Cognitive Testing Protocol: Version 1 - English (Page 2A-2)
Cognitive Testing Protocol: Version 2 - English (Page 2A-35)
Youth Version 1 of Facility Items for Testing - English (Page 2A-54)
Youth Version 2 of Facility Items for Testing – English (Page 2A-65)
National Survey of Youth in Custody (NSYC-3)
Spanish Cognitive Interview
Guide
Version 1
Hello. My name is ( ) and I work for Westat, a research firm outside of Washington, DC. We are working with the U.S. Department of Justice on a special study called the National Survey of Youth in Custody. Today I would like to show you some of the questions we are considering for the study and get your reactions to them. Let’s start by going over some details about the study.
HAND COPY OF ASSENT FORM TO R AND READ FORM ALOUD
ANSWER PARTICIPANT’S QUESTIONS, IF ANY, AND ASK FOR ASSENT.
Are you willing to participate in this study?
IF R SAYS “YES”, ASK THEM TO MARK THE “YES” BOX. INTERVIEWER WILL THEN SIGN AND DATE THE YOUTH ASSENT FORM.
IF THE R SAYS “NO”, ASK THEM TO MARK THE “NO” BOX, THANK THEM, AND END THE INTERVIEW.
Thank you.
Now I’m going to hand you the questions a few at a time. I will read them aloud while you look at them. After I’ve finished reading the question, you can circle your answer. Later, there will be some questions that I ask you NOT to answer, but just to look at and think about. For those, I’ll let you know before I show them to you.
After you answer each question, we will stop to talk about it. I might ask you to tell me what you were thinking about when you answered the question, what the question was asking, or anything else you might think about the question. We are also interested in whether any of the words or phrases in the question are confusing or awkward. This will help us figure out how we can improve the questions.
Sometimes, I’ll ask you about some of the words in the question. If you don't understand a question, please tell me, because that's just the sort of thing I’m trying to find out here.
Do you have any questions before we begin?
SECTION 1: Staff Treatment
Here are the first set of questions. I’m going to read them aloud. Please circle your answers and then we’ll talk about the questions and the answers you gave.
[AFTER R HAS ANSWERED ALL THE ITEMS IN SECTION 2, ASK PROBES]
[INTERVIEWER: MAKE NOTE OF ANY HESITATION OR SIGNS OF CONFUSION AS RESPONDENT IS ANSWERING, AND PROBE AFTER SERIES HAS BEEN ANSWERED]
ST1. How many staff explain facility rules clearly?
|
|
Comments/Problems |
None of the staff |
1 |
|
Few of the staff |
2 |
|
Most of the staff |
3 |
|
All of the staff |
4 |
ST5. How many staff give youth the chance to tell their side before making decisions?
|
|
Comments/Problems |
None of the staff |
1 |
|
Few of the staff |
2 |
|
Most of the staff |
3 |
|
All of the staff |
4 |
ST6. How many staff act honestly?
|
|
Comments/Problems |
None of the staff |
1 |
|
Few of the staff |
2 |
|
Most of the staff |
3 |
|
All of the staff |
4 |
[IF R HESITATED OR SHOWED ANY CONFUSION:] I noticed you seemed to hesitate with question __. Can you tell me more about what you were thinking? [RECORD ISSUE NEXT TO ITEM]
How
easy or hard was it to answer these questions?
What made these
items [easy/hard]?
ST1-ST6: Easy/Hard to Answer |
|
NOTES: All Easy Hard |
Comments/Problems
|
Was
it hard to choose between All, Most, Few, or None of the staff?
[IF
YES]
Can
you tell me more about what made it hard?
ST1-ST6: Easy/Hard to Choose Between Categories |
|
NOTES: Easy Hard |
Comments/Problems
|
Any other comments on this set of questions before we move on?
NOTES: Other comments
|
SECTION 2: Misconduct/Victimization
Here is the next question. Again, I’m going to read it aloud. Please circle your answer and then we’ll talk about the question and the answer you gave.
MV10. [Since coming to this facility OR In the past 12 months] Have you been written up or charged for breaking facility rules such as talking back to staff, being out of place, or not following directions?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
[IF YES]: Can you tell me more about your answer? [RECORD RESPONSES NEXT TO ITEM]
[IF NO]: What do you think this question is asking about? [RECORD RESPONSES NEXT TO ITEM]
[ASK ALL]:
The question talks about being written up for “being out of place.” What does that mean to you?
Can you give an example of how kids can be written up for being out of place?
MV10: Comprehension of “being out of place” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
Is
being “written up” and being “charged” the
same thing or are those different?
[If
NO:] How
are they different?
MV10: Interpretation: “Written up” vs “Charged” |
|
NOTES: Same Different
|
Comments/Problems
|
SECTION 3: Education on PREA
Here is the next question. I’m going to read it aloud. Please circle your answer and then we’ll talk about the question and the answer you gave.
EP1. After you got to this facility, when did you first learn that all forms of sexual abuse and harassment are not allowed?
|
|
Comments/Problems |
On the day you got here (within the first 24 hours) |
1 |
|
Between 1 and 10 days after you got here |
2 |
|
More than 10 days after you got here |
3 |
|
You were never told that all forms of sexual abuse and harassment are not allowed |
4 |
Tell me about how you decided on your answers. [RECORD RESPONSES NEXT TO ITEM]
What
do you think this question is asking?
EP1: Question comprehension |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
[If R answered codes 1-3, CONTINUE with question and answer format]
[If R answered code 4] Even though you haven’t been told the rules about sexual activity at this facility, I would still like to talk about the next few questions about this topic. Please do not circle an answer or tell me your answer. I’m going to read this whole list and then I’ll just ask you how you interpreted some of the items.
EP3. How were you given information about these rules?
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
[IF R answered the questions]: Tell me more your answers to these items... [RECORD RESPONSES NEXT TO ITEM]
[ASK ALL]:
Do any of these items seem confusing or unclear to you? [RECORD RESPONSES NEXT TO ITEM]
What do you think is meant by a “handbook with the facility rules”? [RECORD RESPONSES NEXT TO ITEM]
What do you think is meant by “Something else”? [RECORD RESPONSES NEXT TO ITEM]
Are there any other ways you could get information about the rules that aren’t listed here?
EP3: Other ways of getting information |
|
NOTES: Yes No |
Comments
|
EP4. Is there a staff member you would feel safe reporting any sexual abuse to?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
Tell me about how you decided on your answer. [RECORD RESPONSES NEXT TO ITEM]
What do you think this question is asking?
EP4: Question comprehension |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
SECTION 4: Mental Health
These next questions will be used to get information about the mental health of youth in this facility. Please go ahead and circle your answers as I read the questions.
MH1. In the past 30 days, how often did you have each of the following experiences:
|
All of the time |
Most of the time |
Some of the time |
A little of the time |
None of the time |
Comments/Problems |
FL5. a. How often did you feel nervous? |
1 |
2 |
3 |
4 |
5 |
|
b. How often did you feel hopeless? |
1 |
2 |
3 |
4 |
5 |
|
c. How often did you feel restless or fidgety? |
1 |
2 |
3 |
4 |
5 |
|
d. How often did you feel so depressed that nothing could cheer you up? |
1 |
2 |
3 |
4 |
5 |
|
e. How often did you feel that everything was an effort? |
1 |
2 |
3 |
4 |
5 |
|
f. How often did you feel worthless? |
1 |
2 |
3 |
4 |
5 |
|
(IF ANY CODES 1-4 IN A-F, REPEAT THOSE ITEMS AS YOU READ ITEM G AND HAVE RESPONDENT CIRCLE AN ANSWER)
(IF “NONE OF THE TIME” TO ALL ITEMS A-F): For this next question, let’s assume that a youth answers that they were feeling some of these ways some of the time in the past 30 days. Here is the next question they would be asked.
|
More often |
Less often |
About the same |
Comments/Problems |
FL5. g. You said you felt the following ways in the past 30 days. • (IF MH1A=1-4) Nervous • (IF MH1B=1-4) Hopeless • (IF MH1C=1-4) Restless or fidgety • (IF MH1D=1-4) So depressed that nothing could cheer you up • (IF MH1E=1-4) Everything was an effort • (IF MH1F=1-4) Worthless Taking them altogether, did these feelings occur more often in the past 30 days than is usual for you, less often than usual, or about the same as usual? |
1 |
2 |
3 |
|
Look at item f. What do you think is meant by “worthless”? [RECORD RESPONSES NEXT TO ITEM]
Look at item g. What do you think this last question is asking about? [RECORD RESPONSES NEXT TO ITEM]
[IF RESPONDENT ANSWERED QUESTION] How did you decide on your answer to this question?
MH1g: Decide on answer |
Comments
|
[IF RESPONDENT ANSWERED QUESTION] How easy or difficult was it for you to answer?
MH1g: Easy/Difficult |
|
NOTES: Easy Difficult |
Comments/Problems
|
SECTION 5: Reporting Sexual Assault By Another Youth
These next questions will be used to get more information about sexual contact that happened between youth at this facility. Again, I do not want to know about your own experiences. I just want you to tell me what the questions might mean to someone in the facility, so please do not circle an answer for these.
[DO NOT HAVE RESPONDENT CIRCLE ANSWERS FOR SECTION 6]
D2. Before you had forced sexual contact with this other youth, did any of these things happen?
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
they treated you like a favorite or treated you better than they treat most other youth |
1 |
2 |
|
Look at item c. What do you think this is asking? What is meant by “special protection from other youth”? [RECORD RESPONSES NEXT TO ITEM]
Do you have any other comments on these questions? [RECORD RESPONSES NEXT TO ITEM]
D18SP. Where was the other youth living at the time?
In the same room as you 1
In the same housing area as you, but not in the same room 2
In a different housing area than you 3
How easy or hard would it be to answer this question?
D18SP: Easy/Hard |
|
NOTES: Easy Hard |
Comments/Problems
|
What does the term “housing area” mean in this question?
D18SP: Comprehension of “housing area” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
D19SP. How well did you know the other youth at the time?
By sight only 1
Knew the person, but not well 2
Well known 3
How easy or hard would it be to answer this question?
D19SP: Easy/Hard |
|
NOTES: Easy Hard |
Comments/Problems
|
This question asks about “knowing a person, but not well” – what do you think that means?
D19SP: Comprehension of “knew the person, but not well” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
D27. Has that youth also had any type of sexual contact with any other youth at this facility?
Yes,
I am sure they have had sexual contact with other
youth at this
facility 1
Yes,
I think they have had sexual contact with other
youth, but I am
not sure 2
No,
I don’t think they have had sexual contact with
other
youth at this facility 3
This question asks about having sexual contact with “any other youth” at this facility – what do you think that means? Does it mean just one other youth, or possibly with more than one other youth?
D27: Comprehension of “any other youth” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
D29. In the days after this happened, how did you feel about what happened?
Very upset................................... 1
A little upset......................................... 2
Not upset at all..................................... 3
Glad it happened ................................. 4
How easy or hard would it be to answer this question?
D29. Easy/Hard |
|
NOTES: Easy Hard |
Comments/Problems
|
In your mind, what’s the difference between being “very upset” about something and “a little upset”?
D29. Response scale: “very upset” vs. “a little upset” |
Comments/Problems
|
For this next set of questions, I’d like you to imagine that you had answered that you were upset about the sexual contact that had happened with another youth in this facility. Again, do not actually answer the questions, just tell me your reactions to them.
D30. (IF D29=1, 2 or 3) Did you feel any of the following ways after this happened?
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
Do you have any overall comments on these questions?
D30a-g: Overall Comments |
NOTES:
|
Are
any of these categories unfamiliar to you or unclear?
[If
YES]:
Which
one is that?
D30a-g: Unfamiliar/unclear |
|
NOTES: Familiar/Clear Unfamiliar/Unclear |
Comments/Problems
|
Looking at item d, what does the word “helpless” mean? [RECORD RESPONSES NEXT TO ITEM]
Looking at item e, What about the word “violated?” [RECORD RESPONSES NEXT TO ITEM]
For this next set of questions, I’d like you to imagine that you had answered that you were not upset or that you were actually glad about the sexual contact that had happened with another youth in this facility. Again, do not actually answer the questions; just tell me your reactions to them.
D31. (IF D29= 5) Did you feel any of the following ways after this happened?
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
Do you have any overall comments on these questions?
D31a-f: Overall Comments |
NOTES:
|
Looking at item c, can you think of an example where someone might say yes to this, meaning they felt like they had “gotten what they wanted”? [RECORD RESPONSES NEXT TO ITEM]
Looking at item d, what do you think this one is asking about? [RECORD RESPONSES NEXT TO ITEM]
For this next question, please imagine that someone said their feelings had changed since the incident happened. Again, do not circle an answer to this question – we will just talk about it.
D33. Thinking about it now, how do you feel about what happened?
Very upset............................................ 1
A little upset......................................... 2
Not upset at all..................................... 3
Glad it happened ................................. 4
How easy or difficult do you think it might be for someone to answer this question? (Explain.)
D33: Easy/Difficult |
|
NOTES: Easy Difficult |
Comments/Problems
|
Any other comments on this set of questions before we move on?
17: Overall Comments |
NOTES:
|
SECTION 6: Disability Questions
Now I’d like to shift gears and show you some other questions being considered for this survey. For these, I don’t want you to actually answer the questions. Instead, I will read each question aloud while you look at them and then we’ll talk about them.
[ASK EACH QUESTION THEN ADMINISTER PROBES BEFORE MOVING ON]
DI1. Because of a physical, mental or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?
YES 1
NO 2
What do you think this question is asking about?
DI1: Interpretation |
Comments/Problems |
What type of condition might make someone say yes to this question?
DI1: Type of condition |
Comments/Problems
|
For the next 2 questions, imagine someone had said yes to the question we just talked about – “Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?” The follow-up questions are:
DI2. Is the difficulty you experience because of a physical problem?
YES 1
NO 2
What types of physical problems do you think this might be asking about?
DI2: Type of physical problems |
Comments/Problems
|
DI3. Is the difficulty you experience because of a mental or emotional problem?
YES 1
NO 2
What types of mental or emotional problems do you think this might be asking about?
DI3: Type of mental or emotional problems |
Comments/Problems
|
DI8. Did a doctor, school counselor or other professional ever tell you that you have…
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
This set of questions asks about whether “a professional” ever told you any of the following. What do you think is meant by “a professional”?
DI8: Comprehension of “professional” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
What do you think item f is asking about? [RECORD RESPONSES NEXT TO ITEM]
What do you think item g is asking about? [RECORD RESPONSES NEXT TO ITEM]
What would make someone say yes to item h? [RECORD RESPONSES NEXT TO ITEM]
SECTION 7: Sexual Orientation and Gender Identity (IF TIME PERMITS)
The final set of questions asks about gender and sexual orientation. After I’ve finished reading the question, you can go ahead and circle your answer.
[ASK ALL QUESTIONS BEFORE ADMINISTERING PROBES]
GI1.
What sex were you assigned at birth, on your original birth
certificate?
Male 1
Female 2
What do you think this question is asking?
(IF NEEDED) What do you think about the phrase “sex you were assigned at birth?” What do you think that means?
GI1: Interpretation |
|
NOTES: Understood Misunderstood |
Comments/Problems |
Tell me what you know about your birth certificate.
Have you seen your birth certificate?
Do you know what kinds of information are included on your birth certificate?
GI1: Birth Certificate |
Comments/Problems
|
GI2.
Do you currently describe yourself as male, female or transgender?
[Definition
of transgender. “Some people describe themselves as transgender
when they experience a different gender identity from their sex at
birth. For example, a person born into a male body, but who feels
female or lives as a woman.]
|
|
Comments/Problems |
Male |
1 |
|
Female |
2 |
|
Transgender |
3 |
|
Something else |
4 |
|
Not sure |
5 |
Let’s take a look at the definition of transgender. Did you find anything in this definition confusing or unclear?
[IF YES]: What part(s) were confusing or unclear?
[IF NEEDED]: Before this interview, had you heard of the word “transgender” before?
GI2: Definition of “transgender” |
|
NOTES: Clear Confusing |
Comments/Problems |
Can you think of a situation where someone would circle “None of these” or “Not sure?”
GI2: “None of these” or “Not sure” |
Comments/Problems
|
GI3. Do you consider yourself…?
|
|
Comments/Problems |
(MALES) Gay (FEMALES) Lesbian or gay (OTHER) Gay or lesbian |
1 |
|
(MALES) Not gay, that is, heterosexual (FEMALES) Not gay or lesbian, that is, heterosexual (OTHER) Not gay or lesbian, that is, heterosexual |
2 |
|
Bisexual |
3 |
|
Something else |
4 |
|
Not sure |
5 |
[If R answered anything but straight]: How did you decide on your answer? [RECORD RESPONSES NEXT TO ITEM]
[If R answered straight]: What do you think this question is asking? [RECORD RESPONSES NEXT TO ITEM]
Do you find any of these answers confusing or unclear?
[If YES]: Which answer was that? Why do you think it was confusing/unclear?
GI3: Response options comprehension |
|
NOTES: Clear Confusing |
Comments/Problems |
GI4. People are different in their sexual attraction to other people. Which best describes your feelings?
|
|
Comments/Problems |
Only attracted to males |
1 |
|
Mostly attracted to males |
2 |
|
Equally attracted to females and males |
3 |
|
Mostly attracted to females |
4 |
|
Only attracted to females |
5 |
|
Something else |
6 |
|
Not sure |
7 |
Tell me more about your answer to this question. [RECORD RESPONSES NEXT TO ITEM]
What do think this question is asking?
GI4: Question comprehension |
|
NOTES: Understood Misunderstood |
Comments/Problems |
Any other comments on this set of questions before we move on?
NOTES: Other comments
|
SECTION 8: Facility Living Conditions (IF TIME PERMITS)
Here is the last set of questions. Please go ahead and circle your answer to each question as we read through them.
[AFTER R HAS ANSWERED ALL THE ITEMS IN SECTION 1, ASK PROBES]
|
Yes |
No |
Comments/Problems |
|
FL5. FL7. The temperature usually feels ok here--it isn't too hot or too cold. |
1 |
2 |
|
|
FL6. FL8. Room lights are turned off or dimmed at night when youth are sleeping. |
1 |
2 |
|
|
FL7. FL9. The facility is noisy at night when youth are sleeping. |
1 |
2 |
|
|
FL10. I am allowed to take a shower every day. |
1 |
2 |
|
|
F10. FL12. I am allowed to decorate where I sleep to make it feel like I have my own personal space. |
1 |
2 |
Problems
|
Explanation of answer
|
F13. I am allowed to wear my hair the way I want |
1 |
2 |
|
|
F12. FL14. I am allowed to talk to other youth during meal time |
1 |
2 |
|
|
F13. FL15. The staff here set up celebrations for holidays and/or youths' birthdays |
1 |
2 |
|
|
Were
any of these questions confusing or not clear?
[IF
YES]: Which
item was that, and what was confusing about it?
[RECORD
RESPONSES NEXT TO ITEM]
[If YES to FL12]: You answered “Yes” to question #12. Can you tell me more about your answer? [RECORD RESPONSES NEXT TO ITEM]
[If
NO to FL12]: Can
you tell me more about why you answered “No” to question
#12? [RECORD
RESPONSES NEXT TO ITEM]
Do you have any other comments on any of these questions?
NOTES: Other comments
|
Closing
Those are all the questions I have for you.
DISCUSS
ANY RESPONDENT COMMENTS.
Would you like to speak with a counselor?
Thank you for your time.
National Survey of Youth in Custody (NSYC-3)
Spanish Cognitive Interview
Guide
Version 2
Hello. My name is ( ) and I work for Westat, a research firm outside of Washington, DC. We are working with the U.S. Department of Justice on a special study called the National Survey of Youth in Custody. Today I would like to show you some of the questions we are considering for the study and get your reactions to them. Let’s start by going over some details about the study.
HAND COPY OF ASSENT FORM TO R AND READ FORM ALOUD
ANSWER PARTICIPANT’S QUESTIONS, IF ANY, AND ASK FOR ASSENT.
Are you willing to participate in this study?
IF R SAYS “YES”, ASK THEM TO MARK THE “YES” BOX. INTERVIEWER WILL THEN SIGN AND DATE THE YOUTH ASSENT FORM.
IF THE R SAYS “NO”, ASK THEM TO MARK THE “NO” BOX, THANK THEM, AND END THE INTERVIEW.
Thank you.
Now I’m going to hand you the questions a few at a time. I will read them aloud while you look at them. After I’ve finished reading the question, you can circle your answer. Sometimes, there will be some questions that I ask you NOT to answer, but just to look at and think about. For those, I’ll let you know before I show them to you.
After you answer each question, we will stop to talk about it. I might ask you to tell me what you were thinking about when you answered the question, what the question was asking, or anything else you might think about the question. We are also interested in whether any of the words or phrases in the question are confusing or awkward. This will help us figure out how we can improve the questions.
Sometimes, I’ll ask you about some of the words in the question. If you don't understand a question, please tell me, because that's just the sort of thing I’m trying to find out here, OK?
Do you have any questions before we begin?
SECTION 1: Legal Counsel & Institutional Experiences
Here are the first questions. I’m going to read them aloud. Please circle your answers and then we’ll talk about the question and the answers you gave.
LC1. Have you seen or talked to a lawyer or legal counsel since you have been in this facility?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
LC2. [IF LC1 = NO] Would this facility allow you to see or talk to a lawyer if you wanted to?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
LC3. [IF LC1 = NO] Since you have been at this facility, have you been told that you cannot see or talk to a lawyer?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
What is the 2nd question asking? [RECORD ISSUE NEXT TO ITEM]
How about the 3rd question? [RECORD ISSUE NEXT TO ITEM]
Did you have any difficulty answering these questions? (Explain)
LC1-3: Difficulty answering |
|
NOTES: Yes No |
Comments/Problems
|
SECTION 2: Solitary Confinement
Now let’s go on to the next questions. Again, I will read them out loud and you should circle your answers.
SC1. Since coming to this facility have you ever been isolated or secluded in a separate room, other than your own room, without contact with other youth?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
[IF YES]: Can you tell me more about your answer? [RECORD RESPONSES NEXT TO ITEM]
[IF NO]: What is this question asking? [RECORD RESPONSES NEXT TO ITEM]
[ALL]:
When you read “isolated or secluded in a separate room”, what did you think of?
SC1: Comprehension of “isolated or secluded in a separate room” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
What does “without contact with other youth” mean to you?
SC1: Comprehension of “without contact with other youth” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
When/If this happens at this facility, is there a special word or phrase you use to describe it?
SC1: Special word or phrase |
|
NOTES: Yes No |
Comments/Problems
|
[If R answered YES to SC1, continue with the question and answer format]
[If R answered NO to SC1]: Even though you answered No to this question, I would still like to talk about the next few questions about this topic. Please do not circle an answer or tell me your answer. I’m going to read this whole list and then I’ll just ask you how you interpreted some of the items.
SC2. What was the reason you were isolated or secluded in a separate room, other than your own room, without contact with other youth?
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
[If R answered SC2]: Tell me more about your answers to these items... [RECORD RESPONSES NEXT TO ITEM]
[If R answered SC2 and said “NO” to all]: Do you know what the reasons were for being isolated or secluded to a separate room? Is there some other reason that is missing from this list? [RECORD ISSUES NEXT TO ITEM]
[ASK ALL]:
Do any of these items (a - e) seem confusing or unclear to you?
SC2a-e: Confusing/Unclear |
|
NOTES Clear Confusing/Unclear |
Comments/Problems
|
Can
you think of any other reasons why someone might be isolated or
secluded in a separate room without contact with other youth?
[If
Yes]
Can
you tell me more about that?
SC2 a-e: Other reasons |
|
NOTES: Yes No |
Comments/Problems
|
[CONTINUE BY HAVING R ANSWER THE QUESTION IF SC1=YES, OR BY ONLY REVIEWING THE QUESTION IF SC1=NO]:
SC3. Since coming to this facility, how many times have you ever been isolated or secluded in a separate room, other than your own room, without contact with other youth?
|
|
Comments/Problems |
1 time |
1 |
|
2-5 times |
2 |
|
6 or more times |
3 |
[If R answered SC3]: How did you decide on your answer to this question? [RECORD RESPONSES NEXT TO ITEM]
[ASK ALL]: What do you think is meant by a “time”? (IF NEEDED: What if you were isolated or secluded for a few hours at two different points in a day, for different reasons? Would that could as 1 time, or 2 times?) [RECORD RESPONSES NEXT TO ITEM]
SC4. Since coming to this facility, what was the longest time you were isolated or secluded in a separate room, other than your own room, without contact with other youth?
|
|
Comments/Problems |
Less than 3 hours |
1 |
|
3 hours or more but less than 6 hours |
2 |
|
6 hours or more but less than 1 day |
3 |
|
1 day or more but less than 1 week |
4 |
|
1 week or more |
5 |
[If R answered the question]: How did you decide on your answer? [RECORD RESPONSES NEXT TO ITEM]
[ASK ALL]:
What do you think this question is asking?
SC4: Question comprehension |
|
NOTES Understood Misunderstood |
Comments/Problems
|
Were
any of these answer choices confusing or unclear?
[If
YES]:
Which
option was that and what made it confusing?
SC4: Response options |
|
NOTES: Clear Confusing |
Comments/Problems
|
Here is the next question. Please answer it after I’ve read it to you.
SC5. Since coming to this facility, have you been isolated or secluded to your own room for breaking facility rules?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
[IF YES]: Can you tell me more about your answer? [RECORD RESPONSES NEXT TO ITEM]
[IF NO]: What does this question mean to you? [RECORD RESPONSES NEXT TO ITEM]
[ASK ALL]:
What does being “isolated or secluded to your own room” mean in this question?
SC5: Comprehension of “ isolated or secluded to your own room” |
|
NOTES: Understood Misunderstood |
Comments
|
How is this different than being placed in a separate room?
SC5: “Separate room” vs “ isolated or secluded to your own room” |
|
NOTES: Understood Misunderstood |
Comments
|
SECTION 3: Youth Gang Involvement
Here is the next question. Please circle an answer after I’ve read it to you.
GA3. Are you a member of a gang in this facility?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
[IF YES]: Can you tell me more about your answer? [RECORD RESPONSE NEXT TO ITEM]
[IF NO]: What do you think this question is asking about? [RECORD RESPONSE NEXT TO ITEM]
[ASK ALL]:
What comes to mind when you hear “a gang in this facility?”
Are you thinking just about gangs in this facility, or are you also thinking about gangs outside of this facility?
GA3: Comprehension of “a gang in this facility” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
[If R answered YES, continue with question and answer format]
[If R answered NO to being in a gang (GA3)]: Even though you answered No to being in a gang, I would still like to show you this next question. You do not have to answer it. We can just talk about it and you can tell me what you think. Ok?
GA4. When did you join this gang?
|
|
Comments/Problems |
Since I got here |
1 |
|
Before I got here |
2 |
[If R answered the question]: Tell me more about your answer. [RECORD RESPONSE NEXT TO ITEM]
[If R answered the question]: How easy or hard was it to answer this question?
GA4: Easy/Hard to Answer |
|
NOTES: Easy Hard |
Comments/Problems
|
[If R did not answer the question]: What do you think this question is asking? [RECORD RESPONSE NEXT TO ITEM]
Now I’m going to hand you the next questions. After I’ve read the questions, go ahead and circle your answers and then we’ll talk about them.
[AFTER R HAS ANSWERED GA7 AND GA8, ASK PROBES]
GA7. Has a gang in this facility ever tried to recruit you?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
[IF YES]: What were you thinking when you came up with your answer? [RECORD RESPONSE NEXT TO ITEM]
[IF NO]: Can you give me an example of a situation where someone might answer yes to this question? [RECORD RESPONSE NEXT TO ITEM]
[ASK ALL]:
What does it mean when a gang “tries to recruit you?” Can you give me an example?
GA7: Comprehension of “gang tries to recruit you” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
GA8. Have you ever had to do something or pay someone to have a gang in this facility leave you alone?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
[IF YES]: Tell me more about your answer. [RECORD RESPONSE NEXT TO ITEM]
[IF NO]: What do you think this question is asking about? [RECORD RESPONSE NEXT TO ITEM]
Could you give me an example of a situation where this might happen?
SECTION 4: Treatment Programs and Services– Drug use
Now I’d like to shift gears and show you some other questions being considered for this survey. For these, I don’t want you to actually answer the questions. Instead, I will read each question aloud while you look at them and then we’ll talk about them.
TP1. The next questions are about drugs you may have taken on your own – that is, without a doctor telling you to take them.
Have you ever used...
YES NO
m. anti-anxiety drugs or tranquilizers (such as Ativan, Valium, or Xanax)
without a doctor’s prescription 1 2
n. Synthetic drugs (such as synthetic marijuana, K2, Spice,
fake weed, King Kong, Yucatan Fire, Skunk, bath salts) 1 2
o. Cough syrup to get high 1 2
Looking at item m, what do you think is meant by “anti-anxiety drugs”?
TP1: Comprehension of “anti-anxiety drugs” |
|
NOTES: Understood Misunderstood |
Comments
|
Looking at item n, are there any categories missing for examples of synthetic drugs that you know about?
C1n: Missing categories |
|
NOTES: Yes No |
Comments/Problems
|
If a doctor told someone to take cough syrup, how would that person answer item o?
C1o: Cough syrup |
Comments/Problems
|
SECTION 5: Grooming by Staff
These next questions will be used to get information about interactions that may happen between youth and staff at this facility. I don’t want you to answer these questions. I just want you to tell me what the questions might mean to someone in the facility, so please do not circle an answer for these.
[DO NOT HAVE RESPONDENT CIRCLE ANSWERS FOR SECTION 5]
GR8. Since you got here, has any staff member ever spent time alone with you AND asked you not to tell anyone?
Yes 1
No 2
What types of situations do you think this question is asking about?
GR8: Question comprehension |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
(IF NEEDED) When you read “has any staff member ever spent time alone with you”, what did that make you think of?
GR8: Comprehension of “has any staff member ever spent time alone with you ” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
(IF NEEDED) Can you give me an example of a time when staff are alone with youth?
GR8: Example of situation |
|
NOTES: Yes No |
Comments/Problems
|
GR9. Since you got here, has any staff member ever shared that they felt emotionally close to you or that they had special feelings for you?
Yes 1
No 2
What do you think this question is asking about?
GR9: Question comprehension |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
(IF NEEDED) The question talks about staff feeling “emotionally close” or having “special feelings” for you. Do they mean the same thing or are they something different?
GR9: Interpretation: “emotionally close” vs “special feelings” |
|
NOTES: Same Different
|
Comments/Problems
|
GR10. Since you got here, has any staff member talked to you about sex in a way that was not part of their regular job duties, joked with you about sex, or shared sexual stories with you?
Yes 1
No 2
Can you give me an example of a situation where someone might answer yes to this question? Please do not share any names and do not share your own experiences.
GR10: Example of situation |
|
NOTES: Yes No |
Comments/Problems
|
GR11. Since you got here, has any staff member ever contacted you in other ways when they were not at the facility?
Yes 1
No 2
Can you give me an example of a situation where someone might answer yes to this question? Please do not share any names and do not share your own experiences.
GR10: Example of situation |
|
NOTES: Yes No |
Comments/Problems
|
Any
other comments on this set of questions before we move on?
NOTES: Other comments
|
SECTION 6: Staff Incident Details
These next questions will be used to get more information about any sexual contact that may have happened between youth and staff at this facility. I don’t want you to answer these questions about yourself. I just want you to tell me what the words might mean if a youth did have sexual contact with a staff member and was being asked these questions about their experience. So please do not circle an answer for these.
[DO NOT HAVE RESPONDENT CIRCLE ANSWERS FOR SECTION 5]
E24SP. Was the staff member who you had sexual contact with…
|
|
Comments/Problems |
A staff member who directly supervises youth/correctional officer |
1 |
|
A teacher or educator |
2 |
|
Medical or mental health staff |
3 |
|
Other staff working in the facility |
4 |
|
A volunteer in the facility |
5 |
|
Let’s look at the answer choices for this question...
Do
any of these seem confusing or unclear?
[If
YES]:
Which
one is that? What makes it confusing/unclear? [RECORD
RESPONSE NEXT TO ITEM]
Can you think of any other types of staff members that we may have missed who are at this facility?
E24SP. Types of staff missing |
|
NOTES: Yes No |
Comments/Problems
|
Here is the next question. Again, do not answer the question, just listen.
E28. Was there anyone who knew what was happening?
Yes, other youth 1
Yes, other staff 2
Yes, both youth and staff 3
No 4
What do you think this question is asking about?
E28: Question comprehension |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
What do you think of when you hear “anyone who knew what was happening?”
E28: Comprehension of “anyone who knew what was happening” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
Here is the next question. Again, do not answer the question, just listen and think about it.
E29. What were these other youth doing at the time?
|
YES |
NO |
Comments/Problems |
They were helping make it happen |
1 |
2 |
|
They were trying to stop it from happening |
1 |
2 |
|
They knew it was happening, but did nothing |
1 |
2 |
|
Let’s look at just the answer choices for this question...
What
do you think these categories mean? (GO THROUGH EACH ONE) [RECORD
RESPONSES NEXT TO ITEMS]
[IF NEEDED] Were any of them confusing or unclear? [RECORD RESPONSES NEXT TO ITEMS]
[If YES]: Which one is that? What makes it confusing/unclear?
E29: Response options |
|
NOTES: Clear Confusing |
Comments/Problems
|
Here is the next question. Again, do not answer the questions, just listen and think about them.
E31. Has that staff member also had any type of sexual contact with any other youth at this facility?
Yes,
I am sure they have had sexual contact with other
youth at this
facility 1
Yes,
I think they have had sexual contact with other
youth, but I am
not sure 2
No,
I don’t think they have had sexual contact with
other
youth at this facility 3
This question asks about having sexual contact with “any other youth” at this facility – what do you think that means? Does it mean just one other youth, or possibly with more than one other youth?
E31: Comprehension of “any other youth” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
Here are the next questions. Again, do not answer the questions, just listen and think about them.
E32. Did this staff person do any of the following AFTER this happened?
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
Do you have any overall comments on these questions first?
E32. Overall comments |
Comments/Problems
|
Do
any of these categories seem confusing or unclear? [RECORD
RESPONSES NEXT TO ITEM]
[If
YES]: Which
one is that? What makes it confusing/unclear?
Looking at item b, what does it mean to “threaten to hurt someone”? Can you give an example?
E32b: Comprehension of “threaten to hurt someone” |
|
NOTES: Understood Misunderstood |
Comments
|
Looking at item c, what does “blame it on you” mean to you?
E32c: Comprehension of “blame it on you” |
|
NOTES: Understood Misunderstood |
Comments
|
Here are the next questions. Again, do not answer the questions, just listen and think about them.
E33. In the days after this happened, how did you feel about what happened?
Very upset........................................... 1
A little upset......................................... 2
Not upset at all..................................... 3
Glad it happened ................................. 4
How easy or hard would it be to answer this question?
E33. Easy/Hard |
|
NOTES: Easy Hard |
Comments/Problems
|
In your mind, what’s the difference between being “very upset” about something and “a little upset”?
E33. Response scale: “very upset” vs. “a little upset” |
Comments/Problems
|
For this next set of questions, I’d like you to imagine that you had answered that you were upset about the sexual contact that had happened with a staff member in this facility. Again, do not actually answer the questions, just tell me your reactions to them.
E34. Did you feel any of the following ways after this happened?
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
Do you have any overall comments on these questions first?
E34. Overall comments |
Comments/Problems
|
Are
any of these categories unfamiliar to you or unclear? [RECORD
RESPONSES NEXT TO ITEM]
[If
YES]:
Which
one is that?
Looking at item d, what does the word “helpless” mean?
E34d: Comprehension of “helpless” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
Looking at item e, What about the word “violated?”
E34e: Comprehension of “violated” |
|
NOTES: Understood Misunderstood |
Comments/Problems
|
For this next set of questions, I’d like you to imagine that you had answered that you were not upset or that you were actually glad about the sexual contact that had happened with a staff member in this facility. Again, do not actually answer the questions, just tell me your reactions to them.
E35. Did you feel any of the following ways after this happened?
|
Yes |
No |
Comments/Problems |
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
|
1 |
2 |
|
Do you have any overall comments on these questions first?
E35. Overall comments |
Comments/Problems
|
Looking at item c, can you think of an example where someone might say yes to this, meaning they felt like they had “gotten what they wanted”? [RECORD RESPONSES NEXT TO ITEM]
Looking at item d, what do you think this one is asking about? [RECORD RESPONSES NEXT TO ITEM]
Let’s keep thinking about what these next questions might mean to someone in the facility. Again, please do not circle an answer for these.
For this next question, please imagine that someone said their feelings had changed since the incident happened. Again, do not circle an answer to this question – we will just talk about it.
E37. Thinking about it now, how do you feel about what happened?
Very upset........................................... 1
A little upset......................................... 2
Not upset at all..................................... 3
Glad it happened ................................. 4
How easy or difficult do you think it might be for someone to answer this question? (Explain.)
E37: Easy/Difficult |
|
NOTES: Easy Difficult |
Comments/Problems
|
SECTION 7: History of Victimization
Please read these next three questions, but do not circle an answer to them – we will just talk about them.
HV1. Before you came to this place, had anyone ever forced you to have any kind of sexual contact?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
HV2. Did any of this happen while you were in a corrections facility?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
HV3. Did any of this happen while you were being arrested or detained by a law enforcement officer?
|
|
Comments/Problems |
Yes |
1 |
|
No |
2 |
What do you think the 3rd question is asking about? [RECORD RESPONSES NEXT TO ITEM]
What do you think is meant by “a law enforcement officer”? While you’re being arrested or detained, what are the different types of law enforcement officers you might be in contact with?
HV3: Comprehension of “law enforcement officer” |
|
NOTES: Understood Misunderstood |
Comments
|
What would make someone say yes to this 3rd question? [RECORD RESPONSES NEXT TO ITEM]
SECTION 8: Youth Education and Aspirations
For the next set of questions, we want you to think about the last school you attended before you came to this facility.
YE1. Thinking about the last school you attended before you came here, which of the statements below best describes how you felt overall about going to school?
You liked going to school a lot 1
You kind of liked going to school a lot 2
You kind of liked going to school 3
You didn’t like going to school 4
You hated going to school 5
Can you tell me more about your answer? How did you decide which answer to pick?
Were any of these categories hard to understand?
YE1: Feelings about school |
Comments/Problems
|
SECTION 9: Sexual Orientation and Gender Identity (IF TIME PERMITS)
The final set of questions asks about gender and sexual orientation. After I’ve finished reading the question, you can go ahead and circle your answer.
[ASK ALL QUESTIONS BEFORE ADMINISTERING PROBES]
GI1.
What sex were you assigned at birth, on your original birth
certificate?
Male 1
Female 2
What do you think this question is asking?
(IF NEEDED) What do you think about the phrase “sex you were assigned at birth?” What do you think that means?
GI1: Interpretation |
|
NOTES: Understood Misunderstood |
Comments/Problems |
Tell me what you know about your birth certificate.
Have you seen your birth certificate?
Do you know what kinds of information are included on your birth certificate?
GI1: Birth Certificate |
Comments/Problems
|
GI2.
Do you currently describe yourself as male, female or transgender?
[Definition
of transgender. “Some people describe themselves as transgender
when they experience a different gender identity from their sex at
birth. For example, a person born into a male body, but who feels
female or lives as a woman.]
|
|
Comments/Problems |
Male |
1 |
|
Female |
2 |
|
Transgender |
3 |
|
Something else |
4 |
|
Not sure |
5 |
Let’s take a look at the definition of transgender. Did you find anything in this definition confusing or unclear?
[IF YES]: What part(s) were confusing or unclear?
[IF NEEDED]: Before this interview, had you heard of the word “transgender” before?
GI2: Definition of “transgender” |
|
NOTES: Clear Confusing |
Comments/Problems |
Can you think of a situation where someone would circle “None of these” or “Not sure?”
GI2: “None of these” or “Not sure” |
Comments/Problems
|
GI3. Do you consider yourself…?
|
|
Comments/Problems |
(MALES) Gay (FEMALES) Lesbian or gay (OTHER) Gay or lesbian |
1 |
|
(MALES) Not gay, that is, heterosexual (FEMALES) Not gay or lesbian, that is, heterosexual (OTHER) Not gay or lesbian, that is, heterosexual |
2 |
|
Bisexual |
3 |
|
Something else |
4 |
|
Not sure |
5 |
[If R answered anything but straight]: How did you decide on your answer? [RECORD RESPONSES NEXT TO ITEM]
[If R answered straight]: What do you think this question is asking? [RECORD RESPONSES NEXT TO ITEM]
Do you find any of these answers confusing or unclear?
[If YES]: Which answer was that? Why do you think it was confusing/unclear?
GI3: Response options comprehension |
|
NOTES: Clear Confusing |
Comments/Problems |
GI4. People are different in their sexual attraction to other people. Which best describes your feelings?
|
|
Comments/Problems |
Only attracted to males |
1 |
|
Mostly attracted to males |
2 |
|
Equally attracted to females and males |
3 |
|
Mostly attracted to females |
4 |
|
Only attracted to females |
5 |
|
Something else |
6 |
|
Not sure |
7 |
Tell me more about your answer to this question. [RECORD RESPONSES NEXT TO ITEM]
What do think this question is asking?
GI4: Question comprehension |
|
NOTES: Understood Misunderstood |
Comments/Problems |
Any other comments on this set of questions?
NOTES: Other comments
|
Closing
Those are all the questions I have for you.
DISCUSS
ANY RESPONDENT COMMENTS.
Would you like to speak with a counselor?
Thank you for your time.
SECTION 1:
Please answer the questions on this page.
ST1. How many staff explain facility rules clearly?
None of the staff 1
Few of the staff 2
Most of the staff 3
All of the staff 4
ST5. How many staff give youth the chance to tell their side before making decisions?
None of the staff 1
Few of the staff 2
Most of the staff 3
All of the staff 4
ST6. How many staff act honestly?
None of the staff 1
Few of the staff 2
Most of the staff 3
All of the staff 4
SECTION 2: Please answer the question on this page.
MV10. [Since coming to this facility OR In the past 12 months] Have you been written up or charged for breaking facility rules such as talking back to staff, being out of place, or not following directions?
Yes 1
No 2
SECTION 3: Please answer the questions on this
page.
EP1. After you got to this facility, when did you first learn that all forms of sexual abuse and harassment are not allowed?
On the day you got here (within the first 24 hours) 1
Between 1 and 10 days after you got here 2
More than 10 days after you got here 3
You were never told that all forms of sexual abuse and
harassment are not allowed 4
EP3. How were you given information about these rules?
|
Yes |
No |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
EP4. Is there a staff member you would feel safe reporting any sexual abuse to?
Yes 1
No 2
SECTION 4: Please answer the questions on this page.
MH1. In the past 30 days, how often did you have each of the following experiences:
All Most Some A
little None
of the of the of the of the of
the
time time time time time
a. How often did you feel nervous? 1 2 3 4 5
b. How often did you feel hopeless? 1 2 3 4 5
c. How often did you feel restless or fidgety? 1 2 3 4 5
d. How
often did you feel so depressed that
nothing could cheer you
up? 1 2 3 4 5
e. How
often did you feel that everything
was an effort? 1 2 3 4 5
f. How often did you feel worthless? 1 2 3 4 5
About
More Less the
often often same
g. You said you felt the following ways in the past 30 days.
• (IF MH1A=1-4) Nervous
• (IF MH1B=1-4) Hopeless
• (IF MH1C=1-4) Restless or fidgety
• (IF MH1D=1-4) So depressed that nothing could cheer you up
• (IF MH1E=1-4) Everything was an effort
• (IF MH1F=1-4) Worthless
Taking
them altogether, did these feelings occur more
often
in the past 30 days than is usual for you, less
often
than usual, or about
the same
as usual? 1 2 3
SECTION 5: PLEASE DO NOT CIRCLE ANY RESPONSES ON THIS PAGE
D2. Before you had forced sexual contact with this other youth, did any of these things happen?
YES NO
Did the youth ever offer you things like drugs, cigarettes, alcohol or
other items you were not allowed to have in the facility? 1 2
Did the youth ever give you money or
other special gifts? By “special gift,” we mean something that
they probably would not have given to most other youth 1 2
Did the youth ever offer you special
protection from other youth? By “special,” we mean that they
treated you like a favorite or treated you better than they treat
most other youth 1 2
D18SP. Where was the other youth living at the time?
In the same room as you 1
In the same housing area as you, but not in the same room 2
In a different housing area than you 3
D19SP. How well did you know the other youth at the time?
By sight only 1
Knew the person, but not well 2
Well known 3
D27. Has that youth also had any type of sexual contact with any other youth at this facility?
Yes,
I am sure they have had sexual contact with other
youth at this
facility 1
Yes,
I think they have had sexual contact with other
youth, but I am
not sure 2
No,
I don’t think they have had sexual contact with
other
youth at this facility 3
D29. In the days after this happened, how did you feel about what happened?
Very upset............................................ 1
A little upset......................................... 2
Not upset at all..................................... 3
Glad it happened ................................. 4
PLEASE DO NOT CIRCLE ANY RESPONSES ON THIS PAGE
D30. Did you feel any of the following ways after this happened?
YES NO
a. Worried or anxious?........................................................... 1 2
b. Angry?............................................................................... 1 2
c. Sad or depressed?............................................................. 1 2
d. Helpless?........................................................................ 1 2
e. Violated?........................................................................... 1 2
f. Like you couldn’t trust people?........................................... 1 2
g. Fearful?............................................................................. 1 2
D31. Did you feel any of the following ways after this happened?
YES NO
a. Like the other youth really cared about you.......................... 1 2
b. Like you really cared about the other youth.......................... 1 2
c. Like you had gotten what you wanted.................................. 1 2
d. Like you would get something from the other youth in return. 1 2
f. Like you wanted it to happen again..................................... 1 2
D33. Thinking about it now, how do you feel about what happened?
Very upset................................... 1
A little upset......................................... 2
Not upset at all..................................... 3
Glad it happened ................................. 4
SECTION 6: PLEASE DO NOT CIRCLE ANY RESPONSES ON
THIS PAGE
DI1. Because of a physical, mental or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?
YES.................................................... 1
NO...................................................... 2
DI2. Is the difficulty you experience because of a physical problem?
YES.................................................... 1
NO...................................................... 2
DI3. Is the difficulty you experience because of a mental or emotional problem?
YES.................................................... 1
NO...................................................... 2
DI8. Did a doctor, school counselor or other professional ever tell you that you have…
YES NO
a. ADD or ADHD (Attention Deficit Disorder)? 1 2
b. Dyslexia? 1 2
c. A learning disability? 1 2
d. Autism or Asperger’s? 1 2
e. Depression? 1 2
f. Post-traumatic stress disorder or PTSD? 1 2
g. Another
anxiety disorder, such panic disorder, obsessive
compulsive
disorder (OCD), or social anxiety? 1 2
h. A mental or emotional condition other than those listed above? 1 2
SECTION 7: Please answer the questions on this page.
GI1.
What sex were you assigned at birth, on your original birth
certificate?
Male 1
Female 2
GI2.
Do you currently describe yourself as male, female or transgender?
[Definition
of transgender. “Some people describe themselves as transgender
when they experience a different gender identity from their sex at
birth. For example, a person born into a male body, but who feels
female or lives as a woman.]
Male 1
Female 2
Transgender 3
Something else 4
Not sure 5
(IF YOU ARE MALE:)
GI3. Do you consider yourself...
Gay 1
Not gay, that is, heterosexual 2
Bisexual 3
Something else 4
Not sure 5
(IF YOU ARE FEMALE:)
GI3. Do you consider yourself...
Lesbian or gay 1
Not gay or lesbian, that is, heterosexual 2
Bisexual 3
Something else 4
Not sure 5
(IF YOU ARE TRANSGENDER, NONE OF THESE, OR NOT SURE:)
GI3. Do you consider yourself...
Gay or lesbian 1
Not gay or lesbian, that is, heterosexual 2
Bisexual 3
Something else 4
Not sure 5
GI4. People are different in their sexual attraction to other people. Which best describes your feelings?
Only attracted to males 1
Mostly attracted to males 2
Equally attracted to females and males 3
Mostly attracted to females 4
Only attracted to females 5
Something else ………………………………….6
Not sure 7
SECTION 8: Please answer the questions on this page.
Please answer the following questions about this facility. |
Yes |
No |
FL7. The temperature usually feels ok here--it isn't too hot or too cold. |
1 |
2 |
FL8. Room lights are turned off or dimmed at night when youth are sleeping. |
1 |
2 |
FL9. The facility is noisy
at night when youth are |
1 |
2 |
FL10. I am allowed to take a shower every day... |
1 |
2 |
F12. I am allowed to decorate where I sleep to make it feel like I have my own personal space. |
1 |
2 |
F13. I am allowed to wear my hair the way I want |
1 |
2 |
F14. I am allowed to talk to other youth during meal time. |
1 |
2 |
F15. The staff here set up celebrations for holidays and/or youths' birthdays |
1 |
2 |
SECTION 1: Please
answer the question on this page.
LC1. Have you seen or talked to a lawyer or legal counsel since you have been in this facility?
Yes 1
No 2
LC2. [IF LC1 = NO] Would this facility allow you to see or talk to a lawyer if you wanted to?
Yes 1
No 2
LC3. [IF LC1 = NO] Since you have been at this facility, have you been told that you cannot see or talk to a lawyer?
Yes 1
No 2
SECTION 2: Please
answer the questions on this page.
SC1. Since coming to this facility have you ever been isolated or secluded in a separate room other than your own room, without contact with other youth?
Yes 1
No 2
SC2. What was the reason you were isolated or secluded in a separate room, other than your own room, without contact with other youth?
|
Yes |
No |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
SC3. Since coming to this facility, how many times have you ever been isolated or secluded in a separate room, other than your own room, without contact with other youth?
1 time 1
2-5 times 2
6 or more times 3
SC4. Since coming to this facility, what was the longest time you were isolated or secluded in a separate room, other than your own room, without contact with other youth?
Less than 3 hours 1
3 hours or more but less than 6 hours 2
6 hours or more but less than 1 day 3
1 day or more but less than 1 week 4
1 week or more 5
Please answer the question on this page.
SC5. Since coming to this facility, have you been isolated or secluded to your own room for breaking facility rules?
Yes 1
No 2
SECTION 3: Please
answer the questions on this page.
GA3. Are you a member of a gang in this facility?
Yes 1
No 2
GA4. When did you join this gang?
Since I got here 1
Before I got here 2
Please answer the questions on this page.
GA7. Has a gang in this facility ever tried to recruit you?
Yes 1
No 2
GA8. Have you ever had to do something or pay someone to have a gang in this facility leave you alone?
Yes 1
No 2
SECTION 4:
PLEASE DO
NOT CIRCLE ANY ANSWERS ON THIS PAGE
TP1. The next questions are about drugs you may have taken on your own – that is, without a doctor telling you to take them.
Have you ever used...
YES NO
m. anti-anxiety drugs or tranquilizers (such as Ativan, Valium, or Xanax)
without a doctor’s prescription 1 2
n. Synthetic drugs (such as synthetic marijuana, K2, Spice,
fake weed, King Kong, Yucatan Fire, Skunk, bath salts) 1 2
o. Cough syrup to get high 1 2
SECTION 5: PLEASE
DO NOT CIRCLE ANY RESPONSES ON THIS PAGE
GR8. Since you got here, has any staff member ever spent time alone with you AND asked you not to tell anyone?
Yes 1
No 2
GR9. Since you got here, has any staff member ever shared that they felt emotionally close to you or that they had special feelings for you?
Yes 1
No 2
GR10. Since you got here, has any staff member talked to you about sex in a way that was not part of their regular job duties, joked with you about sex, or shared sexual stories with you?
Yes 1
No 2
GR11. Since you got here, has any staff member ever contacted you in other ways when they were not at the facility?
Yes 1
No 2
SECTION 6: PLEASE
DO NOT CIRCLE ANY ANSWERS ON THIS PAGE
E24SP. Was the staff member who you had sexual contact with…
A staff member who directly supervises youth/correctional officer 1
A teacher or educator 2
A doctor, nurse, or other medical staff 3
A therapist or other mental health staff 4
Other staff working in the facility 5
A volunteer in the facility 6
E28. Still thinking just about this time that you had sexual contact with a staff member, was there anyone who knew what was happening?
Yes, other youth 1
Yes, other staff 2
Yes, both youth and staff 3
No 4
E29. What were these other youth doing at the time?
YES NO
a. They were helping make it happen 1 2
b. They were trying to stop it from happening 1 2
c. They knew it was happening, but did nothing 1 2
PLEASE DO NOT CIRCLE ANY ANSWERS TO THE QUESTIONS ON THIS PAGE
E31. Has that staff member also had any type of sexual contact with any other youth at this facility?
Yes,
I am sure they have had sexual contact with other
youth at this
facility 1
Yes,
I think they have had sexual contact with other
youth, but I am
not sure 2
No,
I don’t think they have had sexual contact with
other
youth at this facility 3
E32. Did this staff person do any of the following AFTER this happened?
|
Yes |
No |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
|
1 |
2 |
E33. In the days after this happened, how did you feel about what happened?
Very upset.......................................... 1
A little upset......................................... 2
Not upset at all..................................... 3
Glad it happened ................................. 4
PLEASE DO NOT CIRCLE ANY ANSWERS TO THE QUESTIONS ON THIS PAGE
E34. Did you feel any of the following ways after this happened?
YES NO
a. Worried or anxious?........................................................... 1 2
b. Angry?............................................................................... 1 2
c. Sad or depressed?............................................................. 1 2
d. Helpless?........................................................................ 1 2
e. Violated?........................................................................... 1 2
f. Like you couldn’t trust people?........................................... 1 2
g. Fearful?............................................................................. 1 2
E35. Did you feel any of the following ways after this happened?
YES NO
a. Like the staff member really cared about you..................... 1 2
b. Like you really cared about the staff member..................... 1 2
c. Like you had gotten what you wanted................................. 1 2
d.
Like you would get something from the staff member
in
return............................................................................
1
2
e. Like you wanted it to happen again.................................... 1 2
E37. Thinking about it now, how do you feel about what happened?
Very upset........................................... 1
A little upset......................................... 2
Not upset at all..................................... 3
Glad it happened ................................. 4
SECTION 7: PLEASE
DO NOT CIRCLE ANY ANSWERS ON THIS PAGE
HV1. Before you came to this place, had anyone ever forced you to have any kind of sexual contact?
YES.................................................... 1
NO...................................................... 2
HV2. Did any of this happen while you were in a corrections facility?
YES.................................................... 1
NO...................................................... 2
HV3. Did any of this happen while you were being arrested or detained by a law enforcement officer?
YES.................................................... 1
NO...................................................... 2
SECTION 8: Please answer the questions on this page
For the next set of questions, we want you to think about the last school you attended before you came to this facility.
YE1. Thinking about the last school you attended before you came here, which of the statements below best describes how you felt overall about going to school?
You liked going to school a lot 1
You kind of liked going to school a lot 2
You kind of liked going to school 3
You didn’t like going to school 4
You hated going to school 5
SECTION 9: Please
answer the questions on this page.
GI1.
What sex were you assigned at birth, on your original birth
certificate?
Male 1
Female 2
GI2.
Do you currently describe yourself as male, female or transgender?
[Definition
of transgender. “Some people describe themselves as transgender
when they experience a different gender identity from their sex at
birth. For example, a person born into a male body, but who feels
female or lives as a woman.]
Male 1
Female 2
Transgender 3
Something else 4
Not sure 5
(IF YOU ARE MALE:)
GI3. Do you consider yourself...
Gay 1
Not gay, that is, heterosexual 2
Something else 4
Not sure 5
(IF YOU ARE FEMALE:)
GI3. Do you consider yourself...
Lesbian or gay 1
Not gay or lesbian, that is, heterosexual 2
Bisexual 3
Something else 4
Not sure 5
(IF YOU ARE TRANSGENDER, NONE OF THESE, OR NOT SURE:)
GI3. Do you consider yourself...
Gay or lesbian 1
Not gay or lesbian, that is, heterosexual 2
Bisexual 3
Something else 4
Not sure 5
GI4. People are different in their sexual attraction to other people. Which best describes your feelings?
Only attracted to males 1
Mostly attracted to males 2
Equally attracted to females and males 3
Mostly attracted to females 4
Only attracted to females 5
Something else 6
Not sure 7
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Smith_t |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |