APPROXIMATELY HALF OF EACH GROUP SHOULD BE VA BENEFITS USERS (S9)
IMPORTANT NOTES TO RECRUITER:
If respondent asks who is conducting the research, tell him/her that it is being conducted by Whitman Strategies, an independent opinion research company, on behalf of the Department of Veterans Affairs (the “VA”) and conducted by a third-party. Instruct respondent that the information from this research will be kept private to the extent of the law. No personal identifiers will be disclosed to the VA.
If respondent terminates at any of the following questions, please politely terminate but attempt to get a name and reference (telephone or email) for a fellow area-vet, or a family member/loved one that might be willing to participate:
(IF RESPONDENT CANNOT PARTICIPATE) “I’m sorry that you cannot attend, but do you know of any buddies in the area who have served, or any of your loved ones or family members that might be interested in participating? They will be paid $75 for their time.” When pronouncing VA – say each letter separately “vee-ay”
Name:
Address:
City/State/Zip:
Phone Number:
Date:
Recruited By:
Hello, my name is ( __________ ) and I’m calling from ( ____________ ). We’re conducting a study on different issues in the area, and would like to include your views. I can assure you that we are not trying to sell you anything. If you are invited to attend the group discussion planned for this project, you’ll be paid $75 on the spot for voicing your opinions.
S1. Have you ever served on active duty in the U.S. Armed Forces? This includes serving in the U.S. Armed Forces, as well as activation from the Reserves or National Guard, and applies to combat experience as well as peacetime service.
Yes
No THANK & TERMINATE
S2. And are you currently on active duty?
Yes THANK AND TERMINAGE
No
TERMINATE LANGUAGE: “Thank you. We’re looking for veterans of active duty service.”
S2-1. When you left service, did you do so….
Under honorable discharge
Under general discharge
Under dishonorable discharge TERMINATE
Through another means (SPECIFY______________)
TERMINATE IF ANOTHER MEANS INCLUDES DISHONORABLE DISCHARGE
S3. In which branch or branches did you serve on active duty? {ACCEPT MULTIPLE RESPONSES}
Army
Navy
Air Force
Marine Corps
National Guard/Reserves
Coast Guard
S4. What is your age? ______________ (Record Age)
Under 18 {THANK & TERMINATE}
18-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-65
66-69
70+
S5. [GENDER]: {BY OBSERVATION}
Male
Female
RECRUIT MALE VETS ONLY FOR TODAY’S VETS GROUP
RECRUIT MALE VETS ONLY FOR GAP YEAR VETS
RECRUIT 2-3 FEMALE VETS FOR NEXT GEN GROUP
S6. We would like to know when you served on active duty in the U.S. Armed Forces. If there are different time periods—just tell me.
[DO NOT READ. RECORD TIME PERIOD AND VERIFY BELOW]
|
Time Period |
Conflict |
Yes, Served [CHECK BOX] |
1 |
September 2001 – Present |
Operation Enduring Freedom (Afghanistan), Operation Iraqi Freedom (Iraq), Operation New Dawn (Iraq) |
|
2 |
1990 to 2001 |
First Persian Gulf War |
|
3 |
1975 to 1990 |
|
|
4 |
1962 to 1975 |
Vietnam |
|
5 |
1955 – 1962 |
|
|
6 |
1950 to 1955 |
Korean War |
|
7 |
1947 to 1950 |
|
|
8 |
1941 to 1946 |
World War II |
|
9 |
Before 1941 |
|
|
[INTERVIEWER’S NOTE: FOR EVERY TIME PERIOD MENTIONED BY RESPONDENT THAT HAS TEXT IN CONFLICT BOX—VERIFY BY ASKING RESPONDENT IF HE/SHE SERVED DURING CONFLICT]
S6-1. Code Veteran Type:
1 |
Today’s Vets |
Male Age 55+ |
|
2 |
Gap Year Vets |
Male Age 35-54 S6=2,3 S6 does not = 1 |
|
3 |
Next Generation Vets |
Male or Female Under 45 S6=1 |
|
S7. What was your rank during your last deployment? (READ CHOICES)
E1 to E4
E5 to E8
W1 to W5
O1 to O5
O5 or above
Other _____________
S8. Have you ever applied for or used any benefits through the VA (say “vee-ay”) or Department of Veterans Affairs?
Yes
No
RECRUIT EVEN MIX OF USERS AND NON-USERS PER GROUP
S9. [IF YES in S8] Please tell me which benefits you have applied for from the VA, and which you have actually used… (DO NOT READ LIST)
|
Applied For |
Used |
Health care |
|
|
Life insurance |
|
|
Home loans |
|
|
Education or training |
|
|
Vocational rehabilitation |
|
|
Burial or memorial benefits |
|
|
Disability compensation |
|
|
Pension |
|
|
Dependent benefits |
|
|
Transition assistance |
|
|
S10. Do you belong to any of the following Veteran Service Organization?
VFW
American Legion
Blue Star Families
IAVA
Disabled American Veterans
Another (SPECIFY____________________)
None of these
And now just a few more questions to make sure we get the right mix of veterans…
S11. I’m going to read some statements, for each, tell me if the statement applies to you or not…
RANDOMIZE ORDER OF STATEMENTS
|
Yes |
No |
I suffer from severe post-traumatic stress disorder (PTSD) that makes normal day-to-day activities incredibly difficult for me |
THANK AND TERMINATE |
|
I have sustained severe physical injuries as a result of my military service that make normal day-to-day activities incredibly difficult for me |
THANK AND TERMINATE |
|
TERMINATE LANGUAGE S11: Thank you, but we have already filled our requirements. We appreciate you taking the time to answer these questions, and may be in touch in the near future for another opportunity to share your opinions.
S12. What of these best describes your marital status?
Single
Married
Living with someone
Divorced or Separated
Widower
S12-1. Which of the following income groups reflects your TOTAL HOUSEHOLD INCOME last year before taxes? (Just stop me when I read the correct category.)
{READ CODES 1-7}
Less than $25,000
$25,000 to less than $50,000
$50,000 to less than $75,000
$75,000 to less than $100,000
$100,000 to less than $150,000
$150,000 to less than $200,000
$250,000 or more
Don’t know {Do not read} {THANK & TERMINATE}
Refused/NA {Do not read} {THANK & TERMINATE}
RECRUIT MIX
S13. How would you describe your race? Changes are based on OMB’s guidance
1 White
2 Black or African-American
3 Asian
4 Native Hawaiian or Pacific Islander
5 American Indian or Alaskan Native
6. Hispanic or Latino Yes/No
7 Other {Do not read}
8 Don’t Know {Do not read}
9 Refused {Do not read}
RECRUIT MIX
S14. What do you think is the biggest issue facing this country and what would you do about it?
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
SUBMIT RESPONSES TO S15 TO WHITMAN STRATEGIES EVERY MORNING DURING RECRUITMENT PERIOD.
S15. One last question, changing the subject a little bit: If you could have dinner with any famous person, living or dead, who would you have dinner with and why?
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
IN ANSWERING THE ABOVE, RESPONDENTS MUST BE ABLE TO EASILY AND CLEARLY EXPRESS THEIR OPINIONS.
THANK AND RECRUIT
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Qualitative Screener |
Author | Anastasia Saltarelli |
File Modified | 0000-00-00 |
File Created | 2021-01-27 |