NEW - Instrument #19: RF Follow-up survey - Study Participants

OMB No.: 0970-0403

Expiration Date: xx/xx/20xx

PACT

Responsible Fatherhood

Follow-Up Survey

October 14, 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 45 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 1

A. CONTACT INFORMATION 1 4

B. child roster and father involvement 5

C. Focal child and parenting 14

D. relationSHIP WITH MOTHERS AND KNOWLEDGE OF CHILD SUPPORT 18

E. CO-PARENTING WITH FOCAL MOTHer 22

F. economic stability 25

G. Criminal justice involvement 32

H. well being 33

I. service receipt 37

J. contact information 2 46

all

i1. May I please speak with [SAMPLE MEMBER]? My name is [NAME] and I’m calling from Mathematica Policy Research, a research company in Princeton, New Jersey.

S

PACT Developed

PEAKING WITH SAMPLE MEMBER 1 GO TO i3

SAMPLE MEMBER COMES TO PHONE 2 GO TO i3

SAMPLE MEMBER NOT AVAILABLE 3 GO TO i2

SAMPLE MEMBER DECEASED 0 GO TO END2

i1=2

i2. When would be a good time to reach [SAMPLE MEMBER]?

I

PACT Developed

NSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

INSTRUCTION: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK.

INSTRUCTION: USE THE ‘APPOINTMENT’ TAB OR PRESS <CTRL-S> TO INVOKE THE APPOINTMENT MAKING DIALOG.

(STRING 50) GO TO i8

i1=1 OR 2

If i1 = 2, FILL “Hello, my name is [NAME] and I’m calling from Mathematica Policy Research, a research company in Princeton, New Jersey.”

i

PACT Developed

3. (Hello, my name is [NAME] and I’m calling from Mathematica Policy Research, a research company in Princeton, New Jersey.) I’m calling you about the PACT study you joined when you applied to the [GRANTEE PROGRAM] program about a year ago. You may have received a letter recently to let you know that we would be calling you for a follow-up interview for our study. I’d like to interview you today.

The interview will take about 45 minutes and you will receive $25 for completing the interview. Your participation in the survey is voluntary. You do not have to answer any questions that make you uncomfortable.

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 the interviewers 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.

You may or may not benefit from participating in this study.

Because we want to get your opinion, it is important that you answer the questions without help from anyone else. Of course, you can share what you said with others after we have completed the interview.

This interview may be recorded so my supervisor can monitor the interview and make sure that the questions are asked correctly. These recordings will be destroyed when the study is completed.

Is now a good time to start?

YES 1 GO TO i5

NO 0

i3=0

i

PACT Developed

4. When would be a good time to do the interview?

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

INSTRUCTION: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK.

INSTRUCTION: USE THE ‘APPOINTMENT’ TAB OR PRESS <CTRL-S> TO INVOKE THE APPOINTMENT MAKING DIALOG.

(STRING 50) GO TO i8

i3=1

i5. I just need to verify that I am speaking with the correct person. What is your date of birth?

PACT Developed

| | | / | | | / | | | | |

MONTH DAY YEAR

(1-12) (1-31) (1900-1996)

PROGRAMMER NOTE: IF AT LEAST 2 DATA ELEMENTS MATCH GO TO A1a

DON’T KNOW d GO TO i6

REFUSED r GO TO i6

BIRTHDAY INCORRECT= LESS THAN 2 DATA ELEMENTS MATCH MM/DD/YYYY GO TO i6

PROGRAMMER: NOTE AT LEAST TWO PIECES OF BIRTHDAY INFORMATION MUST MATCH FOR VERIFICATION (FOR EXAMPLE, MONTH AND YEAR)

i5=BIRTHDATE INCORRECT, d OR r

i

PACT Developed

6. And what are the last 4-digits of your Social Security Number?

| | | | | DESCRIPTION IF MATCH GO TO A1a

(0000-9999)

DON’T KNOW d GO TO i7

REFUSED r GO TO i7

SSN INCORRECT FF GO TO i7

i6= D, R or FF

i

PACT Developed

7. I’m sorry. I need to check my records before I can interview you. Is this the best time to reach you in the future?

YES 1

NO, CALL BACK INFO 0

(STRING 50)

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

i7=answer

i

PACT Developed

8. Thank you for taking time to speak with me. Good-bye.

Great. Thank you for taking the time to talk with me today. Before we get started, I would like to make sure we have your name recorded correctly.

ALL

A

BSF 36 Month Follow-up

1a. Can you verify your first name?

PROBE: Can you spell that for me please?

(STRING 50)

FIRST NAME

ALL

A

BSF 36 Month Follow-up

1b. And your middle name please?

PROBE: Can you spell that for me please?

(STRING 50)

MIDDLE NAME

ALL

A

BSF 36 Month Follow-up

1c. And your last name please?

PROBE: Can you spell that for me please?

(STRING 50)

LAST NAME

ALL

Fill [RESP FIRST name] from a1a.

A2. Are you usually called [RESP FIRST NAME] or do you go by another name?

I

BSF 15 Month Follow-up

NSTRUCTION: IF SAME JUST HIT ENTER.

PROBE: Can you spell that for me please?

(STRING 50)

FIRST NAME

Now, I would like to ask you some questions about your children.

ALL

B1. Have you had any babies since we last talked to you in [RA MONTH YEAR]? Please only include babies that are biologically related to you.

PACT developed

INTERVIEWER INSTRUCTION: IF B1= 2, 4, or 6 (BABY DIED), SAY: “I am sorry for your loss.”

YES 1 B2

YES, BUT BABY DIED 2 B4

NO 3 B3

NO, MISCARRIAGE 4 B4

NO, ABORTION 5 B4

NO, BABY DIED 6 B4

DON’T KNOW d B4

REFUSED r B4

IF BASELINE C0 = 1 AND FOLLOW-UP B1=3

B1a. Our records indicate that the last time we talked to you in [RA MONTH YEAR] you were expecting a baby. Was that baby born?

IF RESPONDENT ANSWERS ‘NO’ WITHOUT EXPLANATION, PROBE: I’m sorry…what happened?

PACT developed

INTERVIEWER INSTRUCTION: IF B1A=2, 4, or 6 (BABY DIED), SAY: “I am sorry for your loss.”

YES 1 B2

YES, BUT BABY DIED 2 B4

NO 3 B4

NO, MISCARRIAGE 4 B4

NO, ABORTION 5 B4

NO, BABY DIED 6 B4

NO, DENY PREGNANCY 7 B4

DON’T KNOW d B4

REFUSED r B4

if b1 = 1 or b1a = 1

B

BSF 15 month follow-up

2. ENTER WITHOUT ASKING IF KNOWN: OTHERWISE PROBE:

How many babies have you had since [RA DAY MONTH YEAR]? Please include only babies that are biologically related to you.

INTERVIEWER INSTRUCTION: ENTER THE NUMBER OF BABIES BORN

INTERVIEWER INSTRUCTION: IF B2=0 (BABY DIED), SAY: “I am sorry for your loss.”

| | |NUMBER OF BABIES BORN GO TO B3

(1-99)

BABY DIED 0 GO TO B4

if b1 = 1 or b1a = 1

If b2 = 1, fill “Child”, if b2 > 1, fill children

Now I would like to ask you a few questions about the [child/children] you just told me about.

PROGRAMMER:

CONTINUE LOOP FOR CHILDREN REPORTED AT B2 UP TO 3 CHILDREN.

PACT developed	CHILD 1	CHILD 2	CHILD 3
IF B2 >0 B3. [FOR CHILD 1 (IF B2 >1), SAY: Thinking of the youngest baby born since [RA month year]/ [IFB2=1, SAY]: Please spell your baby’s first and last name for me. FOR CHILD 2-3: Now thinking of the next child born since] [RA month year], please spell that baby’s first and last name for me…	(STRING 50) FIRST NAME (STRING 50) LAST NAME DON’T KNOW d REFUSED r	(STRING 50) FIRST NAME (STRING 50) LAST NAME DON’T KNOW d REFUSED r	(STRING 50) FIRST NAME (STRING 50) LAST NAME DON’T KNOW d REFUSED r
I PACT developed f B2>0 FILL [BABY FIRST NAME] NAME FROM B3 B3a. I want to make sure that we use [BABY FIRST NAME]’s correct first name. Do you call [BABY FIRST NAME] by a different name?	YES 1 NO 0 GO TO B3c DON’T KNOW d GO TO B3c REFUSED r GO TO B3c	YES 1 NO 0 GO TO B3c DON’T KNOW d GO TO B3c REFUSED r GO TO B3c	YES 1 NO 0 GO TO B3c DON’T KNOW d GO TO B3c REFUSED r GO TO B3c
B PACT developed 3a = 1 B3b. Please spell that name for me.	(STRING 50) NAME DON’T KNOW d REFUSED r	(STRING 50) NAME DON’T KNOW d REFUSED r	(STRING 50) NAME DON’T KNOW d REFUSED r
I PACT developed NTERVIEWER: CODE SEX. IF NECESSARY ASK: B3c. Is this baby a boy or a girl?	BOY 1 GIRL 2 DON’T KNOW d REFUSED r	BOY 1 GIRL 2 DON’T KNOW d REFUSED r	BOY 1 GIRL 2 DON’T KNOW d REFUSED r
B2>0 B3d. What is [BABY FIRST NAME]’s date of birth?	PROGRAMMER NOTE: ALLOW REFUSAL IN MM/DD/YYYY | | |/| | |/| | | | | GO TO B3f (0-12) (01-31) (1900-2013) MONTH DAY YEAR DECEASED 1 INTERVIEWER: IF B3d=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 | | |/| | |/| | | | | GO TO B3f (0-12) (01-31) (1900-2013) MONTH DAY YEAR DECEASED 1 INTERVIEWER: IF B3d=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 | | |/| | |/| | | | | GO TO B3f (0-12) (01-31) (1900-2013) MONTH DAY YEAR DECEASED 1 INTERVIEWER: IF B3d=1, THEN SAY: I’m very sorry to hear that. Our condolences for your loss DON’T KNOW d REFUSED r
B PACT developed 3d=d OR r B3e. How old is [BABY FIRST NAME]? Is that weeks, months or years?	| | |.| | (0-99.9) WEEKS 1 MONTHS 2 YEARS 3 DECEASED 4 INTERVIEWER: IF B3e=4, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r	| | |.| | (0-99.9) WEEKS 1 MONTHS 2 YEARS 3 DECEASED 4 INTERVIEWER: IF B3e=4, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r	| | |.| | (0-99.9) WEEKS 1 MONTHS 2 YEARS 3 DECEASED 4 INTERVIEWER: IF B3e=4, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r

PACT developed	CHILD 1	CHILD 2	CHILD 3
If B2>0 B3f. Please tell me [BABY FIRST NAME]’s mother’s first and last name. PROBE: Please spell that for me. INSTRUCTION: IF RESPONDENT DOES NOT GIVE YOU A NAME SAY: I just need a name or initials for her, I will not share this information with anyone. DO NOT CODE “0” UNLESS HE DOES NOT KNOW WHO THE CHILD’S MOTHER IS.	(STRING 50) FIRST NAME (STRING 50) LAST NAME DON’T KNOW d REFUSED r	(STRING 50) FIRST NAME (STRING 50) LAST NAME DON’T KNOW d REFUSED r	(STRING 50) FIRST NAME (STRING 50) LAST NAME DON’T KNOW d REFUSED r
B PACT developed 2>0 AND B3f NE d OR r B3g. Were you and [MOTHER FIRST NAME] married when [BABY FIRST NAME] was born?	YES 1 GO TO B4 NO 0 DON’T KNOW d REFUSED r	YES 1 GO TO B4 NO 0 DON’T KNOW d REFUSED r	YES 1 GO TO B4 NO 0 DON’T KNOW d REFUSED r
B PACT developed 2>0 AND B3g NE 1 B3h. Did you ever sign a document that identifies you as the legal father of [BABY FIRST NAME]? PROBE: This document may be called a paternity affidavit, acknowledgement of paternity, or recognition of paternity. You may have signed it at the hospital. This is a separate document from a birth certificate.	YES 1 GO TO B4 NO 0 DON’T KNOW d REFUSED r	YES 1 GO TO B4 NO 0 DON’T KNOW d REFUSED r	YES 1 GO TO B4 NO 0 DON’T KNOW d REFUSED r
B IF B2 >1 GO TO B3 NEXT CHILD, ELSE GO TO B4 IF B2 >2 GO TO B3 NEXT CHILD, ELSE GO TO B4 GO TO B4 PACT developed 2>0 AND B3g NE 1 B3i. Has a court ruled that you are [BABY FIRST NAME]’s father?	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

ALL

B4. Are you expecting a baby with anyone now?

P

PACT developed

ROBE: We are asking about current pregnancies.

YES 1 GO TO B5

NO 0 GO TO B6

DON’T KNOW d GO TO B6

REFUSED r GO TO B6

B4=1

B5. How many babies are you expecting now?

|

PACT developed

| | NUMBER OF BABIES

(1-99)

DON’T KNOW d

REFUSED r

ALL

IF B2 > 0, FILL “AS WELL AS…”

IF BASELINE C2=1, FILL “CHILD”, IF BASELINE C2 > 1, FILL “CHILDREN”

IF BASELINE C2=1, FILL “THAT CHILD”, IF BASELINE C2 > 1, FILL “THOSE CHILDREN”

IF B2=1, FILL “BABY”, IF B2 > 1, FILL “BABIES”

FILL “# OF CHILDREN AT BASELINE” FROM BASELINE C2

The last time we spoke, you said you had [# OF CHILDREN AT BASELINE] [child/children]. I’d like to start by asking you some questions about [that child/those children] [as well as the [baby/babies] you had in the past year].

PROGRAMMER: FILL NAMES OF ALL CHILDREN FROM BASELINE C3C (OR C3A IF C3C=NULL), THEN FILL NAMES OF BABIES FROM FOLLOW-UP B3. If B3a = 1 FILL NAME FROM B3 OR B3b .

PROGRAMMER: ALLOW UP TO 13 CHILDREN

	CHILD 1	CHILD 2	CHILD 3
A PACT developed LL B6. How close do you feel to [CHILD FIRST NAME]? Do you feel close, somewhat close, or not close?	CLOSE 1 SOMEWHAT CLOSE 2 NOT CLOSE 3	CLOSE 1 SOMEWHAT CLOSE 2 NOT CLOSE 3	CLOSE 1 SOMEWHAT CLOSE 2 NOT CLOSE 3
( FFCWS tailored for PACT BL C6 AGE OR BL C7 ≤ 21 years OR B2 >0) FILL “his” IF BL C5=1 OR FU B3c=1, “her” IF BL C5=2 OR FU B3c=2 B7. Who does [CHILD FIRST NAME] live with? By this we mean who has primary responsibility for [his/her] care? CODE ALL THAT APPLY IF OTHER SPECIFY (99): SPECIFY OTHER PERSON	RESPONDENT 1 CHILD’S MOTHER 2 PATERNAL GRANDPARENTS 3 MATERNAL GRANDPARENTS 4 AUNT, UNCLE, GREAT AUNT OR GREAT UNCLE 5 OTHER ADULT RELATIVE 6 FRIEND OF MOTHER 7 ADOPTIVE PARENT 8 FOSTER CARE 9 GROUP HOME 10 CHILD ON OWN/LIVING WITH A FRIEND 11 INCARCERATED 12 OTHER (SPECIFY) 99 STRING (50) DON’T KNOW d REFUSED r	RESPONDENT 1 CHILD’S MOTHER 2 PATERNAL GRANDPARENTS 3 MATERNAL GRANDPARENTS 4 AUNT, UNCLE, GREAT AUNT OR GREAT UNCLE 5 OTHER ADULT RELATIVE 6 FRIEND OF MOTHER 7 ADOPTIVE PARENT 8 FOSTER CARE 9 GROUP HOME 10 CHILD ON OWN/LIVING WITH A FRIEND 11 INCARCERATED 12 OTHER (SPECIFY) 99 STRING (50) DON’T KNOW d REFUSED r	RESPONDENT 1 CHILD’S MOTHER 2 PATERNAL GRANDPARENTS 3 MATERNAL GRANDPARENTS 4 AUNT, UNCLE, GREAT AUNT OR GREAT UNCLE 5 OTHER ADULT RELATIVE 6 FRIEND OF MOTHER 7 ADOPTIVE PARENT 8 FOSTER CARE 9 GROUP HOME 10 CHILD ON OWN/LIVING WITH A FRIEND 11 INCARCERATED 12 OTHER (SPECIFY) 99 STRING (50) DON’T KNOW d REFUSED r
( PACT developed BL C6 AGE OR BL C7 ≤ 21 years OR B2 >0) B8. How many nights in the past month did you and [CHILD FIRST NAME] stay in the same place? INTERVIEWER: ENTER “31” IF EVERY NIGHT	| | | NIGHTS GO TO B10 (00-31) DON’T KNOW d REFUSED r	| | | NIGHTS GO TO B10 (00-31) DON’T KNOW d REFUSED r	| | | NIGHTS GO TO B10 (00-31) DON’T KNOW d REFUSED r

	CHILD 1	CHILD 2	CHILD 3
WFNJ tailored for PACT B8=d OR r B9. I just need to know a range, can you tell me if it was…?	1-4 nights, 1 5-9 nights, 2 10-14 nights, 3 15-19 nights, or 4 More than 19 nights? 5 NO NIGHTS 0 DON’T KNOW d REFUSED r	1-4 nights, 1 5-9 nights, 2 10-14 nights, 3 15-19 nights, or 4 More than 19 nights? 5 NO NIGHTS 0 DON’T KNOW d REFUSED r	1-4 nights, 1 5-9 nights, 2 10-14 nights, 3 15-19 nights, or 4 More than 19 nights? 5 NO NIGHTS 0 DON’T KNOW d REFUSED r
B FFCWS 7 NE 1 B10. Have you lived with [CHILD FIRST NAME] at any time since [RA DATE]?	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
B PACT developed PACT developed 11. In the past month, how often have you spent time with [CHILD FIRST NAME] in person? Would you say, every day or almost every day, a few times a week, a few times a month, once or twice, or never?	EVERY DAY OR ALMOST EVERY DAY 1 GO TO B13 A FEW TIMES A WEEK…… 2 GO TO B12 A FEW TIMES A MONTH 3 GO TO B12 ONCE OR TWICE .4 GO TO B12 NEVER 5 DON’T KNOW d REFUSED r	EVERY DAY OR ALMOST EVERY DAY 1 GO TO B13 A FEW TIMES A WEEK…… 2 GO TO B12 A FEW TIMES A MONTH 3 GO TO B12 ONCE OR TWICE .4 GO TO B12 NEVER 5 DON’T KNOW d REFUSED r	EVERY DAY OR ALMOST EVERY DAY 1 GO TO B13 A FEW TIMES A WEEK…… 2 GO TO B12 A FEW TIMES A MONTH 3 GO TO B12 ONCE OR TWICE .4 GO TO B12 NEVER 5 DON’T KNOW d REFUSED r
B11=5, d, OR r B11a. When was the last time you spent time with [CHILD FIRST NAME] in person?	| | | / | | | | | MONTH YEAR DON’T KNOW d REFUSED r	| | | / | | | | | MONTH YEAR DON’T KNOW d REFUSED r	| | | / | | | | | MONTH YEAR DON’T KNOW d REFUSED r
B PACT developed 11a=d OR r B11b. Would you say it was three or fewer months ago, four to six months ago, seven to nine months ago, ten to twelve months ago, or more than one year ago?	3 OR FEWER MONTHS AGO 1 4 TO 6 MONTHS 2 7 TO 9 MONTHS 3 10 TO 12 MONTHS 4 MORE THAN ONE YEAR AGO 5 DON’T KNOW d REFUSED r	3 OR FEWER MONTHS AGO 1 4 TO 6 MONTHS 2 7 TO 9 MONTHS 3 10 TO 12 MONTHS 4 MORE THAN ONE YEAR AGO 5 DON’T KNOW d REFUSED r	3 OR FEWER MONTHS AGO 1 4 TO 6 MONTHS 2 7 TO 9 MONTHS 3 10 TO 12 MONTHS 4 MORE THAN ONE YEAR AGO 5 DON’T KNOW d REFUSED r
B11 NE 1 B12. In the past month, how often have you had contact with [CHILD FIRST NAME] that was not in person? This would include having talked on the phone or sent letters, birthday cards, or text messages. Would you say, every day or almost every day, a few times a week, a few times a month, once or twice, or never?	EVERY DAY OR ALMOST EVERY DAY 1 A FEW TIMES A WEEK 2 A FEW TIMES A MONTH 3 ONCE OR TWICE 4 NEVER 5 DON’T KNOW d REFUSED r	EVERY DAY OR ALMOST EVERY DAY 1 A FEW TIMES A WEEK 2 A FEW TIMES A MONTH 3 ONCE OR TWICE 4 NEVER 5 DON’T KNOW d REFUSED r	EVERY DAY OR ALMOST EVERY DAY 1 A FEW TIMES A WEEK 2 A FEW TIMES A MONTH 3 ONCE OR TWICE 4 NEVER 5 DON’T KNOW d REFUSED r

	CHILD 1	CHILD 2	CHILD 3
A PACT developed PACT developed LL B13. In the past month, did [MOTHER FIRST NAME] make it hard for you to see [CHILD FIRST NAME] never, once in awhile, somewhat often, or very often?	NEVER 1 ONCE IN AWHILE 2 SOMEWHAT OFTEN 3 VERY OFTEN 4 DON’T KNOW d REFUSED r	NEVER 1 ONCE IN AWHILE 2 SOMEWHAT OFTEN 3 VERY OFTEN 4 DON’T KNOW d REFUSED r	NEVER 1 ONCE IN AWHILE 2 SOMEWHAT OFTEN 3 VERY OFTEN 4 DON’T KNOW d REFUSED r
ALL B14. In the past month, did you buy things for [CHILD FIRST NAME] that (he/she) needed like diapers, clothes, school supplies, medicine, or other things (he/she) needed? Please only include money you spent directly on your child, not money you gave to [MOTHER FIRST NAME].	YES 1 GO TO B15, CHILD 1 NO 0 DON’T KNOW d REFUSED r	YES 1 GO TO B15, CHILD 2 NO 0 DON’T KNOW d REFUSED r	YES 1 GO TO B15, CHILD 3 NO 0 DON’T KNOW d REFUSED r
B IF BL C2 PLUS FOLLOW-UP B2 > 1 GO TO B6 NEXT CHILD ELSE GO TO B16 IF BL C2 PLUS FOLLOW-UP B2 > 2 GO TO B6 NEXT CHILD ELSE GO TO B16 IF BL C2 PLUS FOLLOW-UP B2 > 3 GO TO B6 NEXT CHILD ELSE GO TO B16 14=1 B BSF 15. How much money did you spend? PROBE: Your best guess is fine.	$| | | , | | | | AMOUNT DON’T KNOW d REFUSED r	$| | | , | | | | AMOUNT DON’T KNOW d REFUSED r	$| | | , | | | | AMOUNT DON’T KNOW d REFUSED r

all

B16. I am going to read you some statements about parenting. Please tell me whether you strongly agree, agree, disagree, or strongly disagree.

PROGRAMMER: INSERT A-D

PACT developed	CODE ONE RESPONSE PER ROW
	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
a. How I am with my children affects how they will turn out.	1	2	3	4	d	r
b. I would change my behavior if I had to in order to see my child.	1	2	3	4	d	r
c. It is good for my child to spend time with me.	1	2	3	4	d	r
d. There are things I can do if my child’s mother doesn’t want me to see my child.	1	2	3	4	d	r

B17. This question has been removed from this version.

all

B

PACT developed

18. Over the past year, have you taken specific steps to become a better father?

YES 1 GO TO C1

NO 0

DON’T KNOW d

REFUSED r

B18=0, d or r

B

PACT developed

19. Are you planning to take steps to become a better father?

YES 1

NO 0

DON’T KNOW d

REFUSED r

If FOCAL CHILD IS 0-5 ASK C1a-C1c.

If FOCAL CHILD IS 6-15 ASK C1d-C1i

IF FOCAL CHILD IS 16-21 ASK C1d, C1e, C1f, C1h, C1i

The computer has selected one of your children for me to ask additional questions about. Now I would like to ask you some questions about the time you spent with [FOCAL CHILD].

C1. How often in the past month have you…[INSERT A-I]. Would you say never, once in a while, somewhat often, or very often?

	CODE ONE RESPONSE PER ROW
	NEVER	ONCE IN A WHILE	SOMEWHAT OFTEN	VERY OFTEN	DK	REF
a PACT developed . read books or told stories to [FOCAL CHILD]?	0	1	2	3	d	r
b HM Follow-Up . fed [FOCAL CHILD] or given [him/her] something to eat?	0	1	2	3	d	r
c HM Follow-Up . played with [FOCAL CHILD] inside or outdoors?	0	1	2	3	d	r
d EHS modified . had a meal together with [FOCAL CHILD]?	0	1	2	3	d	r
e HM Follow-Up . talked with [FOCAL CHILD] about [his/her] friends?	0	1	2	3	d	r
f Panel Study of Income Dynamics HM Follow-Up . spent time with [FOCAL CHILD] doing things [he/she] likes?	0	1	2	3	d	r
g. worked on homework together?	0	1	2	3	d	r
h PACT developed . talked with [FOCAL CHILD] about things [he/she] is especially interested in?	0	1	2	3	d	r
i PACT developed . taken [FOCAL CHILD] places [he/she] needed to go?	0	1	2	3	d	r

IF FOCAL CHILD IS 0-5 ASK C2B AND C2D

IF FOCAL CHILD IS 6-21 ASK C2A-C2D.

C2. How often do you… [INSERT A-D]. Would you say never, once in a while, somewhat often, or very often?

	CODE ONE RESPONSE PER ROW
	NEVER	ONCE IN A WHILE	SOMEWHAT OFTEN	VERY OFTEN	DK	REF
a Modified from PPQ . Encourage [FOCAL CHILD] to talk about [his/her] feelings?	0	1	2	3	d	r
b Modified from PPQ . Praise [FOCAL CHILD] when [he/she] behaves well or meets a goal?	0	1	2	3	d	r
c PACT developed . Talk to [FOCAL CHILD] about how things are going at school or work?	0	1	2	3	d	r
d PACT developed . Show patience with [FOCAL CHILD] when [he/she] is upset?	0	1	2	3	d	r

IF FOCAL CHILD IS 3-15 ASK C3a-g

IF FOCAL CHILD IS 16-21 ASK C3a,C3d AND C3e

FOR C3c, FILL ‘HE’ IF BASELINE D4=1, ELSE FILL ‘SHE’

C3. Thinking about the times when [FOCAL CHILD] has done something wrong, how often do you… [INSERT a-g]. Would you say never, once in awhile, somewhat often, or very often?

	NEVER	ONCE IN A WHILE	SOMEWHAT OFTEN	VERY OFTEN	DK	REF
a Modified from CTSPC . Take away privileges from [FOCAL CHILD]?	0	1	2	3	d	r
b Modified from CTSPC . Explain why something was wrong?	0	1	2	3	d	r
c Modified from CTSPC Modified from CTSPC . Encourage [FOCAL CHILD] to do something else instead of what [he/ she] was doing wrong?	0	1	2	3	d	r
d. Shout, yell, or scream at [FOCAL CHILD]?	0	1	2	3	d	r
e Modified from CTSPC . Call [FOCAL CHILD] dumb or lazy or some other name like that?	0	1	2	3	d	r
f Modified from CTSPC . Spank [FOCAL CHILD] with your hand?	0	1	2	3	d	r
g PACT developed . Make decisions about what [FOCAL CHILD] is allowed to do when you’re together? This could include things like what [he/she] is allowed to eat or wear.	0	1	2	3	d	r

all

C4. Now, we would like your opinion on parenting. For the following statements, please answer if you strongly agree, agree, disagree, or strongly disagree. [INSERT a-c] Do you strongly agree, agree, disagree or strongly disagree?

	CODE ONE RESPONSE PER ROW
	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
a PACT developed . Parents who praise their child a lot can spoil them.	0	1	2	3	d	r
b Modified from AAPI-2 . Good children always obey their parents.	0	1	2	3	d	r
c Modified from AAPI-2 . “Because I said so!” is the only reason parents need to give.	0	1	2	3	d	r

Now I am going to read you some statements about you as a father. Please answer if you strongly agree, agree, disagree, or strongly disagree. [INSERT d-f]. Do you strongly agree, agree, disagree or strongly disagree?

	CODE ONE RESPONSE PER ROW
	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
d PACT Developed . I am confident in my parenting skills.	0	1	2	3	d	r
e PACT Developed . I like being known as a father.	0	1	2	3	d	r
f Father Role Salience . Being a father has changed me a lot.	0	1	2	3	d	r

All

C5. Are you satisfied with how much you see [FOCAL CHILD]?

YES 1 GO TO C5c

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

C5=0 or d or r

C5a. Over the past year, have you taken specific steps to see [FOCAL CHILD] more?

Y

PACT Developed

ES 1 GO TO C5c

NO 0

DON’T KNOW d

REFUSED r

C5a=0 or d or r

C5b. Are you planning to take steps to see [FOCAL CHILD] more?

YES 1

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

All

C5c. Do you strongly agree, agree, disagree or strongly disagree with the following statement. My relationship with [FOCAL CHILD] improved over the past year. Do you…

strongly agree, 1

a

PACT Developed

gree, 2

disagree, or 3

strongly disagree 4

DON’T KNOW d

REFUSED r

DO NOT ASK ABOUT A MOTHER IF SHE WAS REPORTED DECEASED AT BASELINE (BL C21 NE 5 OR BL D2 NE 6), OR IF ALL OF HER CHILDREN WERE REPORTED DECEASED (bl C6 NE 1 AND (FU B1 NE 2, 6 AND FU B1A NE 2, 6 AND FU B3D NE 1 AND FU B3E NE 4).

MOTHER FIRST NAME(S) FROM BL C8 OR BL C9a OR FU B3f

IF BL D2 NE 1, FILL “or have you never been married to each other”

IF BL D2=1, FILL “or”

	MOTHER 1	MOTHER 2	MOTHER 3
BSF tailored for PACT D1. Now I would like to talk to you about your relationship[s] with the [mother/mothers] of your [child/children]. Let’s talk about [MOTHER FIRST NAME]. Are you and [MOTHER FIRST NAME] married, divorced, [or] separated [or have you never been married to each other]?	MARRIED 1 GO TO D4 DIVORCED 2 SEPARATED 3 ANNULLED 4 NEVER MARRIED… 5 DECEASED 6 GO TO D1, MOTHER 2 IF NUMBER OF MOTHERS > 1 ELSE GO TO D11 INTERVIEWER: IF D1=6, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r	PROGRAMMER: DELETE “MARRIED” FROM QUESTION IF D1, MOTHER 1 = 1 OR 3 MARRIED 1 GO TO D4 DIVORCED 2 SEPARATED 3 ANNULLED 4 NEVER MARRIED.. 5 DECEASED 6 GO TO D1, MOTHER 2 IF NUMBER OF MOTHERS > 2 ELSE GO TO D11 INTERVIEWER: IF D1=6, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r	PROGRAMMER: DELETE “MARRIED” FROM QUESTION IF D1, MOTHER 1 = 1 OR 3 MARRIED 1 GO TO D4 DIVORCED 2 SEPARATED 3 ANNULLED 4 NEVER MARRIED.. 5 DECEASED 6 GO TO D1, MOTHER 2 IF NUMBER OF MOTHERS > 3 ELSE GO TO D11 INTERVIEWER: IF D1=6, THEN SAY: I’m very sorry to hear that. Our condolences for your loss. DON’T KNOW d REFUSED r
D IF D2=1 OR 2, GO TO D4 IF D2=3, d, OR r, GO TO D3 IF D2=1 OR 2, GO TO D4 IF D2=3, d, OR r, GO TO D3 IF D2=1 OR 2, GO TO D4 IF D2=3, d, OR r, GO TO D3 BSF 1=2, 3, 4, 5, d, OR r D2. How would you describe your current relationship with [MOTHER FIRST NAME]? We are romantically involved on a steady basis, we are involved in an on-again-off-again romantic relationship, or we are not in a romantic relationship.	ROMANTICALLY INVOLVED ON STEADY BASIS 1 INVOLVED ON-AND-OFF AGAIN 2 NOT IN ROMANTIC RELATIONSHIP 3 DON’T KNOW d REFUSED r	ROMANTICALLY INVOLVED ON STEADY BASIS 1 INVOLVED ON-AND-OFF AGAIN 2 NOT IN ROMANTIC RELATIONSHIP 3 DON’T KNOW d REFUSED r	ROMANTICALLY INVOLVED ON STEADY BASIS 1 INVOLVED ON-AND-OFF AGAIN 2 NOT IN ROMANTIC RELATIONSHIP 3 DON’T KNOW d REFUSED r
D PACT developed 2=3, d, OR r D3. Do you have any contact with [MOTHER FIRST NAME]?	YES 1 NO 0 GO TO D6 DON’T KNOW d GO TO D6 REFUSED r GO TO D6	YES 1 NO 0 GO TO D6 DON’T KNOW d GO TO D6 REFUSED r GO TO D6	YES 1 NO 0 GO TO D6 DON’T KNOW d GO TO D6 REFUSED r GO TO D6

	MOTHER 1	MOTHER 2	MOTHER 3
BSF tailored for PACT (D1=1) OR (D2=1 OR 2) OR (D3=1) D4. Do you live with [MOTHER FIRST NAME] all of the time? By this I mean you do not have another place that you consider your home. PROBE: This is where you receive your mail, have keys, pay rent.	YES 1 GO TO D6 NO 0 DON’T KNOW d REFUSED r	YES 1 GO TO D6 NO 0 DON’T KNOW d REFUSED r	YES 1 GO TO D6 NO 0 DON’T KNOW d REFUSED r
D PACT developed 4=0, d, OR r D5. How many nights a week do you stay with [MOTHER FIRST NAME] in the same place?	0 0 1 1 2 2 3 3 4 4 5 5 6 6 7 7 DON’T KNOW d REFUSED r	0 0 1 1 2 2 3 3 4 4 5 5 6 6 7 7 DON’T KNOW d REFUSED r	0 0 1 1 2 2 3 3 4 4 5 5 6 6 7 7 DON’T KNOW d REFUSED r
BSF tailored for PACT D1 NE 1 Now, I’m going to ask you some questions about the financial support you may provide to your (child/children). D6. Do you have a legal arrangement or child support order that requires you to provide financial support for any children you have with [MOTHER FIRST NAME]?	YES 1 NO 0 GO TO D8 DON’T KNOW d GO TO D8 REFUSED r GO TO D8	YES 1 NO 0 GO TO D8 DON’T KNOW d GO TO D8 REFUSED r GO TO D8	YES 1 NO 0 GO TO D8 DON’T KNOW d GO TO D8 REFUSED r GO TO D8
D BSF 6=1 D7. In the past month, how much did you pay for that legal order or arrangement you have with [MOTHER FIRST NAME]? Please do not include money you already told me about that you spent on your child, and please do not include any money you gave directly to [MOTHER FIRST NAME].	$| |,| | | | AMOUNT (0-5000) DON’T KNOW d REFUSED r	$| |,| | | | AMOUNT (0-5000) DON’T KNOW d REFUSED r	$| |,| | | | AMOUNT (0-5000) DON’T KNOW d REFUSED r

	MOTHER 1	MOTHER 2	MOTHER 3
FFCWS D1 NE 1 D8. In the past month, have you given financial support to [MOTHER FIRST NAME] directly instead of or in addition to any formal child support you may have paid?	YES 1 GO TO D9 NO 0 GO TO D10 DON’T KNOW d GO TO D10 REFUSED r GO TO D10	YES 1 GO TO D9 NO 0 GO TO D10 DON’T KNOW d GO TO D10 REFUSED r GO TO D10	YES 1 GO TO D9 NO 0 GO TO D10 DON’T KNOW d GO TO D10 REFUSED r GO TO D10
FFCWS D8=1 D9. [IF D6=1, THEN READ Not including money that you paid as part of formal child support,] How much money did you give [MOTHER FIRST NAME] in the past month? Please do not include money you already told me about that you spent directly on your child.	$| |,| | | | AMOUNT (0-5000) DON’T KNOW d REFUSED r	$| |,| | | | AMOUNT (0-5000) DON’T KNOW d REFUSED r	$| |,| | | | AMOUNT (0-5000) DON’T KNOW d REFUSED r
PAM IF MORE MOTHERS, GO TO D1, NEXT MOTHER. ELSE GO TO D11. IF MORE MOTHERS, GO TO D1, NEXT MOTHER. ELSE GO TO D11. IF MORE MOTHERS, GO TO D1, NEXT MOTHER. ELSE GO TO D11. D1 NE 6 D10. Now, I would like to ask about you and [MOTHER FIRST NAME] as parents. For the following statement, please tell me if you strongly agree, agree, disagree, or strongly disagree. [MOTHER FIRST NAME] and I are a good parenting team.	STRONGLY AGREE 1 AGREE 2 DISAGREE 3 STRONGLY DISAGREE 4 DON’T KNOW d REFUSED r	STRONGLY AGREE 1 AGREE 2 DISAGREE 3 STRONGLY DISAGREE 4 DON’T KNOW d REFUSED r	STRONGLY AGREE 1 AGREE 2 DISAGREE 3 STRONGLY DISAGREE 4 DON’T KNOW d REFUSED r

all

D11. Next, I am going to read you some statements about child support. Please answer if you strongly agree, agree, disagree, or strongly disagree. [STATEMENT A-D] Do you strongly agree, agree, disagree, or strongly disagree?

	CODE ONE RESPONSE PER ROW
	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
a PACT Developed . Fathers can get help with their child support by calling the child support agency.	1	2	3	4	d	r
b PACT Developed . A father has the right to ask for a change in the amount of his child support order.	1	2	3	4	d	r
c PACT Developed . A father is required to pay child support even if the mother of his child has a new partner.	1	2	3	4	d	r
d PACT Developed . The child support system is unfair to dads.	1	2	3	4	d	r
e PACT Developed . A father is required to pay child support even if the child’s mother prevents him from seeing his child.	1	2	3	4	d	r
f PACT Developed . It is important for children that fathers pay child support.	1	2	3	4	d	r

D6=1 for any mother

D12. Do you know how to request a change in your child support order if you lose your job or earn less money?

YES 1

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

D6=1 for any mother

D13. Do you know the name of a specific person to call at the child support agency if you have questions about your order?

YES 1

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

Now, I would like to talk about you and [FOCAL MOTHER’S FIRST NAME], as parents.

All

E1. The following statements are about how you and [FOCAL MOTHER’S FIRST NAME] work together to care for [FOCAL CHILD].

BSF 15 M

For each statement, please answer if you strongly agree, agree, disagree, or strongly disagree.

[STATEMENT A-F] Do you strongly agree, agree, disagree, or strongly disagree with this statement?

	CODE ONE RESPONSE PER ROW
	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
a PAM . I feel good about [FOCAL MOTHER’S FIRST NAME]’s judgment about what is right for [FOCAL CHILD].	1	2	3	4	d	r
b PAM . [FOCAL MOTHER’S FIRST NAME] and I would basically describe [FOCAL CHILD] in the same way.	1	2	3	4	d	r
c PAM . When there is a problem with [FOCAL CHILD], we work out a good solution together	1	2	3	4	d	r
d PAM . [FOCAL MOTHER’S FIRST NAME] and I communicate well about [FOCAL CHILD].	1	2	3	4	d	r
e PAM . [FOCAL MOTHER’S FIRST NAME] believes I am a good parent.	1	2	3	4	d	r
f PACT . I am more hopeful now than a year ago that my relationship with [FOCAL MOTHER FIRST NAME] will improve.	1	2	3	4	d	r

All

E1g. Do you get along with [FOCAL MOTHER’S FIRST NAME] better now than you did a year ago?

Y

PACT Developed

ES 1

NO 0

DON’T KNOW d

REFUSED r

All

E1h. Does [FOCAL MOTHER’S FIRST NAME] trust you more than she did a year ago?

Y

PACT Developed

ES 1

NO 0

DON’T KNOW d

REFUSED r

All

E2. Do you want to show [FOCAL MOTHER’S FIRST NAME] that you are a good parent?

Y

PACT Developed

ES 1 E2a

NO 0 E3

DON’T KNOW d E2a

REFUSED r E2a

E2=1 or d or r

E2a. Over the past year, have you taken specific steps to show [FOCAL MOTHER’S FIRST NAME] that you are a good parent?

YES 1 E3

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

E2a=0 or d or r

E2b. Are you planning to take steps sometime soon to show [FOCAL MOTHER’s FIRST NAME] that you are a good parent?

YES 1

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

D1=1 or D2=1 or 2 or D3 =1 (R HAS CONTACT WITH MOTHER) ELSE GO TO F1

E3. Now, I am going to read you some statements about things parents may experience when they are together. Tell me if this often happens, sometimes happens, rarely happens or never happens.

[STATEMENT A-F] Does this happen often, sometimes, rarely, or never?

	CODE ONE RESPONSE PER ROW
	OFTEN	SOMETIMES	RARELY	NEVER	DK	REF
a BSF 15 month follow-up . [FOCAL MOTHER’S FIRST NAME] and I are good at solving our differences.	1	2	3	4	d	r
b BSF 15 month follow-up . When [FOCAL MOTHER’S FIRST NAME] and I argue, one of us is going to say something we will regret.	1	2	3	4	d	r
c BSF 15 month follow-up . When [FOCAL MOTHER’S FIRST NAME] and I argue, I get very upset.	1	2	3	4	d	r
d BSF 15 month follow-up . [FOCAL MOTHER’S FIRST NAME] and I are pretty good listeners, even when we have different positions on things.	1	2	3	4	d	r
e BSF 15 month follow-up . When [FOCAL MOTHER’S FIRST NAME] and I argue, one of us withdraws and refuses to talk about it anymore.	1	2	3	4	d	r
f PACT developed . When [FOCAL MOTHER’S FIRST NAME] and I fight, things get physical.	1	2	3	4	d	r

Now I would like to ask some questions about your work.

ALL

F

WIA

1. Do you currently have a paid job?

YES 1 GO TO F2

NO 0 GO TO F1a

DON’T KNOW d GO TO F1a

REFUSED r GO TO F1a

F1a. Have you had any jobs in the past three months?

Y

PACT developed

ES 1 GO TO F3b

NO 0 GO TO F10

DON’T KNOW d GO TO F10

REFUSED r GO TO F10

NOTE: SPACE FOR 3RD, 4TH, AND 5TH JOB WILL BE IN CATI PROGRAM.

	JOB 1	JOB 2
F1=1 (CURRENTLY EMPLOYED) F WIA 2. Please tell me who you work for. This could be the name of a company, organization, person, or it could be yourself.	COMPANY NAME (SPECIFY) 99 (STRING 50) SELF-EMPLOYED 2 DON’T KNOW d REFUSED r	COMPANY NAME (SPECIFY) 99 (STRING 50) SELF-EMPLOYED 2 DON’T KNOW d REFUSED r
F PACT developed 1=1 (CURRENTLY EMPLOYED) F3. Do you have any other jobs now?	YES 1 GO TO F3a, JOB 2 NO 0 GO TO F3c DON’T KNOW d GO TO F3c REFUSED r GO TO F3c	YES 1 GO TO F3a, JOB 3 NO 0 GO TO F3c DON’T KNOW d GO TO F3c REFUSED r GO TO F3c
F IF F1=1 LOOP F3 AND F3a UP TO 6 JOBS UNTIL F3=(0,d, r). WHEN F3= 0,d,or r GO TO F3c. 1=1 (CURRENTLY EMPLOYED) F WIA 3a. Please tell me who you work for on that job? INTERVIEWER INSTRUCTION: ASK RESPONDENT FOR A DIFFERENT NAME THAN GIVEN AT F2.		COMPANY NAME (SPECIFY) 99 (STRING 50) SELF-EMPLOYED 2 DON’T KNOW d REFUSED r
F PACT developed 1a=1 (NOT CURRENTLY EMPLOYED) F3b. Please tell me who you worked for? INTERVIEWER INSTRUCTION: ASK RESPONDENT FOR A DIFFERENT NAME THAN GIVEN AT F2 & F3a.	COMPANY NAME (SPECIFY) 99 (STRING 50) SELF-EMPLOYED 2 DON’T KNOW d REFUSED r	COMPANY NAME (SPECIFY) 99 (STRING 50) SELF-EMPLOYED 2 DON’T KNOW d REFUSED r
I PACT developed IF F3c=1 LOOP F3b AND F3c UNTIL F3C=0,d, or r UP TO 6 JOBS. WHEN F3C=0, d, or r GO TO F4. IF F3c=1 LOOP F3b AND F3c UNTIL F3C=0,d, or r UP TO 6 JOBS. WHEN F3C=0, d, or r GO TO F4. f F3=(0, d, r) [TOLD INTERVIEW THAT NO MORE CURRENT JOBS] or F1a=1 [NOT CURRENTLY EMPLOYED BUT EMPLOYED IN PAST 3 MONTHS] F3c. Have you had any other jobs in the past three months that you haven’t told me about?	YES 1 GO TO F3b, JOB 2 NO 0 GO TO F4 DON’T KNOW d GO TO F4 REFUSED r GO TO F4	YES 1 GO TO F3b, JOB 3 NO 0 GO TO F4 DON’T KNOW d GO TO F4 REFUSED r GO TO F4
F1=1 OR F1a=1 F WIA 4. Now thinking of the job you do at [JOB NAME 1] When did you start working for [JOB NAME 1]? INTERVIEWER: RECORD MONTH AND YEAR. NOTE: ALLOW SKIP ON MONTH.	| | | / | | | | | MONTH YEAR (1-12) (1990-2014) STILL AT JOB 98 DON’T KNOW d REFUSED r	| | | / | | | | | MONTH YEAR (1-12) (1990-2014) STILL AT JOB 98 DON’T KNOW d REFUSED r
F1=1 OR F1a=1 F WIA 5. When did that job end? INTERVIEWER: RECORD MONTH AND YEAR.	| | | / | | | | | MONTH YEAR (1-12) (2013-2014) STILL AT JOB 98 DON’T KNOW d REFUSED r	| | | / | | | | | MONTH YEAR (1-12) (2013-2014) STILL AT JOB 98 DON’T KNOW d REFUSED r

	JOB 1	JOB 2
F1=1 OR F1a=1 FILL “ARE” IF F5=98, ELSE FILL “WERE” F WIA 6. Which of the following best describes your work at [JOB NAME]? (Are/Were) you working . . .	CODE ONE ONLY as a regular full-time or part-time employee, 1 for a temporary help agency, 2 self-employed, 4 as a day laborer, 5 or something else (PLEASE specify)? 99 (STRING (100)) DON’T KNOW d REFUSED r	CODE ONE ONLY as a regular full-time or part-time employee, 1 for a temporary help agency, 2 self-employed, 4 as a day laborer, 5 or something else (PLEASE specify)? 99 (STRING (100)) DON’T KNOW d REFUSED r
F1=1 OR F1a=1 FILL “IS” AND “CURRENT” IF F5=98, ELSE FILL “WAS” AND “MOST RECENT” F WIA 7. What (was/is) your (most recent/ current) rate of pay, before taxes and deductions, at that job? PROBE: If your pay (varies/varied), please provide an average amount. ACCEPT MOST CONVENIENT PAY PERIOD. SOFT CHECK: IF ANSWER IS GREATER THAN $50 PER HOUR, $2000 PER WEEK, $4000 ONCE EVERY 2 WEEKS, $4000 TWICE A MONTH, $100,000 PER YEAR, $400 DAY/DAILY, OR $8000 MONTH, SAY: “I RECORDED [F7 ANSWER]. IS THAT CORRECT?”	$ | | | |,| | | |.| | | AVERAGE (0-999,999.99) AMOUNT PER HOUR 1 PER WEEK 2 MONTH 3 ONCE EVERY TWO WEEKS 4 TWICE A MONTH 5 PER YEAR 6 DAY/DAILY 7 PER EVENT/ACTIVITY/UNIT/JOB 8 PLUS TIPS/COMMISSION/BONUS 9 OTHER (SPECIFY) 99 (STRING (100)) DON’T KNOW d REFUSED r	$ | | | |,| | | |.| | | AVERAGE (0-999,999.99) AMOUNT PER HOUR 1 PER WEEK 2 MONTH 3 ONCE EVERY TWO WEEKS 4 TWICE A MONTH 5 PER YEAR 6 DAY/DAILY 7 PER EVENT/ACTIVITY/UNIT/JOB 8 PLUS TIPS/COMMISSION/BONUS 9 OTHER (SPECIFY) 99 (STRING (100)) DON’T KNOW d REFUSED r
F1=1 OR F1a=1 IF F5=98 FILL ‘ARE’, ELSE FILL “WERE” F WIA 8. Which of the following benefits (are/were) available to you on your job (READ EACH ITEM) . . . SELECT IF AVAILABLE, BUT NOT USED.	CODE ALL THAT APPLY Health insurance or membership in an HMO or PPO plan? 1 Paid leave for holidays, vacation or illness? 2 DON’T KNOW d REFUSED r	CODE ALL THAT APPLY Health insurance or membership in an HMO or PPO plan? 1 Paid leave for holidays, vacation or illness? 2 DON’T KNOW d REFUSED r
F IF F3=1 OR F3c=1 GO TO F4 [JOB 2-6] WHEN F3 NE 1 AND F3c NE 1 OR # OF JOBS COLLECTED = 6 GO TO F10 IF F3=1 OR F3c=1 GO TO F4 [JOB 2-6] WHEN (F3 NE 1 AND F3c NE 1) OR # OF JOBS COLLECTED = 6 GO TO F10 1=1 OR F1a=1 IF F5=98 FILL “DO”, ELSE FILL “DID” F WIA 9. How many hours (do/did) you usually work in a week on this job? Your best estimate is fine.	| | | HOURS PER WEEK (0-98) 99 OR MORE HOURS PER WEEK 99 DON’T KNOW d REFUSED r	| | | HOURS PER WEEK (0-98) 99 OR MORE HOURS PER WEEK 99 DON’T KNOW d REFUSED r

all

F

PACT developed

10. Thinking about the past 3 months, was there anything else you did for pay—such as odd jobs, under-the-table jobs, side jobs or informal jobs, that we haven’t already talked about?

YES 1

NO 0 GO TO F12

DON’T KNOW d GO TO F12

REFUSED r GO TO F12

F10=1

F

PACT developed

11. What is your best guess of how much money you made from these activities over the past three months? Please do not include money you made from jobs we talked about earlier.

PROBE: Your best guess is fine.

$| | | , | | | | IN PAST THREE MONTHS

(0-99,999)

DON’T KNOW d

REFUSED r

F1=0, d, r (NOT CURRENTLY EMPLOYED)

F

PACT developed

12. Some people do not want to get a job because, for example, they are in school or caring for a young child. Would you like to get a job?

YES 1 GO TO F13

NO 0 GO TO F16

DON’T KNOW d GO TO F13

REFUSED r GO TO F13

F1=1

F

PACT developed

12a. How satisfied are you with your current job? Would you say very satisfied, somewhat satisfied, or not satisfied?

VERY SATISFIED 1 GO TO F16

SOMEWHAT SATISFIED 2 GO TO F13

NOT SATISFIED 3 GO TO F13

DON’T KNOW d GO TO F13

REFUSED r GO TO F13

F12=1 or d or r OR F12a ne 1

if F1=1 fill “better job” if F1=0, d, r fill “job”

F13. In the past month have you taken steps to find a [job/better job]?

Y

PACT developed

ES 1 GO TO F15

NO 0

DON’T KNOW d

REFUSED r

F13 ne 1

if F1=1 fill “better job” if F1=0, d, r fill “job”

F14. Are you planning to take steps to get a [job/better job] soon?

Y

PACT developed

ES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

F

PACT developed

15. Do you have an updated resume that you can give to employers?

YES 1

NO 0

DON’T KNOW d

REFUSED r

all

The next questions are about where you live.

F

WFNJ

16. 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

HII

17. In the past year, how many times have you moved?

| | | GO TO F19

(0-20)

DON’T KNOW d

REFUSED r

F17 = d or r

F

PACT developed

18. I just need a range. In the past year, would you say you moved…

1-2 times, 1

3-5 times, 2

6-9 times, 3

Or 10 or more times? 4

DON’T KNOW d

REFUSED r

ALL

F19. In the past six months, have you had difficulty paying for your housing?

YES 1

N

HII

O 0

DON’T KNOW d

REFUSED r

I would like to ask you a few questions about your experience with the criminal justice system.

all

G

BSF

1. Have you been arrested since [RA DATE]?

YES 1

NO 0 GO TO H1

DON’T KNOW d GO TO H1

REFUSED r GO TO H1

g1= 1

G

SVORI

2. How many times have you been arrested since [RA DATE]?

INTERVIEWER: CODE 0 IF NEVER ARRESTED

| | | TIMES GO TO H1

(1-99)

NEVER ARRESTED 0 GO TO H1

DON’T KNOW d

REFUSED r

g2=d or r

G

SVORI tailored for PACT

3. Would you say . . .

once or twice, 1

3 to 5 times, 2

6 or more? 3

DON’T KNOW d

REFUSED r

The next questions are about how you are doing.

all

H1. Over the last two weeks, how often have you been bothered by any of the following problems?

PROGRAMMER: INSERT a-h

Would you say that the problem happened not at all, on several days, on more than half the days, or on nearly every day in the last two weeks?

PHQ	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

all

H

PSI

2. For each of the following statements, please tell me if you strongly agree, agree, disagree, or strongly disagree. While you may not find a response that exactly states your feelings, give the response that comes closest to describing how you feel.

PROGRAMMER: INSERT a-c

PROBE: Do you strongly agree, agree, disagree, or strongly disagree?

	CODE ONE RESPONSE PER ROW
	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
a. I feel trapped by my responsibilities as a parent.	1	2	3	4	d	r
b. Sometimes I feel my [child/children] [doesn’t/don’t] like me and [doesn’t/don’t] want to be close to me.	1	2	3	4	d	r
c. When I do things for my [child/children], I get the feeling that my efforts are not appreciated very much.	1	2	3	4	d	r

all

H3. For each of the following statements, please tell me if you strongly agree, agree, disagree, or strongly disagree.

PROGRAMMER: FILL a-f

PROBE: Do you strongly agree, agree, disagree, or strongly disagree?

	CODE ONE RESPONSE PER ROW
Cabrera optimism scale	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
a. I see the future with hope and enthusiasm	1	2	3	4	d	r
b FFCWS . I have little control over the things that happen to me.	1	2	3	4	d	r
c FFCWS . There is really no way I can solve some of the problems I have.	1	2	3	4	d	r
d Cabrera optimism scale . I think I have many things to be proud of.	1	2	3	4	d	r
e FFCWS . I often feel helpless in dealing with problems.	1	2	3	4	d	r
f PACT developed . There is so much to take care of now that it’s hard for me to make plans for the future.	1	2	3	4	d	r

all

H4. Now I am going to ask you about changes that may have occurred over the past year. Please tell me if you strongly agree, agree, disagree, or strongly disagree with the following statements:

PROGRAMMER: INSERT a-f

PROBE: Do you strongly agree, agree, disagree, or strongly disagree?

	CODE ONE RESPONSE PER ROW
	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
a PACT developed . I have become a better father over the past year.	1	2	3	4	d	r
b PACT developed . I am a better role model for my [child/children] than I was a year ago.	1	2	3	4	d	r
c PACT developed . I know more about what it takes to be a responsible father now compared to a year ago.	1	2	3	4	d	r
d PACT developed . I do more to support my [child/children] financially now than I did a year ago.	1	2	3	4	d	r
e PACT developed . I have a better understanding of the child support system than I did a year ago.	1	2	3	4	d	r
f PACT developed . I am taking better care of my health now than I did a year ago.	1	2	3	4	d	r

All

H5. Are you better off financially than you were a year ago?

YES 1

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

All

H6. Do you know how to handle your money and bills better now than you did a year ago?

YES 1

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

All

H7. Is being a responsible dad more important to you now than it was a year ago?

YES 1

N

PACT Developed

O 0

DON’T KNOW d

REFUSED r

Now I would like to ask you about some of the services you may have received since [RA MONTH YEAR].

ALL

I

PACT Developed

1. Since [RA MONTH YEAR], did you participate in a program to help you with reading, writing, math skills, learning English or a program to get a GED, high school diploma, or college degree?

YES 1

NO 0 GO TO I2

DON’T KNOW d GO TO I2

REFUSED r GO TO I2

i1 = 1

I

PACT Developed

1a. Are you participating in the program now?

YES 1 GO TO I2

NO 0

DON’T KNOW d

REFUSED r

i1a= 0, d, or r

I

PACT Developed

1b. Did you complete the program?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

2. Since [RA MONTH YEAR], did you participate in a training program for a specific job, trade, or occupation?

YES 1

NO 0 GO TO I3

DON’T KNOW d GO TO I3

REFUSED r GO TO I3

i2 = 1

I2a. Are you participating in the program now?

Y

PACT Developed

ES 1 GO TO I3

NO 0

DON’T KNOW d

REFUSED r

i2a= 0, d, r

I2b. Did you complete the program?

Y

PACT Developed

ES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

3. Since [RA MONTH YEAR], did any organizations provide you with names of employers who were interviewing, or set up interviews with employers for you?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

4. Since [RA MONTH YEAR], did you participate in any group activities that helped you get a job in other ways? For example, they may have helped you create a resume, practice interviewing, or talk to you about how to look for a job.

YES 1

NO 0 GO TO I5

DON’T KNOW d GO TO I5

REFUSED r GO TO I5

i4=1

I

PACT Developed

4a. Thinking about since [RA MONTH YEAR], about how many hours in total did you attend these group activities?

PROBE: Your best estimate of the number of hours is fine.

| | | HOURS GO TO I5

(0-999)

DON’T KNOW d

REFUSED r

I4a = d OR r

I4b. I just need to know a range. Can you tell me if it was…?

PACT Developed

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

5. Since [RA MONTH YEAR], did you receive any one-on-one assistance in getting a job?

YES 1

NO 0 GO TO I6

DON’T KNOW d GO TO I6

REFUSED r GO TO I6

i5=1

I

PACT Developed

5a. Since [RA MONTH YEAR], about how many hours in total did you spend getting one-on-one for help in getting a job?

PROBE: Your best estimate of the number of hours is fine.

| | | HOURS GO TO I6

(0-999)

DON’T KNOW d

REFUSED r

I5a = d OR r

I

PACT Developed

5b. I just need to know a range. Can you tell me if it was…?

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

6. Did you have a job in which all or part of your wages were paid for by a program? Sometimes these jobs are called subsidized employment, supported work, or transitional employment.

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

7. Since [RA MONTH YEAR], did you participate in any group activities to help with parenting or being a father? These could be called workshops or classes.

YES 1

NO 0 GO TO I8

DON’T KNOW d GO TO I8

REFUSED r GO TO I8

i7=1

I

PACT Developed

7a. Since [RA MONTH YEAR], about how many hours in total did you spend in these group activities?

| | | HOURS GO TO I8

(0-999)

DON’T KNOW d

REFUSED r

I7a= d OR r

I7b. I just need to know a range. Can you tell me if it was…?

PACT Developed

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

8. Since [RA MONTH YEAR], did you receive any one-on-one assistance from a program on parenting or being a father?

YES 1

NO 0 GO TO I9

DON’T KNOW d GO TO I9

REFUSED r GO TO I9

i8=1

I

PACT Developed

8a. Since [RA MONTH YEAR], about how many hours in total did you spend getting one-on-one assistance in parenting or being a father?

| | | HOURS GO TO I9

(0-999)

DON’T KNOW d

REFUSED r

I8a = d OR r

I8b. I just need to know a range. Can you tell me if it was…?

PACT Developed

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

9. Since [RA MONTH YEAR], did you participate in any group activities to help with your romantic relationships?

YES 1

NO 0 GO TO I10

DON’T KNOW d GO TO I10

REFUSED r GO TO I10

i9=1

I

PACT Developed

9a. Since [RA MONTH YEAR], about how many hours in total did you spend in these group activities?

| | | HOURS GO TO I10

(0-999)

DON’T KNOW d

REFUSED r

I9a = d OR r

I9b. I just need to know a range. Can you tell me if it was…?

PACT Developed

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

D6 = 1 FOR ANY MOTHER

I

PACT Developed

10. Since [RA MONTH YEAR], has someone from a program or agency worked with you on managing your child support order?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

11. Since [RA MONTH YEAR], has someone from a program or agency worked with you on child custody or child visitation arrangements?

YES 1

NO 0

I DON’T HAVE CHILD CUSTODY ARRANGEMENTS 2

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

12. Since [RA MONTH YEAR], has someone from a program or agency helped you out with a legal problem not related to child support or child custody or visitation arrangements?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

13. Since [RA MONTH YEAR], has a program arranged for an event or place you can go with your children such as a party, picnic, get together, or outing?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

14. Since [RA MONTH YEAR], have you received services to help you with anger management?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

I

PACT Developed

15. Since [RA MONTH YEAR], have you received services to help you deal with a mental health, alcohol, or substance abuse problem?

YES 1

NO 0

DON’T KNOW d

REFUSED r

Program group respondents only

I

PACT Developed

16. Overall, how satisfied were you with [NAME OF RF PROGRAM]? Please give me a number on a scale from 1 to 10, where 1 is not at all satisfied and 10 is completely satisfied.

You can choose any number from 1 to 10.

| | | DESCRIPTION

(1-10)

NEVER ATTENDED PROGRAM 99 GO TO I18

DON’T KNOW d

REFUSED r

Program group respondents only I16 NE 99

I

PACT Developed

17. I am going to ask you some questions about how much [NAME OF RF PROGRAM] helped you. Tell me if the program services helped you a lot, some, or not at all.

PROGRAMMER: INSERT A-D	CODE ONE RESPONSE PER ROW
	A LOT	SOME	NOT AT ALL	DK	REF
a. did [NAME OF RF PROGRAM] help prepare you for a job or help you get a job?	1	2	3	d	r
b. did [NAME OF RF PROGRAM] help you be a better parent for your [child/children]?	1	2	3	d	r
c. did [NAME OF RF PROGRAM] help you with your relationship with your [child’s/children’s] [mother/mothers]?	1	2	3	d	r
D6=1 FOR ANY MOTHER d. did [NAME OF RF PROGRAM] help you manage your child support obligations?	1	2	3	d	r

PROGRAM GROUP RESPONDENTS ONLY

I18. How likely are you to recommend [NAME OF RF PROGRAM] to others? Would you say…

A

PACT Developed

lot, 1

Some, or 2

Not at all? 3

DON’T KNOW d

REFUSED r

We are almost finished. I just have a few more questions. These will help us contact you if we need to reach you in the future. We will only use this information, including your social networking accounts, if we cannot reach you with the other information you provided us.

all

J1. What is your current address?

PACT Developed

PROBE: Is there an apartment number?

STREET 1

STREET 2

APT. #

CITY

STATE

ZIP

all

J2. What is your current home telephone number?

PACT Developed

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO LANDLINE AT HOME 0

DON’T KNOW d

REFUSED r

all

J3. Do you have a cell phone?

Y

PACT Developed

ES 1

NO 0 GO TO J7

DON’T KNOW d GO TO J7

REFUSED r GO TO J7

J3=1

J4. What is your cell phone number?

PACT Developed

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

DON’T KNOW d

REFUSED r

J3=1

J

Youthbuild

5. I am going to ask you about the kind of cell phone service plan you have with your cell phone provider.

PROGRAMMER: INSERT A-E

	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
(STRING 100)

IF OTHER SPECIFY (99): specify other type of plan

J5d=1

J6. Is it okay for us to text you at this number?

Y

PACT Developed

ES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

J7. What is your email address?

PACT Developed

INTERVIEWER: ENTER E-MAIL ON NEXT SCREEN

(STRING 50)

DON’T HAVE ONE 0

DON’T KNOW d

REFUSED r

ALL

J

Youthbuild

8. Do you have a Facebook account?

YES 1

NO 0 GO TO END

DON’T KNOW d GO TO END

REFUSED r GO TO END

J8=1

J8a. What name do you use on Facebook?

(STRING 50)

DON’T KNOW d

REFUSED r

END OF CALL

E

PACT Developed

ND1. Thank you very much for your time. Those are all the questions I have right now. You will receive a $25 gift card as a token of our appreciation. Thank you for your participation in the PACT study.

E

PACT Developed

ND2. I am sorry to hear that, our condolences for your loss. Thank you for your time.

INTERVIEWER: BRING THIS CASE TO LOCATING FOR CONFIRMATION OF DEATH.