TO 27 – Individual Innovation Survey
Attachment 2
Phase 2
Screener and Individual Innovation Questionnaire
September 4, 2018
Platform ad
Survey description: This survey is about people creating goods or services outside of work.
Time allowed: 20 minutes
Expires: 12/28/2018
Qualifications required: Resides in U.S.
Figure 1. Example ad from previous study
Screener Survey
Introduction
This survey is conducted by the National Center for Science and Engineering Statistics (NCSES) within the National Science Foundation (NSF). This survey is being collected by NCSES under OMB No. 3145-0174. This survey will take approximately three minutes to complete. Your participation is voluntary. The information you provide will contribute to valuable research at NCSES, one of the principal Federal statistical agencies.
This survey is being administered by Mathematica Policy Research, Inc. and resides on a server outside of the NCSES domain. NCSES cannot guarantee the protection of survey responses and advises against the inclusion of sensitive personal information in any response. By proceeding, you give your consent to participate in this survey.
Are you
[Radio button]
Male
Female
What is your age?
[Fill In]
Age ___
What is your state or territory of legal residence? Mark one
[Drop down box]
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AS
GU
MP
PR
VI
Other Not Specified
What is the highest degree or level of school you have completed? Mark one
[Radio Button]
Less than high school/secondary school graduate
Regular high school diploma
GED or alternative credential
Some college credit, but less than 1 year of college credit
1 or more years of college credit, no degree
Associate’s degree (for example: AA, AS)
Bachelor’s degree (for example: BA, BS)
Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA)
Professional degree beyond a bachelor’s degree (for example: MD, DDS, DVM, LLB, JD)
Doctorate degree (for example: PhD, EdD)
Not applicable/Unknown
Are you of Hispanic, Latino, or Spanish origin? Mark one
[Radio Button]
No, not of Hispanic, Latino, or Spanish origin
Yes, Mexican, Mexican Am., Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, another Hispanic, Latino, or Spanish origin
What is your race? Mark one or more
[Check Box]
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
During the three years 2015 to 2017, did you create a new or improved good or service?
[Radio Button]
Yes
No
[If 7 = No, go to end of survey]
Was this new or improved good or service created for your work?
[Radio Button]
Yes
No
Both
[If 8 = Yes, go to end of survey]
Was this new or improved good or service developed on your own time?
[Radio Button]
Yes
No
[If 9 = No, go to end of survey]
Was this new or improved good or service a home-built version of an existing product or process currently on the market?
[Radio Button]
Yes
No
[If 10 = Yes, go to end of survey]
Did this new or improved good or service modify products or processes to create something functionally novel?
[Radio Button]
Yes
No
Was this new or improved good or service a completely new good or service not available on the market?
[Radio Button]
Yes
No
[If 11 and 12 = No, go to end of survey]
Do you use this new good or service or has it been made available to others?
[Radio Button]
(1) I use it
(2) It has been made available to others
(3) I do not use it and it is not available for others to use
[If 13 = (3), go to end of survey]
Individual Innovation Survey
Based on your responses, you are eligible to complete an additional survey about personal innovation. This survey will take approximately 20 minutes to complete. If you complete this survey, you will be awarded a bonus payment of $3.00 in addition to your payment for completing the first survey.
Are you interested in completing this survey?
- Yes, I am interested in completing an additional survey for a bonus payment of $3.00
- No, but I would be willing to be invited to complete this survey at a later date
- No, I am not interested in completing an additional survey
<if yes>
This survey is conducted by the National Center for Science and Engineering Statistics (NCSES) within the National Science Foundation (NSF). This survey is being collected by NCSES under OMB No. 3145-0174. This survey will take approximately 15 minutes to complete. Your participation is voluntary and you have the right to stop at any time.
Please take your time as you answer these questions. The information you provide will contribute to valuable research at NCSES, one of the principal Federal statistical agencies.
This survey is being administered by Mathematica Policy Research, Inc. and resides on a server outside of the NCSES domain. NCSES cannot guarantee the protection of survey responses and advises against the inclusion of sensitive personal information in any response. By proceeding, you give your consent to participate in this survey.
Which of the following best describes the area you live in?
Mark one
[Radio Button]
Urban – a city
Suburban – a smaller community adjacent to or within commuting distance of a city
Rural – the country or an area located outside towns and cities
How many people live or stay in your household?
INCLUDE everyone who is living or staying in your household for more than 2 months.
INCLUDE anyone else staying in your household who does not have another place to stay, even if they are there for 2 months or less.
DO NOT INCLUDE anyone who is living somewhere else for more than 2 months, such as a college student living away or someone in the Armed Forces on deployment.
[Fill In]
Number of people ___
The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM.
Do you have difficulty seeing, even if wearing glasses?
[Radio Button]
No
Yes
Do you have difficulty hearing, even if using a hearing aid?
[Radio Button]
No
Yes
Do you have difficulty walking or climbing steps?
[Radio Button]
No
Yes
Do you have difficulty remembering or concentrating?
[Radio Button]
No
Yes
Do you have difficulty (with self-care such as) washing all over or dressing?
[Radio Button]
No
Yes
Using your usual (customary) language, do you have difficulty communicating, for example understanding or being understood?
[Radio Button]
No
Yes
Were you working for pay or profit during the past week?
Working includes being self-employed and not getting paid that week, on a postdoctoral appointment, traveling while employed, or on any type of paid or unpaid leave, including vacation.
[Radio Button]
Yes
No
[If 9 = Yes go to 11]
Did you look for work during the four weeks preceding today?
[Radio Button]
Yes
No
What is the job category that best describes the last job you held prior to the week of [survey posting date]? Mark one
[Radio Button]
Management Occupations
[Top Executives; Advertising, Marketing, Promotions, Public Relations, and Sales Managers; Operations Specialties Managers; Other Management Occupations]
Business and Financial Operations Occupations
[Business Operations Specialists; Financial Specialists]
Computer and Mathematical Occupations
[Computer Occupations; Mathematical Science Occupations]
Architecture and Engineering Occupations
[Architects, Surveyors, and Cartographers; Engineers; Drafters, Engineering Technicians; and Mapping Technicians]
Life, Physical, and Social Science Occupations
[Life Scientists; Physical Scientists; Social Scientists and Related Workers; Life, Physical, and Social Science Technicians; Occupational Health and Safety Specialists and Technicians]
Community and Social Service Occupations
[Counselors, Social Workers, and Other Community and Social Service Specialists; Religious Workers]
Legal Occupations
[Lawyers, Judges, and Related Workers; Legal Support Workers]
Educational Instruction and Library Occupations
[Postsecondary Teachers; Preschool, Elementary, Middle, Secondary, and Special Education Teachers; Other Teachers and Instructors; Librarians, Curators, and Archivists; Other Educational Instruction and Library Occupations]
Art, Design, Entertainment, Sports, and Media Occupations
[Art and Design Workers; Entertainers and Performers, Sports and Related Workers; Media and Communication Workers; Media and Communication Equipment Workers]
Healthcare Practitioners and Technical Occupations
[Healthcare Diagnosing or Treatment Practitioners; Health Technologists and Technicians; Other Healthcare Practitioners and Technical Occupations]
Healthcare Support Occupations
[Home Health and Personal Care Aides; and Nursing Assistants, Orderlies, and Psychiatric Aides; Occupational Therapy and Physical Therapist Assistants and Aides; Other Healthcare Support Occupations]
Protective Service Occupations
[Supervisors of Protective Service Workers; Firefighting and Prevention Workers; Law Enforcement Workers; Other Protective Service Workers]
Food Preparation and Serving Related Occupations
[Supervisors of Food Preparation and Serving Workers; Cooks and Food Preparation Workers; Food and Beverage Serving Workers; Other Food Preparation and Serving Related Workers]
Building and Grounds Cleaning and Maintenance Occupations
[Supervisors of Building and Grounds Cleaning and Maintenance Workers; Building Cleaning and Pest Control Workers; Grounds Maintenance Workers]
Personal Care and Service Occupations
[Supervisors of Personal Care and Service Workers; Animal Care and Service Workers; Entertainment Attendants and Related Workers; Funeral Service Workers; Personal Appearance Workers; Baggage Porters, Bellhops, and Concierges; Tour and Travel Guides; Other Personal Care and Service Workers]
Sales and Related Occupations
[Supervisors of Sales Workers; Retail Sales Workers; Sales Representatives, Services; Sales Representatives, Wholesale and Manufacturing; Other Sales and Related Workers]
Office and Administrative Support Occupations
[Supervisors and Office and Administrative Support Workers; Communications Equipment Operators; Financial Clerks; Information and Record Clerks; Material Recording, Scheduling, Dispatching, and Distributing Workers; Secretaries and Administrative Assistants; Other Office and Administrative Support Workers]
Farming, Fishing, and Forestry Occupations
[Supervisors of Farming, Fishing, and Forestry Workers; Agricultural Workers; Fishing and Hunting Workers; Forest, Conservation, and Logging Workers]
Construction and Extraction Occupations
[Supervisors of Construction and Extraction Workers; Construction Trades Workers; Helpers, Construction Trades; Other Construction and Related Workers; Extraction Workers]
Installation, Maintenance, and Repair Occupations
[Supervisors of Installation, Maintenance, and Repair Workers; Electrical and Electronic Equipment Mechanics, Installers, and Repairers; Vehicle and Mobile Equipment Mechanics, Installers, and Repairers; Other Installation, Maintenance, and Repair Occupations]
Production Occupations
[Supervisors of Production Workers; Assemblers and Fabricators; Food Processing Workers; Metal Workers and Plastic Workers; Printing Workers; Textile, Apparel, and Furnishings Workers; Woodworkers; Plant and System Operators; Other Production Occupations]
Transportation and Material Moving Occupation
[Supervisors of Transportation and Material Moving Workers; Air Transportation Workers; Motor Vehicle Operators; Rail Transportation Workers, Water Transportation Workers; Other Transportation Workers; Material Moving Workers]
Military Specific Occupations
[Military Officer Special and Tactical Operations Leaders; First-Line Enlisted Military Supervisors; Military Enlisted Tactical Operations and Air/Weapons Specialists and Crew Members]
Other Occupations Not Specified
Which of the following categories best describes your total household income from all sources, before taxes and deductions, in 2017?
[Drop down box]
Less than $25,000
$25,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $124,999
$125,000 to $144,999
$150,000 or higher
Decline to answer
The next questions ask about new or significantly improved products (goods or services) you developed on your own time.
Within the past three years, did you ever use your own time to create your own computer software including mobile or web apps?
A potential example of computer software is [Example(s): Vignette(s) chosen from Phase 1.]
[Radio Button]
Yes
No
[If 13 = No go to 16]
Did you create multiple computer software products including mobile or web apps during your own time in the last three years?
[Radio Button]
Yes
No
[If 14 = No go to 16]
How many computer software products including mobile or web apps have you created on your own time during the last three years?
[Fill In]
Number of software products ___
Within the past three years, did you ever use your own time to create your own household fixture or furnishing, such as kitchen- and cookware, cleaning devices, lighting, furniture, and more?
A potential example of a household fixture or furnishing is [Example(s): Vignette(s) chosen from Phase 1.]
[Radio Button]
Yes
No
[If 16 = No go to 19]
Did you create multiple household fixtures or furnishings during your own time in the last three years?
[Radio Button]
Yes
No
[If 17 = No go to 19]
How many household fixtures or furnishings have you created on your own time during the last three years?
[Fill In]
Number of household fixture or furnishings ___
Within the past three years, did you ever use your own time to create your own transport or vehicle-related product or part, such as cars, bicycles, scooters or anything related?
A potential example of a transport or vehicle related product or part is [Example(s): Vignette(s) chosen from Phase 1.]
[Radio Button]
Yes
No
[If 19 = No go to 22]
Did you create multiple transport or vehicle-related products or parts during your own time in the last three years?
[Radio Button]
Yes
No
[If 20 = No go to 22]
How many transport or vehicle-related products or parts have you created on your own time during the last three years?
[Fill In]
Number of transport or vehicle-related product or parts ___
Within the past three years, did you ever use your own time to create your own tools or equipment, such as utensils, molds, gardening tools, mechanical or electrical devices, and so on?
A potential example of tools or equipment is [Example(s): Vignette(s) chosen from Phase 1.]
[Radio Button]
Yes
No
[If 22 = No go to 25]
Did you create multiple tools or pieces of equipment during your own time in the last three years?
[Radio Button]
Yes
No
[If 23 = No go to 25]
How many tools or pieces of equipment have you created on your own time during the last three years?
[Fill In]
Number of tools or equipment ___
Within the past three years, did you ever use your own time to create your own sports-, hobby- or entertainment product, such as sports devices or games?
A potential example of a sports hobby or entertainment product is [Example(s): Vignette(s) chosen from Phase 1.]
[Radio Button]
Yes
No
[If 25 = No go to 28]
Did you create multiple sports-, hobby- or entertainment products during your own time in the last three years?
[Radio Button]
Yes
No
[If 26 = No go to 28]
How many sports-, hobby- or entertainment products have you created on your own time during the last three years?
[Fill In]
Number of sports-, hobby- or entertainment products ___
Within the past three years, did you ever use your own time to create your own children- or education-related product, such as toys and tutorials?
A potential example of children or education related product is [Example(s): Vignette(s) chosen from Phase 1.]
[Radio Button]
Yes
No
[If 28 = No go to 31]
Did you create multiple children- or education-related products during your own time in the last three years?
[Radio Button]
Yes
No
[If 29 = No go to 31]
How many children- or education-related products have you created on your own time during the last three years?
[Fill In]
Number of children- or education-related products ___
Within the past three years, did you ever use your own time to create your own help-, care- or medical-related product?
A potential example of a help care or medical related product is [Example(s): Vignette(s) chosen from Phase 1.]
[Radio Button]
Yes
No
[If 31 = No go to 34]
Did you create multiple help-, care- or medical-related products during your own time in the last three years?
[Radio Button]
Yes
No
[If 32 = No go to 34]
How many help-, care- or medical-related products have you created on your own time during the last three years?
[Fill In]
Number of help-, care- or medical-related products ___
Within the past three years, did you ever use your own time to create or modify any other types of products?
[Radio Button]
Yes
No
[If 34 = No go to next decision point]
Did you create multiple other type of products during your own time in the last three years?
[Radio Button]
Yes
No
[If 35 = No go to next decision point]
How many other types of products have you created on your own time during the last three years?
[Fill In]
Number of other types of products ___
What kind of other type of product did you create?
[Open Answer]
[If number of valid innovations (13, 16, 19, 22, 25, 28, 31, 34 = No) = 0 go to End]
[If number of valid innovations (13, 16, 19, 22, 25, 28, 31, 34 = Yes) > 1 go to 38]
[If number of valid innovations (13, 16, 19, 22, 25, 28, 31, 34 = Yes) = 1 go to 39]
You just identified a number of creations. Which one do you consider most significant?
Computer software
Household fixture or furnishing
Transport or vehicle-related product or part
Tool or piece of equipment
Sports-, hobby- or entertainment product
Children- or education-related product
Help-, care- or medical-related product
Other types of products
The next questions ask about the creation you consider most significant. The questions will refer to it as the [insert innovation (response from 38 or if number of valid innovations = 1 response from (13, 16, 19, 22, 25, 28, 31, 34 = Yes)].
What kind of [insert innovation] did you create?
[Open Answer]
What was new about this [insert innovation]?
[Open Answer]
At the time you developed the [insert innovation], could you have bought ready-made similar products on the market?
[Radio Button]
Yes
No
[If 41 = Yes go to End]
Did you primarily create the [insert innovation] to sell, to use yourself, or for some other reason?
[Radio Button]
To sell
To use myself
Other
[If 42 = To sell or To use myself go to 44]
Other - Please specify
[Open Answer]
Did you develop this [insert innovation] because you personally needed it?
[Radio Button]
Yes
No
Did you develop this [insert innovation] because you want to sell it or make money?
[Radio Button]
Yes
No
Did you develop this [insert innovation] because you wanted to learn or to develop your skills?
[Radio Button]
Yes
No
Did you develop this [insert innovation] because you were helping other people?
[Radio Button]
Yes
No
Did you develop this [insert innovation] for the fun of doing it?
[Radio Button]
Yes
No
Did you work with other people to develop this [insert innovation]?
[Radio Button]
Yes
No
[If 49 = No go to 51]
Approximately how many others contributed to developing this [insert innovation]?
[Fill In]
Number of people ___
Did you spend any money developing this [insert innovation]?
[Radio Button]
(1) Yes
(2) No
Did you use any of the following methods to protect this [insert innovation]?
a. Utility patents (patents for inventions) (1) Yes (2) No
b. Design patents (patents for appearance) (1) Yes (2) No
c. Trademarks (1) Yes (2) No
d. Copyrights (1) Yes (2) No
e. Trade secrets (1) Yes (2) No
f. Nondisclosure agreements (1) Yes (2) No
Have you made your [insert innovation] available to others, either for a price or for free?
[Radio Button]
Yes
No
[If 53 = Yes, go to 56]
Supposing that other people would be interested, would you be willing to FREELY share what you know about your [insert innovation]?
[Radio Button]
Yes, with anyone
Yes, but only selectively
No
Supposing that other people would offer some kind of COMPENSATION, would you be willing to share your [insert innovation]?
[Radio Button]
Yes, with anyone
Yes, but only selectively
No
Did you do anything to inform other people or businesses about your [insert innovation]? (For example: showing it off, communicating about it, posting its design to the web)
[Radio Button]
Yes
No
To the best of your knowledge, have any other people adopted your [insert innovation] for personal use?
[Radio Button]
Yes
No
[If 57 = Yes, go to 59]
Do you intend to contact other people who may adopt your [insert innovation] for personal use?
[Radio Button]
Yes
No
Do you, alone or with others, currently own a business you help manage, or are you self-employed?
[Radio Button]
Yes
No
[If 59 = No go to 61]
Did you commercialize your [insert innovation] via your business? Or do you intend to do this?
[Radio Button]
Yes, I commercialized it
Yes, I intend to do so
No
[If 60 = Yes, I commercialized it or Yes, I intend to do so go to 63]
Are you currently, alone or with others, trying to start a new business?
[Radio Button]
Yes
No
[If 61 = No go to 63]
Do you intend to commercialize your [insert innovation] with this new business?
[Radio Button]
Yes
No
Commercial businesses may be interested in your [insert innovation]. Did any commercial business adopt your [insert innovation] with intent to sell?
[Radio Button]
Yes
No
[If 63 = Yes, go to end of survey]
Do you intend to contact commercial businesses to adopt your [insert innovation] for general sale?
[Radio Button]
Yes
No
End of Survey
Thank you for your time.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Jessica Avery |
File Modified | 0000-00-00 |
File Created | 2021-01-20 |