Screener questions

New questions.docx

Generic Clearance for Questionnaire Pretesting Research

Screener questions

OMB: 0607-0725

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Additional screener question on home ownership

This question is from the 2015 American Community Survey, and will be added to the already approved universal screener. Only one word has been changed from the ACS question: the second word has been changed from “this” to “your.”

Is this house, apartment, or mobile home –

  • Owned by you or someone in this household with a mortgage or loan? Include home equity loans.

  • Owned by you or someone in this household free and clear (without a mortgage or loan)?

  • Rented?

  • Occupied without payment of rent?



Income question

This question is from the universal screener. We would like to add a “$50,000-$75,000” category to help us more precisely stratify the focus groups by socioeconomic status.

Is your household’s annual income …

  • Less than $15,000?

  • $15,000 to $25,000?

  • $25,000 to $50,000?

  • $50,000 to $75,000?

  • $75,000 to $100,000?

  • More than $100,000?



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJessica L. Holzberg
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File Created2021-01-28

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