ATTACHMENT A
ANNUAL SURVEY OF REFUGEES
REDESIGN PRETEST
NOTE: Questions appearing in emboldened text have been asked in previous iterations of the Annual Survey of Refugees. Text NOT emboldened represent new questions added to the ASR.
INTRO. We would like you to take part in a study that will help us improve our understanding of refugees in the U.S. It is funded by the Office of Refugee Resettlement and being conducted by the Urban Institute and a research organization called SSRS.
Earlier this year, your household participated in a telephone survey. We will be collecting this survey again and would like to ask for your help in improving the questions that we ask. We will be asking you some questions about your experiences and your reactions to the survey questions. We will send you a $40 gift card to thank you for participating, and it will take up to 2 hours. We can break this up to be as convenient as possible.
Before we start we just need to tell you a few things. You don’t have to answer any questions you don’t want to answer and you can stop the interview at any time. The answers you give will be private and will not have your name on them. Your information is protected by Federal law. You will continue to receive social services and benefits regardless of your decision to participate in the study.
Your participation is voluntary, but it will help the Office of Refugee Resettlement understand what refugees like you are going through. Reports will summarize the responses and will not identify any individuals. Only the researchers at the Urban Institute and SSRS will see your information.
Also, a federal agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number for this information collection is 0970-0355 and the expiration date is 03/31/2018.
Do you have any questions about the study or the interview?
Do you agree to be interviewed?
Next, we would like to ask your permission to record this interview for monitoring purposes. This is also voluntary. We will destroy the recording after this study is completed.
Do we have your permission to record the interview?
___ YES Thank you (BEGIN AUDIO RECORDING)
___ NO Ok, we will not record this interview. (DO NOT RECORD)
Now let’s begin.
[SCREENING TO CONFIRM THIS IS THE PRINCIPAL APPLICANT WHO ANSWERED THE PREVIOUS ASR SURVEY.]
(READ TO ALL)
We would like to start by asking you a few questions about each person who lives in your home, or who is staying or visiting there and has no other home.
(ASK ALL)
[PN: ALLOW UP TO 5 NAMES TO BE ENTERED.]
Q1. Let's start with you. <Auto-fill name of Respondent> Not counting you, tell me the names of each person who lives there starting with the oldest person.
(INTERVIEWER: If respondent does not want to provide names of household members, tell them we are only using the name to refer to the correct person in later questions. Just a first name or initials are fine.)
(PROBE: ARE THERE OTHER PERSONS WHO USUALLY LIVE HERE BUT ARE TEMPORARILY ABSENT?)
1 [RECORD RESPONDENT NAME]
2 [RECORD HH MEMBER #2 IF APPLICABLE]
3 [RECORD HH MEMBER #3 IF APPLICABLE]
4 [RECORD HH MEMBER #4 IF APPLICABLE]
5 [RECORD HH MEMBER #5 IF APPLICABLE]
(ASK ALL)
Q1b. How many additional people, if any, live in your home?
________ (RANGE: 0-15)
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
[PN: ASK Q2 through Q16 for each HH member named in Q1, including the respondent.] [If there are additional household members over 5 individuals, please collect Q2 and Q4 on those additional household members.]
Q2.
What is (INSERT NAME)’s relationship to you?
(DO NOT READ LIST)
01 Self
02 Husband or wife
03 Unmarried partner
04 Biological son or daughter
05 Adopted son or daughter
06 Stepson or stepdaughter
07 Brother or sister
08 Father or mother
09 Grandchild
10 Parent-in-law
11 Son-in-law or daughter-in-law
12 Other relative
13 Roomer or boarder
14 Housemate or roommate
15 Foster child
16 Other non-relative
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q3. Is (INSERT NAME) male or female?
(INTERVIEWER: CONFIRM BASED ON NAME; PROBE AS APPROPRIATE AND EXPLAIN NEED FOR ASKING THIS QUESTION]
1 Male
2 Female
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q4. What is (INSERT NAME)’s age?
. (INTERVIEWER: Please report babies as age 0 when the child is less than 1 year old)
___________ [RANGE 1-110]
000 Less than one year
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q5. What is (INSERT NAME)’s date of birth?
1 ENTER 2-DIGIT MONTH
2 ENTER 2-DIGIT DAY
3 ENTER 4-DIGIT YEAR
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(IF Q4 = AGE 15 OR OLDER AND NOT ALREADY COMMUNICATED ABOVE IN RELATIONSHIP)
Q6. What is (INSERT NAME)’s current marital status?
(DO NOT READ)
[INTERVIEWER: CONSIDER CULTURAL KNOWLEDGE TO DETERMINE WHETHER THIS IS AN APPROPRIATE QUESTION ABOUT WOMEN IN THE HOUSEHOLD]
1 Now married, spouse living in household
2 Now married, spouse not living in household
3 Divorced or separated
4 Never married
5 Widowed
6 Other (SPECIFY) _______________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q7. What is (INSERT NAME)’s country of birth?
(DO NOT READ LIST)
United States
Afghanistan
02 Bhutan
03 Burma
04 Burundi
05 Cuba
06 Democratic Republic of the Congo
07 Eritrea
08 Ethiopia
09 Iran
10 Iraq
11 Jordan
12 Kenya
13 Malaysia
14 Nepal
15 Rwanda
16 Somalia
17 Sudan
18 Syria
19 Tanzania
20 Thailand
21 Uganda
22 Ukraine
23 Other (SPECIFY) _______________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Were all members of this household born in [INSERT COUNTRY NAME] or were any members born in another country? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(ASK IF Q7!=01)
Q8. At what age did [INSERT NAME) arrive in the US?
____ [RANGE 1-110]
000 Less than one year
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q7!=01)
Q9. Did [insert name] enter as a refugee?
[PROBE: either as a Principal Applicant or as part of a refugee family]
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Did all members of this household arrive in the U.S. as a refugee? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(ASK IF Q7!=01)
Q10. In what month and year did (INSERT NAME) arrive in the U.S.?
1 [ENTER 2-DIGIT MONTH]
2 [ENTER 4-DIGIT YEAR]
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Did all members of this household arrive in the U.S. in [INSERT YEAR], or did any members arrive in a different year? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(ASK IF Q7!=01)
Q11. In what state did [insert name] originally resettle?
[PN: SHOW STATE LIST]
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
When first arriving in the U.S., did all members of this household originally settle in [INSERT STATE NAME] or did any members originally settle in a different state? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(ASK ALL)
Q12. What is (INSERT NAME)’s country of citizenship?
(DO NOT READ LIST)
01 Afghanistan
02 Bhutan
03 Burma
04 Burundi
05 Cuba
06 Democratic Republic of the Congo
07 Eritrea
08 Ethiopia
09 Iran
10 Iraq
11 Jordan
12 Kenya
13 Malaysia
14 Nepal
15 Rwanda
16 Somalia
17 Sudan
18 Syria
19 Tanzania
20 Thailand
21 Uganda
22 Ukraine
23 United States
24 No citizenship
25 Other (SPECIFY) _______________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Do all members of this household have citizenship from [INSERT CITIZENSHIP COUNTRY], or do some members have a different citizenship? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(ASK ALL)
Q13. What is (INSERT NAME)’s ethnic origin?
(DO NOT READ LIST)
01 ARAB
02 ARMENIAN
03 ASHARAF
04 BANTU
05 BANYAMULENGE, BANYAMULENGUE
06 BEMBE, BEMBA, MBEMBE
07 BURMESE
08 CHALDEAN
09 CHIN
10 CUBAN
11 DAROD
12 FARS
13 FUR
14 GREAT RUSSIAN
15 HAWIYE
16 HAZARA
17 HUTU
18 JEWISH
19 KACHIN
20 KAREN
21 KAREN NI (KAYAR)
22 KUNAMA
23 KURD
24 LHOTSAMPA
25 MASSALIT
26 OROMO
27 PASHTOON
28 PERSIAN
29 ROHINGYA
30 SAHO
31 SIRYAC
32 TAJIK
33 TIGRINYA
34 TUTSI
35 UKRAINIAN
36 ZAGAWA
37 OTHER (SPECIFY) _______________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Are all members of this household of [INSERT ETHNIC ORIGIN] origin, or do some members have a different ethnic origin? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(ASK ALL)
Q14. What is [insert name]'s race?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
1 White
2 Black or African American
3 Asian
4 Middle Eastern
5 Latino/Hispanic
6 Other (Specify) _______________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Are all members of this household [INSERT RACE], or do some members have a different race? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(ASK ALL)
Q15. Did [INSERT NAME] live in this house or apartment 1 year ago?
Yes
No
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Did all members of this household [live/not live] in this house or apartment 1 year ago? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(IF Q15=2)
Q16. One year ago, was [INSERT NAME] living…
1 In a different state
2 In this state but a different town, city, or metropolitan area
3 In this town, city, or metropolitan area
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Is this true for other members of this household who did not live here last year? (INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)
(ASK IF APPLICABLE BASED ON HH ROSTER (i.e. THERE ARE CHILDREN OR ELDERLY IN THE HOUSEHOLD))
Q17. Who if anyone in the household is responsible for most of the daily caregiving for any children, disabled, or elderly who live in this house or apartment?
[LIST ROSTER NUMBER]
(DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Now I want to ask you some questions about your experience before your arrival in the U.S. First, about when you lived in your home country.
(ASK ALL)
Q18. Before you left your home country, were you working?
(INTERVIEWER: This may be confusing for some, such as those who were born in a refugee camp. Describe reaction in Specify field. If respondents are confused by “your home country”, refer to “before you came to the U.S.”)
Yes
No
(DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q18=01)
Q19. Did you own your own business or work for your family business or farm?
Yes, SPECIFY _______________
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q18=02, 97, 98, OR 99)
Q20. What were you primarily doing before you left your home country?
Not working but looking for a job
Serving in the military
Studying
Taking care of children or family
Disabled and unable to work
Retired and not working
Other, SPECIFY ___________
(DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK IF Q18=01, 97, 98, OR 99)
Q21. In your home country, what kind of work did you do, that is, what was your occupation? For example: plumber, typist, or farmer.
_______ (RECORD RESPONSE)
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Next let’s talk about your experience after you leaving your home country and while you were displaced: the time before your arrival in the U.S.
(ASK ALL)
Q22. In what year did you leave your home country?
(INTERVIEWER: This may be confusing for some, such as those who were born in a refugee camp. Describe reaction in Not Applicable Specify field. If respondents are confused by “after you left your home country” in the following questions, refer to “before you came to the US”.)
____________
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q23. After you left your home country and while you were displaced, were you living…
In a refugee camp
In a city, town, village, or countryside
In another type of location, SPECIFY ___________
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q24. How long were you displaced? By this I mean, how many years went by after leaving your home country and before coming to the US?
________
(DO NOT READ) NOT APPLICABLE, SPECIFY WHY___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q25. Was your education or schooling interrupted when you had to flee and leave your home country?
Yes
No
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF R HAS CHILDREN AGED 6 OR OLDER in HH Roster above)
Q26. During the time after leaving your home country and while you were displaced, were your children able to go to school?
Yes
No
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q27. During the time after leaving your home country and while you were displaced, were you working?
Yes
No
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q27=01)
Q28. Did you own your own business or work for your family business or farm?
Yes, SPECIFY _______________
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q28=01, 97, 98, OR 99)
Q28b. While you were displaced, what kind of work did you do, that is, what was your occupation? For example: plumber, typist, or farmer.
_______ (RECORD RESPONSE)
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q27=02, 97, 98, OR 99)
Q29. What were you primarily doing during the time before you came to the U.S. (IF NEEDED: while you were displaced)?
Not working but looking for a job
Serving in the military
Studying
Taking care of children or family
Disabled and unable to work
Retired and not working
Other, SPECIFY ___________
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q30. What was the highest degree or level of school that you completed before coming to the U.S.?
(DO NOT READ LIST)
No schooling
Primary or elementary school
High school (secondary)
Some technical or vocational training
Some university classes but did not attain degree
University (bachelor's degree)
Advanced degree (master's, PhD, or professional degree)
(DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Next I want to ask about your ability in your native language and in English.
(ASK ALL)
Q31. How well can you read in your native language?
1 Very well
2 Well
3 Not well
4 Not at all
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q32. How well can you write in your native language?
1 Very well
2 Well
3 Not well
4 Not at all
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q33. Before coming to the U.S. did you study English or take ESL or English classes?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q34. When you arrived in the U.S., how well did you speak English?
1 Very well
2 Well
3 Not well
4 Not at all
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q35. How well do you speak English now?
1 Very well
2 Well
3 Not well
4 Not at all
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q35=3 or 4)
Q36. In which settings do you have trouble communicating because of your English ability?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)
1 When buying groceries
2 At work
3 In training classes
4 In a social setting with Americans (native English speakers)
5 With heath care providers
6 At the pharmacy
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q37. Have you ever taken any ESL or English classes in the U.S?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q37=01)
Q38. Where have you taken ESL or English classes in the U.S.?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER: IF NEEDED ON CHURCH OR OTHER RELIGIOUS ORGANIZATION OR GROUP: like a temple, synagogue, or mosque)
(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)
At work
Local school or college
Library
Refugee resettlement organization
Church or other religious organization
Community or ethnic organization
OTHER (SPECIFY) ___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q39. Which of the following challenges, if any, have you had taking ESL or English classes in the US?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
No challenges
Classes not available
Work responsibilities
Child care or family responsibilities
Cost
Low literacy in own language
OTHER, (SPECIFY) ___________
(DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
(DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Next I would like to ask some questions about any programs or classes you may have taken here in the U.S. other than studying English.
(ASK ALL)
Q40. In the last year, have you participated in a program to prepare you for a job?
(INTERVIEWER: IF NEEDED: job training classes or programs or job search training (interview and resume preparation, job search training))
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q40=01)
Q41. Where did you take this job preparation program?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER:
PAUSE AND CAPTURE EACH ONE)
At work
Local school or college
Library
Refugee resettlement organization
Church or other religious organization
Community or ethnic organization
OTHER (SPECIFY) ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q42. Since arriving in the U.S., have you pursued a degree or certificate by attending school, community college, or college, with classes either online or in a classroom?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q42=01)
Q43. At what level was/is the degree or certificate program?
GED or high school equivalency
Professional certificate
Associate's degree
Bachelor's degree
Advanced degree (master's, PhD, or professional)
OTHER (SPECIFY) ________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q42=01)
Q44. What were your goals in pursuing this degree or certificate?
(DO NOT READ)
Earn a higher wage
Get a better job
OTHER (SPECIFY) _____
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q42=01)
Q45. Have you completed this degree or certificate?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q46. Which of the following challenges, if any, have you had getting training or education?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
No challenges
Classes not available
Limited English ability
Work responsibilities
Child care or family responsibilities
Cost
Low literacy in own language
OTHER (SPECIFY) ___________
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
[Note the work questions Q47-74 will be asked about all eligible refugee adults in the household, not just the respondent. Interviewer will go through all questions for the respondent, then cycle through for each of the remaining adult household members. If there was uncertainty about the age, refugee status, or entrance year for any household members, err on including all adult household members in this section.]
In this next part of the survey, I’d like to ask about you and other adult members of your household: [fill in the names of those eligible based on the screening/HH roster]. First we will talk about your employment.
(ASK ALL)
Q47. Last week, did [INSERT NAME] work for pay at a job or business?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99)
Q48. How did [INSERT NAME] usually get to work last week?
Car, truck, or van
Public transportation (bus, streetcar, subway)
Taxicab or car share such as Uber
Bicycle
Walked
Worked at home
OTHER (SPECIFY) ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99)
Q49. How many hours did [INSERT NAME] work at all jobs last week?
________ (RANGE: 0-96)
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=02)
Q50. Although [INSERT NAME] did not work last week, did [INSERT NAME] have a job or business at any time in the past year?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99 or Q50=01, 98, OR 99)
Q51. In the past year, how many weeks did [INSERT NAME] work, even for a few hours, including paid vacation, paid sick leave, and military service?
(INTERVIEWER: If they’re having difficulty giving you a number of weeks, probe for dates and calculate the number of weeks)
________ (RANGE: 0-52)
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99 or Q50=01, 98, OR 99)
Q52. How many hours per week did [INSERT NAME] usually work?
________ (RANGE: 0-168)
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99 OR Q50=01, 98, OR 99)
Q53. Was/were [INSERT NAME] employed for pay by:
(INTERVIEWER: IF NEEDED on Government: local, state, or federal)
(INTERVIEWER: IF NEEDED on Private for-profit: business or individual, "in the private sector"]
(INTERVIEWER: IF NEEDED Private not-for-profit: includes tax exempt or charitable organization)
Government
Private for-profit
Private not-for-profit
Self-employed in own business, professional practice, or farm
OTHER (SPECIFY) ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99 or Q50=01, 98, OR 99)
Q54. What kind of work did/does [INSERT NAME] do, that is, what is [INSERT NAME]’S occupation? For example: plumber, typist, or farmer.
(INTERVIEWER: IF NEEDED: what is the work you are doing?)
________ (record occupation)
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99 or Q50=01, 98, OR 99)
Q55. What kind of business or industry is/was this?
[INTERVIEWER: Describe the activity at the location where employed, for example, hospital, airport, bank, manufacturing]
________ (record industry)
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99 or Q50=01, 98, OR 99)
Q56. What is [INSERT NAME]'s hourly wage at his/her primary job?
________ (RANGE: 0-96)
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK IF Q47=01, 98, OR 99 or Q50=01, 98, OR 99)
Q57. How much does [INSERT NAME] approximately earn each month from all job(s)?
________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK IF Q47=02)
Q58. During the last 4 weeks, has [INSERT NAME] been actively looking for work?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q58=02, 98, OR 99)
Q59. Is [INSERT NAME] ...
Wanting to find work but limited by poor health or disability
Wanting to find work but limited by English ability
Attending school or training
Providing child care or family caregiving
Elderly (past retirement age)
OTHER (SPECIFY) ___________
98 (DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK IF Q50=02)
Q60. Has [INSERT NAME] ever worked since coming to the U.S.?
1 Yes
2 No, never worked in the U.S
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q58=02, 98, OR 99)
Q61. Since [INSERT NAME] arrived in the U.S., has [INSERT NAME] ever actively looked for work?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q60=02, 98, OR 99)
Q62. Which of the following challenges, if any, has [INSERT NAME] faced in finding a job in the US?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)
No challenges
Limited English ability
Not knowing how to find a job
Employers do not recognize qualifications or work experience from outside the US
Not having family or friends who could help
Not being able to find or afford child care
OTHER (SPECIFY) ___________
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
[NEXT SECTION ONLY IF HAS EVER WORKED IN THE US] Now let’s talk about your first job that you got in the U.S.
(ASK IF Q47=01, Q50=01, OR Q60=01)
Q63. How many months did it take for [INSERT NAME] to get your/his/her first job in the U.S?
________ (RANGE: 0-168)
8 (DO NOT READ) Don’t know
9 (DO NOT READ) Refused
(ASK IF Q47=01, Q50=01, OR Q60=01)
Q64. Who was the most helpful to [INSERT NAME] to get your/his/her first job in the US?
Got it myself/himself/herself
Relatives
Friends
Refugee resettlement organization/case worker
Government agency
Private employment agency
OTHER (SPECIFY) ___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK IF Q47=01, Q50=01, OR Q60=01)
Q65. Is [INSERT NAME]’s most recent job the same as that first job in the U.S., or have/has you/he/she had different jobs since that first job?
(DO NOT READ)
1 Yes, still working at the same job
2 No, has worked in different jobs since then
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, Q50=01, OR Q60=01)
Q66. What kind of work did you/he/she do in that first job, that is, what was your/his/her occupation? For example: plumber, typist, or farmer.
_______ (RECORD RESPONSE)
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, Q50=01, OR Q60=01)
Q67. Did that first job come with health insurance benefits?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q47=01, Q50=01, OR Q60=01)
Q68. How well did that first job match with your/his/her skills?
Well matched
Somewhat matched
Somewhat unmatched
Very unmatched
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK IF Q65=02, 98, OR 99)
Q69. Does [INSERT NAME]'s most recent job align better with your/his/her skills?
(DO NOT READ)
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q65=02, 98, OR 99)
Q70. Does [INSERT NAME]'s most recent job provide a higher hourly wage?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q30=04-07)
Q71. Has [INSERT NAME]’s education, degree, or certificate earned outside the U.S. been recognized in the U.S.?
Fully recognized
Partially recognized
Not at all recognized
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q30=04-07)
Q72. Has [INSERT NAME] applied for a U.S. professional license to recognize your/his/her education and experience earned outside the U.S.?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q30=04-07)
Q73. Does [INSERT NAME]’s most recent job make use of his/her/your most recent training and education obtained outside the US?
Makes full use
Makes some use
Does not make use
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q30=04-07)
Q74. Does [INSERT NAME]‘s current job make use of his/her/your most recent training and education obtained in the US?
Makes full use
Makes some use
Does not make use
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
[SHIFT BACK HERE TO ASKING ONLY ABOUT THE RESPONDENT, NOT ALL ELIGIBLE ADULTS]
Now I would like to ask you some questions about your family and how you support yourselves.
(ASK ALL)
Q75. How many people in your family work at least part time?
________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK IF Q75>0)
Q76. Are any of the wage earners under 18 years old?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q77. Approximately, what is your family's average monthly net household income? (INTERVIEWER: this means how much money do they take in, after taxes are removed)
________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q78. Is your family's monthly income sufficient to cover rent, food, and other expenses necessary for daily living? Would you say it is:
Too low
Enough
More than enough
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q79. Does your family get any help from:
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)
Family members in another household
Friends
Refugee resettlement organization/case worker
Church or other religious organization
Community or ethnic organization
Library
Student loans or scholarships
Savings
OTHER (SPECIFY)
(DO NOT READ) Don’t know
(DO NOT READ) Refused
Next I would like to ask about your family’s receipt of different government benefits.
(ASK ALL)
Q80. In the past year, have one or more persons in your family received food stamps? This is when the government gives you vouchers that you exchange for food, also known as “SNAP”.
(INTERVIEWER: Food stamps, now known the Supplemental Nutrition Assistance Program (SNAP), are vouchers issued by the government for low income families or individuals that can be exchanged for food.)
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(IF THERE ARE CHILDREN <18 in the Household)
Q81. In the past year, have one or more persons in your family received [INTERVIEWERS: REFER TO LIST OF STATE-LEVEL TANF PROGRAMS NAMES]. This is when the government provides cash assistance to families with children to help pay for food, shelter, utilities, and non-medical expenses.
(INTERVIEWER: TANF is a federally-funded program run by states that provides limited cash assistance to extremely low-income parents and their children. TANF provides financial assistance to help pay for food, shelter, utilities, and expenses other than medical. Each state in the U.S. has a different name for its TANF program, see list provided to match to respondent’s current state.]
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q82. In the past year, have one or more persons in your family received “SSI” or Supplemental Security Income? This is when the government provides cash assistance to the elderly and disabled.
(INTERVIEWER: Supplemental Security Income (SSI) is a United States government program that provides stipends to low income people who are either aged 65 or older, blind, or disabled.)
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q83. In the past year, have one or more persons in your family received income from General Assistance or other welfare? This is when the government assists adults in meeting their basic needs for housing, utilities, personal needs, and transportation.
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q84. Did one or more persons in your family ever receive “Refugee Cash Assistance”? This is when the government provides assistance to refugees who are not eligible for TANF or SSI during their first 8 months in the US.
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q85. In the past year, have you received any other government supports, from federal, state, or local government?
Yes, (SPECIFY) ___________
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Next I would like to ask you some questions about your neighborhood and connections to the community.
(ASK ALL)
Q86. When you arrived in the U.S., how many family members were already living in the U.S.?
________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK if Q86>0)
Q87. How many family members, if any, live in the same community as you (INTERVIEWER: city, town, metropolitan area) as you now?
________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q88. How many of your neighbors share your background?
(INTERVIEWERS: if necessary: They share the same culture, ethnic group, language, or religion)
All or most
About half
Only a few
None
(DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q89. Have you visited the home of any friends or neighbors of the same background, or have any visited your home?
(INTERVIEWERS: if necessary: They share the same culture, ethnic group, language, or religion)
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q90. Have you visited the home of any friends or neighbors of a different background, or have any visited your home?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q90=01)
Q91. How did you meet this person (or these people) (IF NEEDED: of a different background)?
(DO NOT READ)
Through work
Through children's school
At ESL or other training class
Through church or other religious organization
Through community or ethnic organization or club
Through sports club or team
Through resettlement agency/case worker
OTHER (SPECIFY) ___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q92. How welcome do you feel in the U.S.?
Very welcome
Somewhat welcome
Somewhat unwelcome
Very unwelcome
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q93. Which, if any kinds of groups or organizations have you participated in?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
[INTERVIEWER: PAUSE AND CAPTURE EACH ONE]
(INTERVIEWER: IF NEEDED ON GROUP RELATED TO CHILDREN'S SCHOOL: like the PTA or parents' volunteering groups)
Group related to children's school
Church or other religious organization or group
Community or ethnic organization or club
Sports club or team
Other (SPECIFY) _________
None
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF NOT U.S. CITIZEN FROM HOUSEHOLD ROSTER)
Q94. Are you planning to become a U.S. citizen?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q94=02, 98, OR 99)
Q95. Have you applied for a green card (to become a permanent resident)?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Next I’d like to talk about your everyday life and what it’s like to live in your city or town.
(ASK ALL)
Q96. Do you have anyone you can go to for advice on how to get things done in the U.S.?
Yes, Specify_____________
No
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q97. Do you have a U.S. driver's license?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q98. How difficult or easy is it to buy groceries?
Very difficult
Somewhat difficult
Somewhat easy
Very easy
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q99. How difficult or easy is it to use public transportation (bus, subway, etc)?
Very difficult
Somewhat difficult
Somewhat easy
Very easy
Not Applicable, there is no public transportation where I live
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q100. How connected do you feel to other refugees in your town or city?
Very connected
Somewhat connected
Somewhat isolated
Very isolated
(DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
Q101. How connected do you feel to non-refugees in your town or city?
Very connected
Somewhat connected
Somewhat isolated
Very isolated
(DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
(DO NOT READ) Don’t know
(DO NOT READ) Refused
I am now going to ask you about assets that you own in the U.S.
(ASK ALL)
Q102. Do you own...
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
[INTERVIEWER: PAUSE AND CAPTURE EACH ONE]
A car or truck
A house or apartment
A mobile home
A business or farm
A plot of land
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q103. Do you own any other assets, in the U.S. or elsewhere?
[INTERVIEWER: THIS COULD INCLUDE BANK ACCOUNTS OR OTHER FINANCIAL RESOURCES, A CAR OR TRUCK, A HOME, BUSINESS OR FARM, PLOT OF LAND, OTHER PROPERTY, EQUIPMENT, LIVESTOCK, OR OTHER BELONGINGS THAT HAVE MONETARY VALUE]
Yes (SPECIFY) ___________
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q104. Which if any do you plan to buy in the future?
[PN: ALLOW MULTIPLE RESPONSES – CODES 8-9 MUTUALLY EXCLUSIVE]
[INTERVIEWER: PAUSE AND CAPTURE EACH ONE]
A car/truck
A house or apartment
A mobile home
A business or farm
A plot of land
OTHER (SPECIFY) ___________
None
(DO NOT READ) Don’t know
(DO NOT READ) Refused
Now I will ask you some questions about where you currently live.
(ASK ALL)
Q105. Is your house or apartment where you currently live…
Owned or being bought by someone in the household
Rented
OTHER (SPECIFY) ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q106. How much do you pay each month to the monthly rent or housing payment for the apartment or house where you live?
(INTERVIEWER: THE TOTAL RENT FOR A UNIT MAY BE $800 PER MONTH, AND WE WANT TO KNOW HOW MUCH THIS INDIVIDUAL CONTRIBUTES PERSONALLY TO THAT $800]
---------
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q107. What is the total monthly rent or housing payment for where you live?
(INTERVIEWER: HERE YOU WANT TO KNOW WHAT THE MONTHLY RENT IS, NOT JUST WHAT THE INDIVIDUAL RESPONDENT CONTRIBUTES EACH MONTH]
--------
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q108. Is your rent amount lower because you are either in a federal, state or local government housing program?
[INTERVIEWER: THIS MAY INCLUDE SECTION 8 HOUSING, SUBSIDIZED HOUSING OR A HOUSING VOUCHER.]
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q109. How safe do you feel being alone inside your home? (INTERVIEWER: If needed: apartment/house)
Very safe
Somewhat safe
Somewhat unsafe
Very unsafe
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q110. How safe do you feel outside, in your neighborhood?
Very safe
Somewhat safe
Somewhat unsafe
Very unsafe
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q111. Since coming to the U.S., have you or any one in your family been the victim of a crime such as assault, robbery, or vandalism?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q112. Discrimination may happen when people are perceived as being different than others. Since coming to the U.S., have you experienced discrimination or been treated unfairly by others because of your ethnicity, race, skin color, culture, language or accent, gender, or religion?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q112=01, 98, OR 99)
Q113. In which places or situations do you feel you experienced discrimination or were treated unfairly?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
[INTERVIEWER: PAUSE AND CAPTURE EACH ONE]
On the street
In local businesses
At work or when applying for a job or promotion
When dealing with police or courts
In school or class
When looking for a place to live or when renting or buying a home
When dealing with health care providers
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Next I’d like to talk about your health and your access to health care services.
(ASK ALL)
Q114. Have you visited the doctor for a routine physical exam within the past year?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q115. Do you have a “primary care provider”, one person you think of as your personal health care provider?
1 Yes, only one
2 Yes, more than one
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK
ALL)
Q116. Do you know how to make an appointment to see a doctor?
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q117. What is your usual source of medical care?
Primary care doctor at private office or health clinic
“Urgent care”
Emergency room at a hospital
Healer from your country
OTHER (SPECIFY) _______
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q118. Would you say that in general your physical health is?
Excellent
Very Good
Good
Fair
Poor
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q119. Would you say that in general your mental health is?
Excellent
Very Good
Good
Fair
Poor
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q120. Who do you talk to when you feel stressed or anxious?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)
No one
Friend or family member
Resettlement agency case worker
Health care provider
Religious leader
Healer from your country or folk healer
OTHER (SPECIFY) _______
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q121. How do you keep healthy?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)
Exercise
Eating well
Meditation/prayer
Seeing my health care provider regularly
Engaging in social/community activities
None
OTHER (SPECIFY) _______
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q122. When you or family members have a medical problem, who do you go to first?
Friend or family member
Resettlement organization/case worker
Health care provider
Religious leader
Healer from my country or folk healer
OTHER (SPECIFY) _______
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q123. In the past year, have you or family members received any type of health care services from doctors, nurses, dentists, clinics or hospitals?
(INTERVIEWER: Note this should not include traditional healers.)
1 Yes
2 No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q124. Which of the following challenges, if any, do you or family members face in receiving medical care?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)
No challenges
Don’t know how to find a medical provider
No translator or interpreter
Transportation challenges
Cost of care
No insurance coverage
(DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q125. In the past year, have you or family members delayed seeking medical care because of worry about the costs?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q126. What kind of health insurance or health care coverage do you have?
(INTERVIEWER: Medicaid and CHIP are federally-funded programs run by states, that provide health care coverage to low-income adults, children, pregnant women, elderly, and people with disabilities. Each state in the U.S. has a different name for its Medicaid and CHIP programs, see list provided to match to respondent’s current state. CHIP is the Children’s Health Insurance Program, which provides health coverage to children]
No insurance
Insurance through own employment
Insurance through family member’s employment
Medicaid or CHIP (INTERVIEWER: REFER TO CHIP PROGRAM NAMES)
OTHER (SPECIFY) _______
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF HAVE CHILDREN IN HH ROSTER)
Q126B. What kind of health insurance or health care coverage does/do your child/children have?
No insurance
Insurance through my employment
Insurance through other family member’s employment
Medicaid or CHIP
OTHER (SPECIFY) _______
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q127. Back when you arrived in the U.S., did one or more persons in your family ever receive "Refugee Medical Assistance"? This is when the government provides medical assistance to refugees who are not eligible for Medicaid, during their first 8 months in the US.
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q128. In the past year, were there any periods when you or family members were without health insurance or health care coverage?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q128=01, 98, OR 99)
Q129. About how many months were you or any of your family members without health insurance or health care coverage?
[INTERVIEWER: THIS MAY VARY ACROSS FAMILY MEMBERS. THIS SHOULD BE LONGEST THAT ANY ONE FAMILY MEMBER WAS WITHOUT HEALTH INSURANCE IN THE PREVIOUS YEAR]
________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
[IF household roster included any children under age of 20 and respondent is their parent or guardian]
I’d like to ask a few questions now about your children.
(ASK IF ANY CHILDREN UNDER AGE OF SIX AND Q47=01)
Q130. How have you arranged for your child(ren) to be taken care of while you work? Please tell me all the types of child care arrangements you have used.
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(DO NOT READ)
Spouse
Older sibling(s)
Other relatives (INTERVIEWER: not spouse or child(ren)'s older siblings)
Friends/neighbors
Out of home (INTERVIEWER: day care/center/babysitter)
OTHER (SPECIFY) _______
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK QUESTIONS 131-138 ABOUT THE OLDEST CHILD IN THE HOUSEHOLD UNDER AGE OF 20 AND OVER AGE 5)
Q131. Did [INSERT CHILD’S NAME] attend school outside the US?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK QUESTIONS 131-138 ABOUT THE OLDEST CHILD IN THE HOUSEHOLD UNDER AGE OF 20 AND OVER AGE 5) Q132. Was [INSERT CHILD’S NAME] enrolled in school last year?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q132=02)
Q133. Why was [INSERT CHILD’S NAME] not enrolled in school?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)
Dropped out of school
Not able to enroll (INTERVIEWER: problems registering, accessing school, etc.)
Is being home schooled (INTERVIEWER: parents have chosen to provide formal education at home rather than sending child to school)
Is pursuing other education, such as GED preparation program
5 Is working full-time
6 Other, SPECIFY
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK QUESTIONS 131-138 ABOUT THE OLDEST CHILD IN THE HOUSEHOLD UNDER AGE OF 20 AND OVER AGE 5)
Q134. As things stand now, what is the highest level of schooling you think [INSERT CHILD’S NAME] will complete?
(DO NOT READ)
Will not finish high school (will drop out)
Will graduate from high school or attain GED, but won't go any further
Will attend vocational or trade school
Will attend community college or college
Will graduate with a college degree
Other, SPECIFY
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK QUESTIONS 131-138 ABOUT THE OLDEST CHILD IN THE HOUSEHOLD UNDER AGE OF 20 AND OVER AGE 5)
Q135. Has [INSERT CHILD’S NAME] had any problems in school?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q135=01)
Q136. What kinds of problems?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
(DO NOT READ)
Limited English ability
Teachers not well prepared for children from your culture
Behavior problems (discipline)
Academic problems
Conflict with classmates or bullying
Not understanding academic expectations in the U.S.
Other, SPECIFY
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK QUESTIONS 131-138 ABOUT THE OLDEST CHILD IN THE HOUSEHOLD UNDER AGE OF 20 AND OVER AGE 5)
Q137. Has a health or education professional told you that [INSERT CHILD’s NAME] has any learning or emotional impairment?
[INTERVIEWER: THIS COULD INCLUDE A LEARNING DISABILITY, AUTISM, ATTENTION DEFICIT DISORDER (ADD OR ADHD), DEPRESSION, ANXIETY, OR OTHER ISSUES]
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q137=01)
Q138. What impairment was diagnosed?
_______ (RECORD RESPONSE)
97 (DO NOT READ) NOT APPLICABLE, SPECIFY WHY: ___________
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Next I will ask you some questions about your [if applicable: and your spouse's] interaction with your children’s school and how you engaged during the last school year.
(ASK IF Q132=01, 98, OR 99)
Q139. During the last school year did you [if applicable: or your spouse] visit [any of] your children’s school?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q132=01, 98, OR 99)
Q138. Did you [or your spouse] attend a school event? (INTERVIEWER: social, sporting, cultural, or educational activity or event)?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q132=01, 98, OR 99)
Q139. Did you [or your spouse] volunteer to help at your children's school?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q132=01, 98, OR 99)
Q140. Did you [or your spouse] phone or speak to a teacher or counselor?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q132=01, 98, OR 99)
Q141. Did you [or your spouse] visit your child's classes?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q132=01, 98, OR 99)
Q142. How difficult or easy is/was it for you [or your spouse] to participate at your children’s school considering your English ability?
Very difficult
Somewhat difficult
Somewhat easy
Very easy
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK IF Q132=01, 98, OR 99)
Q143. Does/did the school have interpreters who speak your native language for meetings or parent-teacher conferences?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q132=01, 98, OR 99)
Q144. Does/did the school have written materials, such as newsletters or school notices, that are translated into your native language?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
Let’s finish up with a few questions about your use of technology.
(ASK ALL)
Q145. Do you know how to use the Internet?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q146. Do you or any member of your household have access to the Internet?
Yes
No
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK ALL)
Q147. What kind of cell phone do you have, if any?
Smartphone
Other type of cell phone
No cell phone but have a landline
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q147=01, 02, 98, OR 99)
Q151. What "apps" do you use on your cell phone?
[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]
Messaging, like WhatsApp, Viber, or Kik
Social media, like Facebook
Translation
Games
Education and learning
OTHER (SPECIFY) _______
98 (DO NOT READ) Don’t know
99 (DO NOT READ) Refused
(ASK IF Q147=01, 02, 98, OR 99)
Q152. In the future, would you be willing to take this survey through an app on your cell phone rather than a telephone interviewer calling you?
Very willing
Somewhat willing
Somewhat unwilling
Not willing
(DO NOT READ) Don’t know
(DO NOT READ) Refused
(ASK ALL)
Q153. Would you be willing to participate in this survey again in the coming years?
Yes
No
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Linda Lomelino |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |