Enclosure 7

ID Assigned:

Location:

Recruiter Initials:

Date:

Ad running in R’s area (if ad):

Screener

Narrative FAQ: Let me tell you a little bit about this study. The Census Bureau is conducting research to make the 2020 Census work better. If you qualify for this study, we will pay you $60 to complete the interview. The interview needs to be face to face, but our interviewer can meet with you at a time and location convenient to you. The interview takes about 90 minutes. All your answers are confidential and protected by law. I have a few questions for you to make sure you qualify.

Bulleted FAQs:

• Purpose: The Census Bureau is conducting research to make the 2020 Census work better. They would like to understand more about how people react to the census as well as how well the census forms work on smartphones and tablets and how to improve them.

• Incentive: If you qualify for this study, we will pay you $60 to help us complete this research.

• RTI/RSS: RTI International is a nonprofit research organization (or RSS is a contract research firm). The Census Bureau contracted with us to conduct this research. We have assisted the Census Bureau with several research studies in the past.

• Interviews: An interviewer would conduct an interview with you. Because of the importance of this study, the interview needs to be face to face, but our interviewer can meet with you at a time and location convenient to you. The interview takes on average 90 minutes during which time you will complete a census form on your smartphone or tablet, then the interviewer will ask you some questions about how you reacted to the census.

• CONFIDENTIALITY: The study is protected by US Code Title 13. Anyone working at RTI (OR RSS), including the interviewer or me, could either go to jail or pay a fine up to $250,000 if we divulge any information about you.

• VERIFICATION: You can call the study’s project manager Mandy Sha at RTI (In SPANISH/CHINESE VERSION: Ms Sha speaks Spanish/Chinese). Her number is (312) 456-5266. I can also have project or other researchers at the Census Bureau who designed this study contact you.

• [WHEN APPROPRIATE] INTERVIEWER: I’m not sure which interviewer will be calling you, the names of the interviewers in this area are [NAME], [NAME], [NAME], but my supervisor assigns the interviewer to the case.

[Note Concerns or Questions]

START HERE

1. What is your name? _____________________

2. Are you male or female?

1. Male

2. Female

3. Other/Something Else

3. And how did you hear about this study?

   1. FRIENDS

   2. FLYER

   3. NEWSPAPER AD

   4. INTERNET AD

   5. OTHERS (SPECIFY: __________________)

4. You said that you [saw] the ad on [way heard]; Can you tell me about your situation and why you thought you might qualify for the study? (Probe: relevant data)

5. Do you work for the United States federal government?

1. YES  Explain: Unfortunately you cannot be paid for your study participation but we would still like you to participate if you qualify. Also, other household members who do not work for the federal government might qualify and could be paid.

2. NO

6. What is your age? ___________________ YEARS OLD

CODE AGE CATEGORY:

1. Under 18 – not Eligible

2. 18-34

3. 35-44

4. 45-54

5. 55-64

6. 65 and older

7. What is your highest level of education completed

1. Less than high School Equivalent

2. Completed High school / GED

3. Some college, no degree

4. college

5. Graduate education

6. Other Education System (Specify___________) Probe as necessary for US Equivalent if Respondent does not know equivalent, ask number of total years and record level name in country of origin_________________________

CODE EDUCATION CATEGORY

1. Less than HS Equivalent

2. HS Equivalent OR SOME COLLEGE

3. college+

8. Are you of Hispanic, Latino or Spanish origin?

   1. Yes

   2. No

9. What is your race and origin? [What other race or origin are you?]

MARK ALL THAT APPLY

• a. white

• b. Black or African American

• c. Middle Eastern

• d. North African

• e. American Indian/Alaska Native

• f. Asian

• g. Native Hawaiian or Pacific Islander

• h. Some Other Race___________________

• i. No other Race [for Hispanic=yes only]

10. In what country or territory were you born? [DON’T READ CHOICES. CIRCLE ONE.]

    1. United States

    2. Other (Specify: _________________________________________)

       1. When did you first move to the U.S./the Mainland? ________

       2. How many years in total have you lived in the U.S./the Mainland? ________

I now have a couple of questions about your current living situation.

11. How many people live in your household including yourself? ______________

12. And for each of the [number] people you mentioned I’d like to get their relationship to you. I don’t need their names, just their relationship to you.

MARK RELATIONSHIP HERE
_______ spouse/Partner	_______ Son-in-law or daughter-in-law
_______ Son or daughter/ Foster child	_______ Other relative
_______ Brother or sister	_______ Housemate or roommate
_______ Father or mother	_______ Landlord
_______ Grandchild	_______ Other nonrelative
_______ Parent-in-law
_______ Roomer or boarder

13. Is [Chinese/Korean/Spanish] your native language, or is your native language some other language?

a. English	b. Mandarin/Korean/Spanish c. Cantonese / Other (Specify:________________)
13A. How well do you speak Mandarin/Korean/Spanish ? a. Very Well c. Not Well b. Well d. Not at all	13C. How well do you speak English? a. Very Well c. Not Well b. Well d. Not at all
13B. How well do you read Spanish/ Korean/ Chinese simplified characters? a. Very Well c. Not Well b. Well d. Not at all	13D. How well do you read English? a. Very Well c. Not Well b. Well d. Not at all
For 13A/B only Cs & Ds circled (r English Only), Not Eligible (Skip to 15)	For 13C/D only Cs & Ds circled (r is target language monolingual), Skip to Q14 (reading ability)
Otherwise continue to Q13E

13E. Do you speak [Chinese/Korean/Spanish] better than English, English better than [Chinese/Korean/Spanish], or both about equally well?

1. [Chinese/Korean/Spanish] better than English

2. English better than [Chinese/Korean/Spanish]

3. Both about equally well

13F. Since you are bilingual, we can do the interview in either language. In which language would you prefer to do the interview if you are eligible?

1. English  Skip to Q15

2. [Chinese/Korean/Spanish]  Skip to Q15

c. Either one - prefer both equally  Skip to Q15

14. [IF Q13=B(native speaker TARGET LANGUAGE SPEAKER) How well do you read Spanish/Korean/Chinese simplified characters?

If bilingual, continue to next question

If monolingual, R is eligible for Part 2b (R as themselves)

a. Very well

If bilingual, not eligible.

b. Well

If monolingual, R is eligible for Part 2b (R as themselves)

c. Not well

 Not eligible.

d. Not at all

INTERNET PROFICIENCY QUESTIONS

15.  During the interviews [we will ask you/we are asking some participants] to access a census form on a smartphone, such as an iPhone or Android phone. Do you have a smartphone with internet access?

1. What kind of phone is that? An iPhone, android or something else?

______________________

1. SMARTPHONE WITH DATA PLAN

2. SMARTPHONE WITHOUT DATA PLAN [REQUIRE WIFI FROM ANOTHER SOURCE]

3. NO SMARTPHONE

4. Other:__________

1. What kind of tablet is that? A Kindle, iPad or something else? ______________________

16. Do you have a tablet with internet access?

a. TABLET WITH DATA PLAN

b. TABLET WITHOUT DATA PLAN

[REQUIRE WIFI FROM ANOTHER SOURCE]

c. NO TABLET

d. Other:__________

17. How comfortable are you using your [smartphone/tablet] to access the internet?

a. Very comfortable  if bilingual, R is eligible for Part 2a (R as enumerator)

b. Somewhat comfortable

If bilingual, R is not eligible for Part 2a (R as enumerator)

c. Not very comfortable

d. Not at all comfortable

Now I just need to collect your contact information.

18. What is the best phone number for me to contact you at if you qualify for the study? //Is it OK to leave texts on that number?

Phone: ____________________________Text yes/no

Is there another number as well? ____________________________ Text yes/no

18. In case you qualify for the study, I want to pass on to the interviewer some information about your general location. In what neighborhood or town do you live in? [Probe if necessary for subdivision/cross-streets/local library, if you do not know the area get cross streets (i.e. in DC/SD)]

Location: ___________________________________________________________________________________

Thank you for your information. I’m going to pass it on to my supervisor [this evening/Monday/etc.] who will let me know if you qualify for the study. If you do [I will call you back and let you know/an interviewer will also call you to set up an interview].

Screener [ONCE APPROVED: OMB Control Number: XXXX-XXXX; Expiration: XX/XX/XX 5