
1 |
0 |
d |
r |
b. Do you have a ‘pay as you go’ plan? |
1 |
0 |
d |
r |
c. Do you have unlimited calling? |
1 |
0 |
d |
r |
d. Do you have unlimited texting? |
1 |
0 |
d |
r |
e. OTHER (SPECIFY) |
1 |
0 |
d |
r |
(100) |
|
|
|
|
IF OTHER SPECIFY (99): specify other type of plan |
SKIP IF INTRO1=0 A7d=0 |
A8. Is it okay for us to text you at this number?
YES 1
NO 0
D
PACT
developed
REFUSED r
ALL |
A9. What is the full name of the person that will participate in [PROGRAM NAME] with you? Please spell that name for me.
INTERVIEWER: CONFIRM LAST NAME GIVEN IS THE FULL LEGAL NAME (i.e. ARE THERE TWO LAST NAMES OR HYPHENATED LAST NAME).
(STRING 50)
FIRST NAME
(STRING 50)
MIDDLE INITIAL/NAME
(STRING 50)
LAST NAME
all |
A
RWTW
MALE 1
FEMALE 2
HARD CHECK: IF [A3a=1 AND A9a=1] OR [A3a=2 AND A9a=2] GO TO END3
ALL |
INSERT first NAME FROM A9 as [PARTNER/SPOUSE NAME] |
A10. I want to make sure that we use (his/her) correct name. Does [PARTNER/SPOUSE NAME] go by another name?
YES 1
NO 0 GO TO A11
DON’T KNOW d GO TO A11
REFUSED r GO TO A11
PROGRAMMER:
IF INTRO1=0 AND A10=0, DK, OR R, GO TO END4
A10=1 |
A10a. Please spell that name for me.
(STRING 50)
NAME
DON’T KNOW d
REFUSED r
PROGRAMMER:
IF INTRO1=0 AND A10a= NAME GIVEN, DK or R, GO TO END4
ALL |
A11. Do you have a biological or adopted child that lives with you?
YES 1 GO TO B1
NO 0
DON’T KNOW d
REFUSED r
A11=0, DK, R |
IF A9a=1 FILL “HIM” IF A9a=2 FILL “HER” FILL [PARTNER/SPOUSE NAME] FROM A9 OR A10a |
A11a. Does [PARTNER/SPOUSE NAME] have a biological or adopted child that lives with (him/her)?
YES 1 GO TO B1
NO 0
DON’T KNOW d
REFUSED r
A11=0, DK, R AND A11a=0, DK, R |
FILL [PARTNER/SPOUSE NAME] FROM A9 OR A10a |
A11b. Are you and [PARTNER/SPOUSE NAME] expecting a child together?
YES 1 GO TO B1
NO 0 GO TO B1
DON’T KNOW d GO TO B1
REFUSED r GO TO B1
Next, I would like to ask you some questions about your background.
All |
B1. Are you Hispanic, Latino, or of Spanish origin?
OMB
NO, NOT OF HISPANIC, LATINO OR SPANISH ORIGIN 0
YES, MEXICAN, MEXICAN AMERICAN, CHICANO 1
YES, PUERTO RICAN 2
YES, CUBAN 3
YES, ANOTHER HISPANIC, LATINO OR SPANISH ORIGIN 4
DON’T KNOW d
REFUSED r
All |
B
OMB
AMERICAN INDIAN OR ALASKA NATIVE 1
ASIAN 2
BLACK OR AFRICAN AMERICAN 3
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER 4
WHITE 5
OTHER (SPECIFY) 99
(STRING 50)
DON’T KNOW d
REFUSED r
IF OTHER SPECIFY (99): SPECIFY OTHER RACE |
All |
B3. What country were you born in?
U
BSF
PUERTO RICO 2
CANADA 3
MEXICO 4
CUBA 5
DOMINICAN REPUBLIC 6
EL SALVADOR 7
HAITI 8
JAMAICA 9
GUATEMALA 10
NICARAGUA 11
OTHER COUNTRY (SPECIFY) 99
(STRING 50)
DON’T KNOW d GO TO B5
REFUSED r GO TO B5
IF OTHER SPECIFY (99): SPECIFY OTHER COUNTRY |
b3 ne 1, d or r |
B4. When did you first come to live in the United States?
I
BSF
SPECIFY YEAR 1
SPECIFY NUMBER OF YEARS AGO 2
| | | | | YEAR
(1900 - 2013)
OR
| | |.| | NUMBER OF YEARS AGO
(0-99.9)
DON’T KNOW d
REFUSED r
All |
B5. What is the highest level of education you have completed?
COBRA
tailored for PACT
DID NOT COMPLETE HIGH SCHOOL OR GED 1
HIGH SCHOOL: DIPLOMA 2
HIGH SCHOOL: GENERAL EDUCATION DEVELOPMENT OR GED 3
SOME COLLEGE/SOME POSTSECONDARY VOCATIONAL COURSES 4
2-YEAR OR 3-YEAR COLLEGE DEGREE (ASSOCIATE’S DEGREE) 5
VOCATIONAL SCHOOL DIPLOMA 6
4-YEAR COLLEGE DEGREE (BACHELOR’S DEGREE) 7
SOME GRADUATE WORK/NO GRADUATE DEGREE 8
GRADUATE OR PROFESSIONAL DEGREE (e.g., MA, MBA, Ph.D., JD, MD) 9
NEVER ATTENDED SCHOOL 10 GO TO B6
DON’T KNOW d
REFUSED r
b3 NE 1 AND B5 NE 10 |
B5a. Did you complete this education in the United States?
Y
PACT
developed
NO 0
DON’T KNOW d
REFUSED r
ALL |
B
BSF
ENGLISH 1
SPANISH 2
OTHER (SPECIFY) 99
(STRING 50)
DON’T KNOW d
REFUSED r
The next questions are about you and [PARTNER/SPOUSE NAME].
ALL |
C
BSF
15 month follow-up
Married, 1
Divorced, 2
Separated, or 3
Have you never been married to each other? 4 GO TO C5
DON’T KNOW d GO TO C5
REFUSED r GO TO C5
C1 = 1, 2 or 3 |
C
BSF
15 month follow-up
INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR.
PROGRAMMER NOTE: ALLOW REFUSAL IN MM/YYYY
| | | / | | | | | DATE OF MARRIAGE
(01-12) (1900-2014)
MONTH YEAR
DON’T KNOW d GO TO C5
REFUSED r GO TO C5
C1= 3 AND C2 NOT=DK, RF |
C
BSF
15 month follow-up
INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR.
PROGRAMMER NOTE: ALLOW REFUSAL IN MM/YYYY GO TO C5
| | | / | | | | | DATE OF SEPARATION
(01-12) (1900-2014)
MONTH YEAR
DON’T KNOW d GO TO C5
REFUSED r GO TO C5
C1=2 AND C2 NOT=DK, RF and c3 NOT= DK, RF |
C
BSF
15 month follow-up
INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR.
PROGRAMMER NOTE: ALLOW REFUSAL IN MM/YYYY
| | | / | | | | | DATE OF END OF MARRIAGE GO TO C5
(01-12) (1900-2014)
MONTH YEAR
DON’T KNOW d GO TO C5
REFUSED r GO TO C5
C1 ≠ 1 |
C
BSF
15 month follow-up
We are romantically involved on a steady basis. 1 GO TO C6
We are involved in an on-again and off-again relationship. 2 GO TO C6
We are not in a romantic relationship. 3 GO TO C10
DON’T KNOW d GO TO C6
REFUSED r GO TO C6
C1 ≠ 1 and c5 ≠ 3 |
C
BSF
baseline
INSTRUCTION: FIRST CODE IF ANSWER IS ‘SPECIFY TOTAL NUMBER’ OR ‘SPECIFY DATE’ YOU WILL BE ABLE TO ENTER NUMBER OF UNITS OR SPECIFIC DATE ON THE NEXT SCREEN.
SPECIFY TOTAL NUMBER (UNITS) 1
SPECIFY DATE 2
| | |.| | # OF UNITS
MONTHS 1
YEARS 2
WEEKS (IF LESS THAN ONE WEEK, ENTER 1 WEEK) 3
OR
| | | / | | | | | SPECIFIC DATE
(01-12) (1900-2014)
DON’T KNOW d
REFUSED r
[C1 =4, dk OR r] and [c5= 1 or 2] |
C
BSF
15 month follow-up
YES 1
NO 0 GO TO C10
DON’T KNOW d GO TO C10
REFUSED r GO TO C10
C7=1 |
C
BSF
15 month follow-up
YES 1
NO 0 GO TO C10
DON’T KNOW d GO TO C10
REFUSED r GO TO C10
C7a = 1 |
C
BSF
15 month follow-up
INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR.
PROGRAMMER NOTE: ALLOW REFUSAL IN MM/YYYY
| | | / | | | | | DATE PLANNING TO MARRY
(01-12) (2012-2100)
MONTH YEAR
INTERVIEWER INSTRUCTION: IF NO DATE IS GIVEN, DO NOT PROBE
NO DATE HAS BEEN SET 13 GO TO C10
DON’T KNOW d GO TO C10
REFUSED r GO TO C10
C1 = 2, 4, dk OR r AND C5 NE 3 AND C7 NE 0, DK OR RF AND C7a NE 0, DK OR RF AND C8 NE 13, DK OR RF |
C
BSF
15 month follow-up
No chance, 0
A little chance, 1
A 50-50 chance, 2
A pretty good chance, or 3
An almost certain chance? 4
DON’T KNOW d
REFUSED r
ALL |
C
BSF
15 month follow-up
All of the time, 1 GO TO C12
Most of the time, 2
Some of the time, or 3
None of the time? 4
DON’T KNOW d
REFUSED r
if c10 ≠ 1 |
C
BSF
15 month follow-up
Every day or almost every day, 1
A few times a week, 2
A few times a month, 3
About once a month, 4
Only a few times in the past year, or 5
Hardly ever or never? 6
DON’T KNOW d
REFUSED r
ALL |
if c1 = 1 or 3 fill “to someone else besides [partner/spouse name]” |
if c1=2 fill “to someone else” |
C
BSF
15 month follow-up
YES 1
NO 0 GO TO C14
DON’T KNOW d GO TO C14
REFUSED r GO TO C14
C12 = 1 |
If c1=1 or 3 and IF C12=1, fill: “Including your current marriage,” |
C
BSF
15 month follow-up
| | | # OF MARRIAGES
(1-99)
DON’T KNOW d
REFUSED r
SOFT CHECK: [IF C1=1,2 OR 3 AND C12=1 AND C13 < 2] OR [IF C1=1,2 OR 3 AND C12=0 AND C13 < 1] You mentioned in a previous question that you were married [INTERVIEWER INSTRUCTION: THE NUMBER OF MARRIAGES IN THIS QUESTION SHOULD BE MORE THAN 1], can you confirm how many times you have been married including your current marriage? [INTERVIEWER: IF C13=0 OR 1AFTER SOFT CHECK, PLEASE CHANGE ANSWER IN C1. |
A11=1 or a11a=1 |
Now I have some questions about your children.
C
PACT
developed
YES 1
NO 0 GO TO C15
DON’T KNOW d GO TO C15
REFUSED r GO TO C15
A11b=1 OR C14=1 |
C
PACT
developed
| | | / | | | / | | | | | DUE DATE
(01-12) (01-31) (2013-2015)
MONTH DAY YEAR
INTERVIEWER INSTRUCTION: ALLOW REFUSAL FOR MM/DD/YYYY
INTERVIEWER INSTRUCTION: IF DAY UNKNOWN RECORD ONLY MONTH AND YEAR.
DON’T KNOW d
REFUSED r
SOFT CHECK: IF DATE GIVEN FOR BABY DUE IS ON OR BEFORE DATE OF INTERVIEW [DATE BABY DUE < DATE OF INTERVIEW] ASK: I want to make sure I have the date the baby is due recorded correctly, you told me the baby is due [Fill date from C14a] is that correct? INTERVIEWER CORRECT DATE GIVEN IF NECESSARY IN C14a. |
A11b=1 OR C14=1 |
C
NSFG
EG-12a
Definitely yes, 1
Probably yes, 2
Probably no, or 3
Definitely no? 4 GO TO C15
DON’T KNOW d
REFUSED r
[A11b=1 OR C14=1] and c14b=1,2,3 d or r |
C
NSFG
EG-17
SOONER 1
RIGHT TIME 2
LATER 3
DIDN’T CARE 4
DON’T KNOW d
REFUSED r
all |
C
Modified
from BSF baseline
| | | CHILDREN
(0-99)
DON’T KNOW d
REFUSED r
all |
IF A3a = 1 FILL “women”, IF A3a = 2, FILL “men” |
C
BSF
baseline
| | | # OF CHILDREN WITH OTHER PARTNER(S)
(0-99)
DON’T KNOW d
REFUSED r
all |
IF A3a = 1 FILL “Men”, IF A3a = 2, FILL ”WOMEN” |
if a3a = 1, Fill ”Her, if a3a = 2, fill ”HIS |
C
BSF
baseline modified
| | | # OF CHILDREN WITH OTHER PARTNER(S)
(0-99)
DON’T KNOW d
REFUSED r
ALL |
C
BSF
baseline modified
YES 1
NO 0 GO TO C19
DON’T KNOW d GO TO C19
REFUSED r GO TO C19
C18 = 1 |
C18a. How many adopted children do you or [PARTNER/SPOUSE NAME] have?
P
BSF
baseline modified
| | | # OF CHILDREN
(0-99)
DON’T KNOW d
REFUSED r
SOFT CHECK: IF C18a=0 AND C18=1 ASK RESPONDENT: How many adopted children do you or [PARTNER/SPOUSE NAME] have? IF ANSWER REMAINS 0, RECODE C18.
PROGRAMMER INSTRUCTION: IF C15+C16+C17+C18a=0 GO TO E1 IF C15 + C16 + C17 +C18a ≥ 1 GO TO C19 |
IF c18=0 FILL NUMBER IF [c15 + c16 + c17 ≥ 1] IF c18=1 fill number if [C15 + C16 + C17+ c18a ≥ 1] |
IF c15 + c16+ C17+ C18a=0 GO TO E1 |
C19. How many of these [FILL NUMBER] children that you or [PARTNER/SPOUSE NAME] have, live with you?
IF C15+C16 +C17 + C18a=1 ASK Does this child that your or [PARTNER/SPOUSE NAME] have, live with you?”
| | | # OF CHILDREN WHO LIVE WITH RESPONDENT
(0-99)
DON’T KNOW d
REFUSED r
PROGRAMMER INSTRUCTION: IF C19=0 GO TO D11, ELSE GO TO D1 |
programmer: We will roster for up to 10 children. THIS INCLUDES ALL children OF respondent including biological, adopted and step children living in the respondents’ household |
Now, we want to talk about the children in your home. In this section, we want to focus on your or [PARTNER/SPOUSE NAME’s] biological children or adopted children who live with you all or most of the time. Please do not include any current pregnancies.
|
CHILD 1 |
CHILD 2 |
CHILD 3 |
T
BSF D1. [FOR CHILD 1 (IF C19 > 1), FILL: Starting with the youngest child in your home FOR CHILD 2-10 FILL: Now thinking of the next youngest child in your home,] please spell this child’s first and last name for me. INSTRUCTION; IF RESPONDENT DOES NOT GIVE FULL NAME PROBE FOR A NAME OR INITIALS
|
FIRST NAME
LAST NAME DECEASED 1 GO TO D10 INTERVIEWER: IF D1 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
FIRST NAME
LAST NAME DECEASED 1 GO TO D10 INTERVIEWER: IF D1 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
FIRST NAME
LAST NAME DECEASED 1 GO TO D10 INTERVIEWER: IF D1 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
D
BSF D2. [CHILD 1 FILL: I want to make sure that we use [CHILD FIRST NAME]’s correct first name.] Do you call [CHILD FIRST NAME] by a different name? |
YES 1 NO 0 GO TO D4 DECEASED 2 GO TO D10 INTERVIEWER: IF D2 =2, THEN SAY: I’m very sorry to hear that. Our condolences for your loss DON’T KNOW d GO TO D4 REFUSED r GO TO D4 |
YES 1 NO 0 GO TO D4 DECEASED 2 GO TO D10 INTERVIEWER: IF D2 =2, THEN SAY: I’m very sorry to hear that. Our condolences for your loss DON’T KNOW d GO TO D4 REFUSED r GO TO D4 |
YES 1 NO 0 GO TO D4 DECEASED 2 GO TO D10 INTERVIEWER: IF D2 =2, THEN SAY: I’m very sorry to hear that. Our condolences for your loss DON’T KNOW d GO TO D4 REFUSED r GO TO D4 |
D
BSF D3. Please spell that name for me. |
NOTE: IF NICKNAME, USE AS FILL FOR [CHILD FIRST NAME] IN REMAINDER OF SURVEY
NICKNAME
DECEASED 1 GO TO D10 INTERVIEWER: IF D3 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
NOTE: IF NICKNAME, USE AS FILL FOR [CHILD FIRST NAME] IN REMAINDER OF SURVEY
NICKNAME
DECEASED 1 GO TO D10 INTERVIEWER: IF D3 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
NOTE: IF NICKNAME, USE AS FILL FOR [CHILD FIRST NAME] IN REMAINDER OF SURVEY
NICKNAME
DECEASED 1 GO TO D10 INTERVIEWER: IF D3 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
D1 NOT=1, D2 NOT=2 AND D3 NOT=1FILL [CHILD FIRST NAME] FROM D1 OR D3 CODE SEX. IF NECESSARY ASK: D4. Is [CHILD FIRST NAME] a boy or girl? |
BOY 1 GIRL 2 DON’T KNOW d REFUSED r DECEASED 3 GO TO D10 INTERVIEWER: IF D4 =3, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
BOY 1 GIRL 2 DON’T KNOW d REFUSED r DECEASED 3 GO TO D10 INTERVIEWER: IF D4 =3, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
BOY 1 GIRL 2 DON’T KNOW d REFUSED r DECEASED 3 GO TO D10 INTERVIEWER: IF D4 =3, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. |
D1 NOT=1, D2 NOT=2, D3 NOT=1 AND D4 NOT-3 D5. What is [CHILD FIRST NAME]’s date of birth? |
PROGRAMMER NOTE: ALLOW REFUSAL IN MM/DD/YYYY | | | / | | | / | | | | | (0-12) (01-31) (1900-2014) MONTH DAY YEAR DECEASED 1 GO TO D10 INTERVIEWER: IF D5 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r |
PROGRAMMER NOTE: ALLOW REFUSAL IN MM/DD/YYYY | | | / | | | / | | | | | (0-12) (01-31) (1900-2014) MONTH DAY YEAR DECEASED 1 GO TO D10 INTERVIEWER: IF D5 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r |
PROGRAMMER NOTE: ALLOW REFUSAL IN MM/DD/YYYY | | | / | | | / | | | | | (0-12) (01-31) (1900-2014) MONTH DAY YEAR DECEASED 1 GO TO D10 INTERVIEWER: IF D5 =1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r |
D
PACT
developed D6. How old is [CHILD FIRST NAME]? Is that weeks, months or years? |
| | | (0-99) WEEKS 1 MONTHS 2 YEARS 3 DECEASED 4 GO TO D10 INTERVIEWER: IF D6=4, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r |
| | | (0-99) WEEKS 1 MONTHS 2 YEARS 3 DECEASED 4 GO TO D10 INTERVIEWER: IF D6=4, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r |
| | | (0-99) WEEKS 1 MONTHS 2 YEARS 3 DECEASED 4 GO TO D10 INTERVIEWER: IF D6=4, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r |
A
IF
D7, CHILD 1 = 1 OR 2 THEN GO TO D8,
OR IF
D7, CHILD 1 = 3 OR 4, GO TO D10.
IF
D7, CHILD 2 = 1 OR 2 THEN GO TO D8,
OR IF
D7, CHILD 2 = 3 OR 4, GO TO D10.
IF
D7, CHILD 3 = 1 OR 2 THEN GO TO D8,
OR IF
D7, CHILD 3 = 3 OR 4, GO TO D10.
FFCWS
tailored for PACT IF RESPONDENT SAYS CHILD DOES NOT LIVE IN HOUSEHOLD, CODE AS 4. D7. Does [CHILD FIRST NAME] live with you . . .
|
All of the time, 1 Most of the time, or 2 Some of the time? 3 NONE OF THE TIME 4 DON’T KNOW d REFUSED r |
All of the time, 1 Most of the time, or 2 Some of the time? 3 NONE OF THE TIME 4 DON’T KNOW d REFUSED r |
All of the time, 1 Most of the time, or 2 Some of the time? 3 NONE OF THE TIME 4 DON’T KNOW d REFUSED r |
|
CHILD 1 |
CHILD 2 |
CHILD 3 |
|
|
D
RWTW
tailored for PACT D8. What is [CHILD FIRST NAME]’s relationship to you? if respondent says sTEPCHILD CODE AS 3 Interviewer Instruction: if respondent says son/daughter probe for response categories |
BIOLOGICAL CHILD 1 ADOPTED CHILD 2 PARTNER’S CHILD 3 NOT RELATED 4 OTHER (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r |
BIOLOGICAL CHILD 1 ADOPTED CHILD 2 PARTNER’S CHILD 3 NOT RELATED 4 OTHER (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r |
BIOLOGICAL CHILD 1 ADOPTED CHILD 2 PARTNER’S CHILD 3 NOT RELATED 4 OTHER (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r |
||
D7, CHILD 1-10 = 1 OR 2 ASK D9, D9. What is [CHILD FIRST NAME’s] relationship to [PARTNER/SPOUSE NAME]? if respondent says sTEPCHILD CODE AS 3 Interviewer Instruction: if respondent says son/daughter probe for response categories |
BIOLOGICAL CHILD 1 ADOPTED CHILD 2 PARTNER’S CHILD 3 NOT RELATED 4 OTHER (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r |
BIOLOGICAL CHILD 1 ADOPTED CHILD 2 PARTNER’S CHILD 3 NOT RELATED 4 OTHER (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r |
BIOLOGICAL CHILD 1 ADOPTED CHILD 2 PARTNER’S CHILD 3 NOT RELATED 4 OTHER (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r |
||
A
PACT
developed
IF
C19=1 AND D10, CHILD 1=0 GO TO D11
IF
C19 ≥2 AND D10, CHILD 1=1 GO TO D1, CHILD 2
IF
C19 >1
AND D10, CHILD 1=0, d OR r
SOFT
CHECK: YOU
TOLD US YOU HAD [FILL NUMBER FROM C19] CHILDREN LIVING WITH YOU.
IS THAT CORRECT?
IF
D1, CHILD 1=1 AND D10, CHILD 1=0 GO TO E1
IF
C19=2 AND D10, CHILD 1=0 GO TO D11
IF
C19 ≥3 AND D10, CHILD 1=1 GO TO D1, CHILD 3
IF
C19 >1
AND D10, CHILD 2=0, d OR r
SOFT
CHECK: YOU
TOLD US YOU HAD [FILL NUMBER FROM C19] CHILDREN LIVING WITH YOU.
IS THAT CORRECT?
IF
[D1, CHILD1=1 AND D1, CHILD 2=1] AND [D10, CHILD 1=0 AND D10,
CHILD 2=0] GO TO E1
IF
C19=3 AND D10, CHILD 1=0 GO TO D11
IF
C19≥4 AND D10, CHILD 1=1 GO TO D1, CHILD 4
IF
C19 >1
AND D10, CHILD 3=0, d OR r
SOFT
CHECK: YOU
TOLD US YOU HAD [FILL NUMBER FROM C19] CHILDREN LIVING WITH YOU.
IS THAT CORRECT?
IF
[D1, CHILD 1=1,D1, CHILD 2=1 AND D1, CHILD 3=1] AND [D10, CHILD
1=0, D10, CHILD 2=0 AND D10, CHILD 3=0 GO TO E1 D10. Do any other biological or adopted children of you or [PARTNER/SPOUSE NAME] live in your home? |
YES 1 NO 0 DON’T KNOW d REFUSED r
|
YES 1 NO 0 DON’T KNOW d REFUSED r
|
YES 1 NO 0 DON’T KNOW d REFUSED r
|
FILL CHILD IF C15+C16+C17+C18A=1 FILL CHILDREN IF C15+C16+C17+C18A > 1 |
D
PAM
PROGRAMMER INSTRUCTION: FILL IF [C15=1 AND C16+C17 ≥1] [This includes children you have in common, as wel as children you or [PARTNER/SPOUSE NAME] have with other partners.]
PROGRAMMER INSTRUCTION: FILL IF [C15=0 AND C16+C17 ≥1] [This includes children you or [PARTNER/SPOUSE NAME] have with other partners.]
For each statement, please answer if you strongly agree, agree, are not sure, disagree, or strongly disagree.
[STATEMENT a to e] Do you strongly agree, agree, are not sure, disagree, or strongly disagree with this statement?
INTERVIEWER: Respondent can refer to Card #1 (blue card) for the answer choices.
|
CODE ONE PER ROW |
|
|||||||
|
STRONGLY AGREE |
AGREE |
NOT SURE |
DISAGREE |
STRONGLY DISAGREE |
DK |
REF |
||
a. I feel good about [PARTNER/SPOUSE NAME]’s judgment about what is right for our [child/children]. |
1 |
2 |
3 |
4 |
5 |
d |
r |
||
b. [PARTNER/SPOUSE NAME] and I are a good team. |
1 |
2 |
3 |
4 |
5 |
d |
r |
||
c. When there is a problem with [our child/one of our children], [PARTNER/SPOUSE NAME] and I work out a good solution together. |
1 |
2 |
3 |
4 |
5 |
d |
r |
||
d
BSF |
1 |
2 |
3 |
4 |
5 |
d |
r |
||
e. [PARTNER/SPOUSE NAME] pays a great deal of attention to our [child/children]. |
1 |
2 |
3 |
4 |
5 |
d |
r |
ALL |
D12. Next, I would like to have your thoughts on a few statements about families. Tell me if you strongly agree, agree, disagree, or strongly disagree with the following statements . . .
INTERVIEWER: Respondent can refer to Card #2 (yellow card) for the answer choices.
BSF
15 month follow-up |
CODE ONE PER ROW |
|||||
|
STRONGLY AGREE |
AGREE |
DISAGREE |
STRONGLY DISAGREE |
DK |
REF |
a. Single parents can bring up children just as well as couples can. |
1 |
2 |
3 |
4 |
d |
r |
b
FF |
1 |
2 |
3 |
4 |
d |
r |
c
FF |
1 |
2 |
3 |
4 |
d |
r |
d
SHM
|
1 |
2 |
3 |
4 |
d |
r |
e. It is better for children if their parents are married. |
1 |
2 |
3 |
4 |
d |
r |
f
FF
MOD FOR PACT |
1 |
2 |
3 |
4 |
d |
r |
ALL |
E
BSF
15 month follow-up modified for PACT
You can choose any number from 0 to 10.
| | | DESCRIPTION
(0-10)
DON’T KNOW d
REFUSED r
ALL |
IF C1 = 1, FILL “MARRIAGE”, IF C1 NE1 = FILL “RELATIONSHIP” |
E
Adapted
from Scott Stanley
| | | DESCRIPTION
(0-10)
DON’T KNOW d
REFUSED r
ALL |
IF C1 = 1, FILL “MARRIAGE”, IF C1 NE1 = FILL “RELATIONSHIP” |
E
Adapted
from Scott Stanley
| | | DESCRIPTION
(0-10)
DON’T KNOW d
REFUSED r
sKIP IF C5=3 |
IF C1 = 1, FILL “MARRIAGE”, IF C1 NE1 = FILL “RELATIONSHIP” |
E
SHM
YES 1
NO 0
NOT IN A RELATIONSHIP 99
DON’T KNOW d
REFUSED r
ALL |
I’m going to ask you some questions about [PARTNER/SPOUSE NAME].
E3. Tell me whether you strongly agree, agree, disagree, or strongly disagree with the following statements.
[STATEMENT a-h] Do you strongly agree, agree, disagree, or strongly disagree?
INTERVIEWER: Respondent can refer to Card #2 (yellow card) for the answer choices.
BSF
15 month follow-up
|
CODE ONE PER ROW |
|||||
|
STRONGLY AGREE |
AGREE |
DISAGREE |
STRONGLY DISAGREE |
DK |
REF |
a. [PARTNER/SPOUSE NAME] is honest and truthful with me. |
1 |
2 |
3 |
4 |
d |
r |
b. I can trust [PARTNER/SPOUSE NAME] completely. |
1 |
2 |
3 |
4 |
d |
r |
c. [PARTNER/SPOUSE NAME] can be counted on to help me. |
1 |
2 |
3 |
4 |
d |
r |
d. [PARTNER/SPOUSE NAME] knows and understands me. |
1 |
2 |
3 |
4 |
d |
r |
e. [PARTNER/SPOUSE NAME] listens to me when I need someone to talk to. |
1 |
2 |
3 |
4 |
d |
r |
f. [PARTNER/SPOUSE NAME] respects me. |
1 |
2 |
3 |
4 |
d |
r |
SKIP IF C5=3 g. [PARTNER/SPOUSE NAME] shows love and affection. |
1 |
2 |
3 |
4 |
d |
r |
h. I feel appreciated by [PARTNER/SPOUSE NAME]. |
1 |
2 |
3 |
4 |
d |
r |
ALL |
E
BSF
15 month
follow-up
[STATEMENT a - n] Does this happen often, sometimes, hardly ever, or never?
INTERVIEWER: Respondent can refer to Card #3 (green card) for the answer choices.
|
CODE ONE PER ROW |
|||||
BSF
15 month |
OFTEN |
SOMETIMES |
HARDLY EVER |
NEVER |
DK |
REF |
a. We are good at solving our differences. |
1 |
2 |
3 |
4 |
d |
r |
b
SHM
|
1 |
2 |
3 |
4 |
d |
r |
c. [PARTNER/SPOUSE NAME] is good at calming me when I get upset. |
1 |
2 |
3 |
4 |
d |
r |
d. Little arguments turn into ugly fights with accusations, criticisms, name calling or bringing up past hurts. |
1 |
2 |
3 |
4 |
d |
r |
e. We are pretty good listeners, even when we have different positions on things. |
1 |
2 |
3 |
4 |
d |
r |
f. [PARTNER/SPOUSE NAME] blames me for things that go wrong. |
1 |
2 |
3 |
4 |
d |
r |
g. Even when arguing we can keep a sense of humor. |
1 |
2 |
3 |
4 |
d |
r |
h. When we argue, I feel personally attacked by [PARTNER/SPOUSE NAME]. |
1 |
2 |
3 |
4 |
d |
r |
i
BSF |
1 |
2 |
3 |
4 |
d |
r |
j. I feel respected even when we disagree. |
1 |
2 |
3 |
4 |
d |
r |
ALL |
E5. In the last three months how often [STATEMENT A-D]…Was it often, sometimes, hardly ever, or never?
INTERVIEWER: Respondent can refer to Card #3 (green card) for the answer choices.
|
CODE ONE PER ROW |
|||||
|
OFTEN |
SOMETIMES |
HARDLY EVER |
NEVER |
DK |
REF |
a
SHM
REVISED FOR PACT |
1 |
2 |
3 |
4 |
d |
r |
b
SHM
REVISED FOR PACT |
1 |
2 |
3 |
4 |
d |
r |
c
SHM
REVISED FOR PACT |
1 |
2 |
3 |
4 |
d |
r |
d
SHM
REVISED FOR PACT |
1 |
2 |
3 |
4 |
d |
r |
ALL |
E
SHM
modified for PACT
Would you say…
Never, 0
Once, 1
Twice, 2
Three to five times, 3
More than five times? 4
DON’T KNOW d
REFUSED r
ALL |
E
BSF
15 month follow-up
BSF
36 month follow-up tailored for PACT
Definitely yes, 1
Probably yes, 2
Probably no, or 3
Definitely no? 4
WAS NEVER IN A ROMANTIC RELATIONSHIP 99
DON’T KNOW d
REFUSED r
ALL |
E
BSF
15 month follow-up
BSF
36 month follow-up tailored for PACT
YES 1
NO 0
WAS NEVER IN A ROMANTIC RELATIONSHIP 99
DON’T KNOW d
REFUSED r
The next questions are about work you have done for pay.
ALL |
F
WFNJ
tailored for PACT
YES 1 GO TO F3
NO 0
DON’T KNOW d
REFUSED r
F1 NE 1 |
F
WFNJ
tailored for PACT
| | | | | | | | GO TO F6
MONTH YEAR
(1-12) (1900-2014)
NEVER WORKED FOR PAY 0 GO TO F6
DON’T KNOW d GO TO F6
REFUSED r GO TO F6
F1=1 |
F
WFNJ
tailored for PACT
$ | | | | , | | | | AMOUNT GO TO F6
(0-999,999)
DON’T KNOW d
REFUSED r
SOFT CHECK: IF ANSWER = 0; INTERVIEWER: CONFIRM ANSWER WITH RESPONDENT. IF THEY DID RECEIVE PAY, PLEASE CHANGE THE ANSWER IN F3. |
SOFT CHECK: IF ANSWER = IS $5,000 OR ABOVE; INTERVIEWER: CONFIRM ANSWER WITH RESPONDENT THIS IS THE AMOUNT THEY MADE IN THE PAST 30 DAYS. IF NOT, PLEASE CHANGE THE ANSWER IN F3. |
F3 = D OR R |
F4. I just need to know a range. Can you tell me if it was . . .
INTERVIEWER INSTRUCTION: YOU CAN STOP READING WHEN RESPONDENT PROVIDES RANGE.
BSF
15 month follow up
Less than $500, 1 GO TO F6
Between $500 and $750, 2 GO TO F6
Between $750 and $1,000, 3 GO TO F6
Between $1,000 and $1,250, 4 GO TO F6
Between $1,250 and $,1500, 5 GO TO F6
Between $1,500 and $1,750, 6 GO TO F6
Between $1,750 and $2,000, 7 GO TO F6
Between $2,000 and $2,500, 8 GO TO F6
Between $2,500 and $,3000, 9 GO TO F6
Between $3,000 and $3,500, 10 GO TO F6
Between $3,500 and $4,000, 11 GO TO F6
Between $4,000 and $4,500, 12 GO TO F6
Between $4,500 and $5,000, 13 GO TO F6
Between $5,000 and $5,500, 14 GO TO F6
Between $5,500 and $6,000 or 15 GO TO F6
$6,000 or more? 16 GO TO F6
DON’T KNOW d
REFUSED r
F4=D OR R |
F
WFNJ
INTERVIEWER INSTRUCTION: IF LESS THAN 1 WEEK, CODE AS 1.
| | WEEKS
(1-4)
DON’T KNOW d GO TO F6
REFUSED r GO TO F6
F4a = ANSWER |
F
RWTW
tailored for PACT
| | | HOURS PER WEEK
(1-98.9)
99 OR MORE HOURS PER WEEK 99
DON’T KNOW d GO TO F6
REFUSED r GO TO F6
F4b =ANSWER |
F
RWTW
tailored for PACT
$ | | | | . | | | PER HOUR
(1-999.99)
DON’T KNOW d GO TO F6
REFUSED r GO TO F6
AMOUNT = 4a ANSWER X 4b ANSWER X 4c ANSWER |
F
RWTW
YES 1
NO 0 GO TO F4a
DON’T KNOW d GO TO F4a
REFUSED r GO TO F4a
SOFT CHECK: IF F4d=0, d or r Say: Ok, let’s go over this again… INTERVIEWER: GO TO F4a |
PROGRAMMER: if F4D= NO, DON’T know OR REFUSED TWICE, GO TO F5. |
If answer at f4d |
F
RWTW
tailored for PACT
YES 1
NO 0 GO TO F6
DON’T KNOW d GO TO F6
REFUSED r GO TO F6
F5=1 |
F
RWTW
tailored for PACT
$ | | | | , | | | | AMOUNT Go to F6
(0-999,999)
DON’T KNOW d
REFUSED r
SOFT CHECK: IF ANSWER = 0; INTERVIEWER: CONFIRM ANSWER WITH RESPONDENT. IF THEY DID NOT RECEIVE TIPS, BONUSES, OR COMMISSIONS, GO BACK TO F5 AND CHANGE TO NO. |
F5a = d or r |
F5b. I just need to know a range. Can you tell me if it was . . .
INTERVIEWER INSTRUCTION: YOU CAN STOP READING WHEN RESPONDENT PROVIDES RANGE.
BSF
15 month follow up
Less than $500, 1
Between $500 and $750, 2
Between $750 and $1,000, 3
Between $1,000 and $1,250, 4
Between $1,250 and $1,500, 5
Between $1,500 and $1,750, 6
Between $1,750 and $2,000, 7
Between $2,000 and $2,500, 8
Between $2,500 and $3,000, 9
Between $3,000 and $3,500, 10
Between $3,500 and $4,000, 11
Between $4,000 and $4,500, 12
Between $4,500 and $5,000, 13
Between $5,000 and $5,500, or 14
Between $5,500 and $6,000? 15
$6,000 or more? 16
DON’T KNOW d
REFUSED r
all |
F
WFNJ
Do you currently own your home, rent it, pay some amount toward rent, live rent free with a friend or relative, or do you have some other arrangement?
OWN OR HAVE MORTGAGE 1
RENT 2
PAY SOME OF THE RENT 3
LIVE RENT FREE (SOMEONE ELSE RENTS/OWNS HOUSE) 4
LIVE IN SHELTER 5
LIVE ON STREETS 6
LIVE IN ABANDONED BUILDING/CAR 7
OTHER (SPECIFY) 99
(STRING 250)
DON’T KNOW d
REFUSED r
IF OTHER SPECIFY (99): What is the other arrangement? |
all |
F
BSF
15 month follow-up
|
CODE ONE PER ROW |
|
|||
|
YES |
NO |
DK |
REF |
|
a. You could not pay the full amount of the rent or mortgage that you were supposed to pay? |
1 |
2 |
d |
r |
|
b. You had service turned off by the water, gas or electric company, or the oil company would not deliver oil because you could not afford to pay the bill? |
1 |
2 |
d |
r |
|
c. You were evicted from your home or apartment because you could not pay the rent or mortgage? |
1 |
2 |
d |
r |
|
d
Gallup |
1 |
2 |
d |
r |
all |
Texas SITE fill [Texas works] for [local name of tanf] NY and FL SITES NO FILL [local name of tanf] |
F8. Now, I’m going to ask you about some benefits you or members of your household may have received.
In the past 30 days, please tell me whether you, [PARTNER/SPOUSE NAME], or the children who live with you received cash welfare which is also known as TANF, [or [LOCAL NAME OF TANF]]?
P
BSF
15 month follow-up
YES 1
NO 0
DON’T KNOW d
REFUSED r
all |
F9. In the 30 days, please tell me whether you, [PARTNER/SPOUSE NAME], or the children who live with you received food stamps, also known as Supplemental Nutrition Assistance Program, or SNAP benefits.
P
BSF
15 month follow-up
YES 1
NO 0
DON’T KNOW d
REFUSED r
The next questions are about your relationship with your biological parents.
ALL |
G1. When you were growing up—that is before you turned 18—did you live most of the time with . . .
BSF
15 month follow up
Both your biological mother and your biological father, 1
Your biological mother only, 2 GO TO G3
Your biological father only, or 3 GO TO G3
Neither of your biological parents? 4 GO TO G3
DON’T KNOW d GO TO G3
REFUSED r GO TO G3
g1=1 |
G
BSF
15 month follow up modified for PACT
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
G3. Were your biological parents ever married to each other?
Y
BSF
15 month follow up
NO 0
DON’T KNOW d
REFUSED r
The next question is about how you are doing.
all |
G4. Over the last two weeks, how often have you been bothered by any of the following problems?
PHQ-8
Would you say that the problem happened not at all, several days, more than half the days, or nearly every day in the last two weeks?
INTERVIEWER: Respondent can refer to Card #4 (pink card) for the answer choices.
|
CODE ONE RESPONSE PER ROW |
|||||
|
NOT AT ALL |
SEVERAL DAYS |
MORE THAN HALF THE DAYS |
NEARLY EVERY DAY |
DK |
REF |
a. Little interest or pleasure in doing things. |
0 |
1 |
2 |
3 |
d |
r |
b. Feeling down, depressed, or hopeless. |
0 |
1 |
2 |
3 |
d |
r |
c. Trouble falling or staying asleep, or sleeping too much. |
0 |
1 |
2 |
3 |
d |
r |
d. Feeling tired or having little energy. |
0 |
1 |
2 |
3 |
d |
r |
e. Poor appetite or overeating. |
0 |
1 |
2 |
3 |
d |
r |
f. Feeling bad about yourself—or that you are a failure or have let yourself or your family down. |
0 |
1 |
2 |
3 |
d |
r |
g. Trouble concentrating on things, such as reading the newspaper or watching television. |
0 |
1 |
2 |
3 |
d |
r |
h. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual. |
0 |
1 |
2 |
3 |
d |
r |
I would like to ask you a few questions about your experience with the criminal justice system.
all |
G
BSF
YES 1
NO 0 GO TO G9
DON’T KNOW d GO TO G9
REFUSED r GO TO G9
G5 = 1 |
G
SVORI
INTERVIEWER: CODE 0 IF NEVER ARRESTED
| | | TIMES
(1-200)
NEVER ARRESTED 0 GO TO G9
DON’T KNOW d GO TO G9
REFUSED r GO TO G9
g6 GE 1 |
G
PACT
DEVELOPED
YES 1
NO 0 GO TO G9
DON’T KNOW d GO TO G9
REFUSED r GO TO G9
G7 = 1 |
G8. Are you currently on parole or probation?
Y
SVORI
NO 0
DON’T KNOW d
REFUSED r
Now, I would like to ask you a few questions about [PARTNER/SPOUSE NAME’S] experience with the criminal justice system.
all |
G
BSF
YES 1
NO 0 GO TO H1
DON’T KNOW d GO TO H1
REFUSED r GO TO H1
G9=1 |
FILL “he” IF A3a=2, FILL “she” IF A3a=1 |
G
SVORI
YES 1
NO 0
DON’T KNOW d
REFUSED r
Now, I’d like to ask you some questions about your interest in [PROGRAM NAME].
ALL |
C15 + C16 + C17 + c18a = 1 say “CHILD”, C15 + C16 + C17 + c18a > 1, say “children”. |
H1. People apply to relationship programs for different reasons. I’m going to read you three reasons why people might apply to these programs. Please tell me which of these reasons was most important to you when you decided to apply to [PROGRAM NAME].
PROGRAMMER: FILL a-c
Which of these reasons was most important to you when you decided to apply to [PROGRAM NAME]?
CODE ANSWER AS ‘1’ (MOST IMPORTANT)
PACT
developed |
CODE ONE ONLY |
||
|
NUMBER |
DK |
REF |
a. Improving your relationship with your [child/children]. |
| | (1) |
d |
r |
b. Improving your job situation. |
| | (1) |
d |
r |
c. Improving your relationship with [PARTNER/SPOUSE NAME]. |
| | (1) |
d |
r |
ALL |
C15 + C16 + C17 + c18a = 1 say “CHILD”, C15 + C16 + C17 + c18a > 1, say “children”. |
H1a. Now, of the two remaining reasons, [PROGRAMMER: FILL REMAINING CHOICES] which of these two was most important to you in your decision to apply to the program?
CODE ANSWER AS ‘2’ (2ND MOST IMPORTANT)
INTERVIEWER: CODE REMAINING OPTION AS ‘3’.
PACT
developed |
CODE ONE PER ROW |
||
|
NUMBER |
DK |
REF |
a. Improving your relationship with your [child/children]. |
| | (2-3) |
d |
r |
b. Improving your job situation. |
| | (2-3) |
d |
r |
c. Improving your relationship with [PARTNER/SPOUSE NAME]. |
| | (2-3) |
d |
r |
all |
H
PACT
developed
| | | DESCRIPTION
(0-10)
DON’T KNOW d
REFUSED r
all |
H
PACT
developed
| | | DESCRIPTION
(0-10)
DON’T KNOW d
REFUSED r
We are almost finished. I just have a few more questions that will help us contact you in about a year. We will only use this information, including your social networking accounts, if we cannot reach you with the information you provided us.
ALL |
I1. What is your email address?
(STRING 50)
DON’T HAVE ONE 0
DON’T KNOW d
REFUSED r
ALL |
I
Youthbuild
Do you have a Facebook account?
YES 1
NO 0 GO TO I3
DON’T KNOW d GO TO I3
REFUSED r GO TO I3
i2=1 |
I2a. What name do you use on Facebook?
(STRING 50)
DON’T KNOW d
REFUSED r
ALL |
I3. Do you have a MySpace account?
YES 1
NO 0 GO TO I4
DON’T KNOW d GO TO I4
REFUSED r GO TO I4
I3=1 |
I3a. What name do you use on MySpace?
(STRING 50)
DON’T KNOW d
REFUSED r
ALL |
I4. Do you have a Twitter account?
YES 1
NO 0 GO TO I5
DON’T KNOW d GO TO I5
REFUSED r GO TO I5
i4=1 |
I4a. What name do you use on Twitter?
(STRING 50)
DON’T KNOW d
REFUSED r
ALL |
I5. Do you have a social networking account other than Facebook, MySpace, or Twitter?
YES 1
NO 0 GO TO I6a
DON’T KNOW d GO TO I6a
REFUSED r GO TO I6a
i5=1 |
I5a. What social networking provider do you use?
(STRING 50)
DON’T KNOW d
REFUSED r
ALL |
I6a.
We are almost finished. I just have a few more questions that will help us contact you in about a year. We will only use this information, including your social networking accounts, if we cannot reach you with the information you provided us.
What is the full name of the first person we should contact?
(STRING 50)
FIRST NAME
(STRING 50)
MIDDLE INITIAL/NAME
(STRING 50)
LAST NAME
DON’T KNOW d GO TO END1
REFUSED r GO TO END1
I6A NE D OR R |
I6b. What is his/her address?
PROBE: Is there an apartment number?
STREET 1
STREET 2
APT. #
CITY
STATE
ZIP
DON’T KNOW d
REFUSED r
I6a NE D OR R |
I6c. What is his/her relationship to you?
MOTHER 1
FATHER 2
SISTER/BROTHER 3
GRANDMOTHER/GRANDFATHER 4
FRIEND 5
OTHER (SPECIFY) 99
(STRING 50)
DON’T KNOW d
REFUSED r
IF OTHER SPECIFY (99): ENTER OTHER RELATIONSHIP TYPE |
I6a NE D OR R |
I6d. What is [his/her] home telephone number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
NO LANDLINE, ONLY CELL PHONE 0
DON’T KNOW d
REFUSED r
I6a NE D OR R |
I6e. Does [he/she] have a cell phone?
YES 1
NO 0 GO TO I6g
DON’T KNOW d GO TO I6g
REFUSED r GO TO I6g
I6e=1 |
I6f. Can I have that number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
DON’T KNOW d
REFUSED r
I6a NE D OR R |
I6g. What is [his/her] work telephone number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
NO WORK NUMBER 0
DON’T KNOW d
REFUSED r
I6a NE D OR R |
I6h. What is [his/her] email address?
(STRING 50)
EMAIL ADDRESS
DOESN’T HAVE ONE 0 GO TO I6j
DON’T KNOW d GO TO I6j
REFUSED r GO TO I6j
I6h NE 0, D, OR R |
I6i. Does [he/she] have another email address?
(STRING 50)
EMAIL ADDRESS
DON’T KNOW d
REFUSED r
I6a NE D OR R |
I6j. Which of the following is the primary social network used by this person?
Facebook, 1
Twitter, 2
MySpace, 3
a personal blog, or 4
some other social network (SPECIFY) 99
(STRING 50)
NONE 0 GO TO I7a
DON’T KNOW d GO TO I7a
REFUSED r GO TO I7a
IF OTHER SPECIFY (99): What other social network do they use? |
I6j = 1, 2, 3, 4, or 99 |
IF I6j=4, FILL “WEB ADDRESS” AND “FOR THAT PERSONAL BLOG” ELSE FILL “NAME” AND “iN THAT SOCIAL NETWORK” |
I6k. What (name/web address) does this person use (in that social network/for that personal blog)?
(STRING 50)
NAME
DON’T KNOW d
REFUSED r
SECOND CONTACT
I6A NE D OR R |
I7a. What is the full name of the second person we should contact?
(STRING 50)
FIRST NAME
(STRING 50)
MIDDLE INITIAL/NAME
(STRING 50)
LAST NAME
DON’T KNOW d GO TO END1
REFUSED r GO TO END1
I7a NE D OR R |
I7b. What is [his/her] address? PROBE: Is there an apartment number?
STREET 1
STREET 2
APT. #
CITY
STATE
ZIP
DON’T KNOW d
REFUSED r
I7a NE D OR R |
I7c. What is [his/her] relationship to you?
MOTHER 1
FATHER 2
SISTER/BROTHER 3
GRANDMOTHER/GRANDFATHER 4
FRIEND 5
OTHER (SPECIFY) 99
(STRING 50)
DON’T KNOW d
REFUSED r
IF OTHER SPECIFY (99): ENTER OTHER RELATIONSHIP TYPE |
I7a NE D OR R |
I7d. What is [his/her] home telephone number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
NO LANDLINE, ONLY CELL PHONE 0
DON’T KNOW d
REFUSED r
I7a NE D OR R |
I7e. Does [he/she] have a cell phone?
YES 1
NO 0 GO TO I7g
DON’T KNOW d GO TO I7g
REFUSED r GO TO I7g
I7e=1 |
I7f. Can I have that number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
DON’T KNOW d
REFUSED r
I7a NE D OR R |
I7g. What is [his/her] work telephone number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
NO WORK NUMBER 0
DON’T KNOW d
REFUSED r
I7a NE D OR R |
I7h. What is [his/her] email address?
(STRING 50)
EMAIL ADDRESS
DOESN’T HAVE ONE 0 GO TO I7j
DON’T KNOW d GO TO I7j
REFUSED r GO TO I7j
I7h NE 0, d, or r |
I7i. Does [he/she] have another email address?
(STRING 50)
EMAIL ADDRESS
DON’T KNOW d
REFUSED r
I7a NE D OR R |
I7j. Which of the following is the primary social network used by this person?
Facebook, 1
Twitter, 2
MySpace, 3
a personal blog, or 4
other some other social network? (SPECIFY) 99
(STRING 50)
NONE 0 GO TO I8a
DON’T KNOW d GO TO I8a
REFUSED r GO TO I8a
IF OTHER SPECIFY (99): What other social network do they use? |
I7j=1, 2, 3, 4 or 99 |
IF I7j=4, FILL “WEB ADDRESS” AND “FOR THAT PERSONAL BLOG” ELSE FILL “NAME” AND “iN THAT SOCIAL NETWORK” |
I7k. What (name/web address) does this person use (in that social network/for that personal blog)?
(STRING 50)
NAME
DON’T KNOW d
REFUSED r
THIRD CONTACT
I7a NE D OR R |
I8a. What is the full name of the third person we should contact?
(STRING 50)
FIRST NAME
(STRING 50)
MIDDLE INITIAL/NAME
(STRING 50)
LAST NAME
DON’T KNOW d GO TO END1
REFUSED r GO TO END1
I8a NE D OR R |
I8b. What is [his/her] address?
STREET 1
STREET 2
APT. #
CITY
STATE
ZIP
DON’T KNOW d
REFUSED r
I8a NE D OR R |
I8c. What is [his/her] relationship to you?
MOTHER 1
FATHER 2
SISTER/BROTHER 3
GRANDMOTHER/GRANDFATHER 4
FRIEND 5
OTHER (SPECIFY) 99
OTHER (SPECIFY) 99
(STRING 50)
DON’T KNOW d
REFUSED r
IF OTHER SPECIFY (99): ENTER OTHER RELATIONSHIP TYPE |
I8a NE D OR R |
I8d. What is [his/her] home telephone number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
NO LANDLINE, ONLY CELL PHONE 0
DON’T KNOW d
REFUSED r
I8a NE D OR R |
I8e. Does [he/she] have a cell phone?
YES 1
NO 0 GO TO I8g
DON’T KNOW d GO TO I8g
REFUSED r GO TO I8g
I8e=1 |
I8f. Can I have that number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
DON’T KNOW d
REFUSED r
I8a NE D OR R |
I8g. What is [his/her] work telephone number?
| | | | - | | | | -| | | | | TELEPHONE
(201-989) (200-999) (0000-9999)
NO WORK NUMBER 0
DON’T KNOW d
REFUSED r
I8a NE D OR R |
I8h. What is [his/her] email address?
(STRING 50)
EMAIL ADDRESS
DOESN’T HAVE ONE 0 GO TO I8j
DON’T KNOW d GO TO I8j
REFUSED r GO TO I8j
I8h NE 0, d, OR R |
I8i. Does [he/she] have another email address?
(STRING 50)
EMAIL ADDRESS
DON’T KNOW d
REFUSED r
I8a NE D OR R |
I8j. Which of the following is the primary social network used by this person?
Facebook, 1
Twitter, 2
MySpace, 3
a personal blog, or 4
Some other social network? (SPECIFY) 99
(STRING 50)
NONE 0 GO TO END1
DON’T KNOW d GO TO END1
REFUSED r GO TO END1
IF OTHER SPECIFY (99): What other social network do they use? |
I8j=1, 2, 3, 4, or 99 |
IF I8j=4, FILL “WEB ADDRESS” AND “FOR THAT PERSONAL BLOG” ELSE FILL “NAME” AND “iN THAT SOCIAL NETWORK” |
I8k. What (name/web address) does this person use (in that social network/for that personal blog)?
(STRING 50)
NAME
DON’T KNOW d
REFUSED r
END OF CALL
ALL |
END1. Those are all of the questions I have. You will receive a $10 gift card as a token of our appreciation. We will be in touch with you again in about a year to see how you are doing. As I mentioned earlier, a computer will randomly assign you and [PARTNER/SPOUSE NAME] to one of two study groups once [he/she] completes the interview. Now I need to speak with the staff person at [PROGRAM NAME], so please do not hang up. Please hand the phone back to the staff person. Thank you.
INTERVIEWER: INFORM PROGRAM STAFF THAT RESPONDENT HAS COMPLETED THE INTERVIEW.
A2 < 18 YEARS OLD AND INTRO1=1 |
END2. Thank you very much for your time. Those are all of the questions I have. Now I need to speak with the staff person at [PROGRAM NAME], so please do not hang up. Can you please hand the phone back to the staff person?
INTERVIEWER: INFORM PROGRAM STAFF THAT RESPONDENT IS NOT ELIGIBLE TO PARTICIPATE IN THE PACT STUDY BECAUSE THE RESPONDENT IS UNDER 18 YEARS OF AGE. IF PARTNER HAS NOT YET COMPLETED BASELINE, INFORM PROGRAM STAFF TO TELL PARTNER NOT TO CALL IN TO COMPLETE. PROVIDE PROGRAM STAFF WITH MPRID. DO NOT GIVE RESPONDENT A GIFT CARD.
[A3a=1 and a9a=1] or [a3a=2 and a9a=2] |
END3. Thank you very much for your time. Those are all of the questions I have. Now I need to speak with the staff person at [PROGRAM NAME], so please do not hang up. Can you please hand the phone back to the staff person?
INTERVIEWER: INFORM PROGRAM STAFF THAT RESPONDENT AND THEIR PARTNER ARE NOT ELIGIBLE TO PARTICIPATE IN THE PACT STUDY. RESPONDENT AND THEIR PARTNER ARE ELIGIBLE TO RECEIVE PROGRAM SERVICES FROM THE SITE. IF PARTNER HAS NOT YET COMPLETED BASELINE, INFORM PROGRAM STAFF TO TELL PARTNER NOT TO CALL IN TO COMPLETE. PROVIDE PROGRAM STAFF WITH MPRID. DO NOT GIVE RESPONDENT A GIFT CARD.
(INTRO1=0 AND A10=0, dk or r) OR (INTRO1=0 AND A10a=Dk or R) |
END4. Those are all of the questions I have. Now I need to speak with the staff person at [PROGRAM NAME], so please do not hang up. Can you please hand the phone back to the staff person? Thank you.
INTERVIEWER: INFORM PROGRAM STAFF THAT RESPONDENT HAS COMPLETED THE INTERVIEW AND HE OR SHE CAN ENTER THEIR INFORMATION INTO PACTIS. PROVIDE PROGRAM STAFF WITH MPRID. DO NOT GIVE RESPONDENT A GIFT CARD.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | PACT HEALTHY MARRIAGE BASELINE DATA COLLECTION |
Subject | CATI |
Author | VARIOUS |
File Modified | 0000-00-00 |
File Created | 2021-01-28 |