Form Interview Verifica Interview Verifica Interview Verification Script

National Mental Health Study Field Test,
Supporting Statement
Attachment AC-2 – CATI Verification Scripts
(Interview Only)

CATI Verification Scripts (Interview Only)

This page intentionally left blank.

Verification Script for Code 70
General Information:
All skips or routing instructions to be programmed are noted next to response in brackets [ ]
Skip path map for each question is indicated by {} beside each question name but should not be programmed.
These are there to aid in testing/review of all the various paths to make sure skips are working properly
Gender = Male/Female
All fills are designated by italics text in parentheses (address)
(FI Pronoun): he/she based on FI’s gender
(FI Description): age, gender, height, race
Program fill for past or future tense as follows:
Use the first portion of the fill (will live/lived)
If Qtr 1 and call is before Feb 15, else use second portion
If Qtr 2 and call is before May 15, else use second portion
If Qtr 3 and call is before August 15, else use second portion
If Qtr 4 and call is before November 15, else use second portion
Program fill for (3-month quarter field period)
Qtr 1= January, February, March
Qtr 2= April, May, June
Qtr 3= July, August, September
Qtr 4 = October, November, December
Program fill for (HH Count Noun)
If number rostered is 1 = person
If number rostered is >1 = people
Program fill for (HH Count Noun 2)
If number rostered is 1 = whether this person is male or female
If number rostered is >1 = how many of these people are male and how many are female
Program fill for (this/these):
If number rostered is 1 = person
If number rostered is >1 = people
(Screening Date) fill: Date of final Screening Code
(Roster Data): age, gender, race for each HH member
(teen demo): demographic data for teen respondent - age, gender. If no gender, use “youth”
(adult demo): demographic data for adult respondent - age, gender. If no gender, use “person”
(teen pronoun): his/her fill for teen respondent
(relationship to R): Relationship to Respondent from Verification Form for age 13-17 (Adult who gave permission
for youth to complete the interview. If “relationship to R” is missing, the word choice after the / will appear.

(city, state and zip code): city, state and zip code for address
(number rostered): total number of people in roster
The responses from the following variable items will need to be available for a frequency or data dump by request:
A1A4 (verbatim elaboration on street number or name discrepancy)
A1B2 (verbatim elaboration on city, state, zip code discrepancy)
A2AELB1 (verbatim elaboration on interview completed some other way)
A3BELB1 (verbatim elaboration on why the R could not enter responses into computer)

DESROS2 (verbatim elaboration on roster discrepancy)
DESROS (verbatim elaboration on roster discrepancy)
MPAYDES1 (verbatim elaboration on how much the R was paid for participation)
PAYCHG (how much the payment influenced the R’s participation)
ELB1A (verbatim elaboration on how the FI was unprofessional)
COMMENTS (verbatim elaboration on how another FI was unprofessional)

Screening Information Provided for Codes 70:
CaseID
Phone number (designates home or work phone)
Address
Demographic data for respondent
Relationship to Respondent (from Verification Form) if R is 13-17
Code 32 info: If a code 32, demographic data for both respondents
(to use on help screen)

Interview Verification Script:
>UNDR18AA<

{DIAL SCREEN}

(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicate that a (teen demo) in your household was interviewed and that (teen’s relationship to
R /an adult) granted permission for this youth to complete the interview.
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored.
May I please speak to (the relationship to R/an adult in the household?)?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>
<3>
<4>
>Cell_Res1<

YES, SPEAKING TO ADULT [UND18B1A]
YES, ADULT IS AVAILABLE (NOT SPEAKING TO ADULT) [if cell number, go to
Cell_Res1, else UND18B1A]
ADULT UNAVAILABLE [CALLBACK]
ADULT UNKNOWN [NOADULTA]
{cell number and UNDR18AA=1}

Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [UND18B1A]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>UND18B1A<

{Cell_Res1 = 1 or not cell number}

IF YOU ARE SPEAKING WITH THE CORRECT ADULT, CONTINUE TO THE THIRD
PARAGRAPH ON THIS SREEN [UND18B1A1]
IF NOT, ONCE YOU ARE CONNECTED WITH THE CORRECT ADULT, RE-INTRODUCE
YOURSELF BEGINNING WITH THE FOLLOWING PARAGRAPH.
(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services. )
Our records indicate that a (teen demo) in your household was interviewed and that (teen pronoun +
relationship to R/someone) granted permission for this youth to complete the interview.
We would like to ask this teen a few questions to help us verify the quality of our interviewer’s
performance. It will take just a few minutes of their time. For training and quality assurance purposes, this

call may be monitored.  Would now be a convenient time for you to put me in touch with this teen?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>
<3>
<4>
>Cell_Res4<

YES, RESPONDENT AVAILABLE [if cell number, go to Cell_Res4, else UNDR18CA]
RESPONDENT UNAVAILABLE [CALLBACK]
RESPONDENT UNKNOWN [UNKNOWNA]
RESPONDENT KNOWN, BUT WILL NEVER BE AVAILABLE [UNKNOWNA]
{cell number and UND18B1A =1}

Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [UNDR18CA]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>UNDR18CA<

{Cell_Res4=1 or not cell number}

(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicated that you were interviewed.
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored.
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
ENTER (1) TO CONTINUE... [A1]
>NOADULTA<

{UND18AA=4}

Is there another adult I could speak to?
<1>
<2>
<3>
<4>
>Cell_Res2<

YES, SPEAKING TO HIM/HER [UND18B1B]
YES, ANOTHER ADULT AVAILABLE [if cell number, go to Cell_Res2, else UND18B1B]
YES, ANOTHER ADULT UNAVAILABLE [CALLBACK]
NO [UNKNOWNA]
{cell number and NOADULTA=1, 2}

Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.

Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [UND18B1B]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>UND18B1B<

{cell number and Cell_Res2 = 1, or not cell number}

IF YOU ARE SPEAKING WITH THE CORRECT ADULT, CONTINUE TO THE THIRD
PARAGRAPH ON THIS SCREEN.
IF NOT, ONCE YOU ARE CONNECTED WITH THE CORRECT ADULT, RE-INTRODUCE
YOURSELF BEGINNING WITH THE FOLLOWING PARAGRAPH.
(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)

Our records indicate that a (teen demo) in your household was interviewed and that (teen pronoun +
relationship to R/someone) granted permission for this youth to complete the interview.
We would like to ask this teen a few questions to help us verify the quality of our interviewer’s
performance. It will take just a few minutes of their time. For training and quality assurance purposes,
this call may be monitored. Would now be a convenient time for you to put me in touch with this teen?
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
<1>
<2>
<3>
<4>
>Cell_Res5<

YES, RESPONDENT AVAILABLE [if cell number, go to Cell_Res5, else UNDR18CB]
RESPONDENT UNAVAILABLE [CALLBACK]
RESPONDENT UNKNOWN [UNKNOWNA]
RESPONDENT KNOWN, BUT WILL NEVER BE AVAILABLE [UNKNOWNA]
{cell number and UND18B1B =1}

Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.
<1> Yes [UNDR18CB]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>UNDR18CB<

{Cell_Res5=1 or not cell number}

(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicated that you were interviewed.
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored.
(This is a scientific research study and the quality of data is essential. We monitor our interviewer’s work
in several ways. One very important check is to call some of the residences that were contacted to ensure
the interviewer followed proper procedures and behaved professionally.)
ENTER (1) TO CONTINUE... [A1]
>ADULTA1A<

{DIAL SCREEN}

(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services. )
Our records indicate that a (adult demo) in your household was interviewed and that they agreed to verify
this interview.
We would like to speak to this person to verify the quality of our interviewer’s performance. It will take
just a few minutes of their time. For training and quality assurance purposes, this call may be monitored.
Would now be a convenient time for you to put me in touch with this person?
(This is a scientific research study and the quality of data is essential. We monitor our
interviewer’s work in several ways. One very important check is to call some of the
residences that were contacted to ensure the interviewer followed proper procedures and
behaved professionally.)
<1>
<2>
<3>
<4>
<5>
>UNKNOWNA<

SPEAKING WITH TARGET RESPONDENT [A1]
YES, RESPONDENT AVAILABLE [if cell number, go to Cell_Res3, else ADULTBA]
RESPONDENT UNAVAILABLE AT THIS TIME [CALLBACK]
RESPONDENT UNKNOWN [UNKNOWNA]
RESPONDENT KNOWN, BUT WILL NEVER BE AVAILABLE [UNKNOWNA]
{UND18B1A=3 OR 4; UND18B1B= 3 OR 4; ADULTA1A= 4 OR 5}

It is important that we verify our interviewer made contact with someone at this number concerning
(address). Is this the correct phone number for (address)?
<1>
<2>
>Cell_Res3<

YES [A1C]
NO [A1C]
{cell number and ADULTA1A = 2}

ONCE SPEAKING WITH THE TARGET RESPONDENT
Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.
Are you in a place where you can safely talk on the phone and answer my questions?
INTERVIEWER: IF THE RESPONDENT CANNOT TALK RIGHT NOW, PLEASE ASK FOR A GOOD
TIME TO CALLBACK; IF THEY SIMPLY HANGUP, SET A RANDOM APPOINTMENT FOR 4
HOURS LATER.

<1> Yes [ADULTBA]
<2> No [END]
<8> Schedule a callback [END]
<9> Other Codes [END]
>ADULTBA<

{cell number and Cell_Res3=1, or not cell number}

(Hello, my name is _______________. I am calling from RTI International regarding a study sponsored by
the U.S. Department of Health and Human Services.)
Our records indicate that you were interviewed.
This call is to verify the quality of our interviewer’s performance. It will take just a few minutes of your
time. For training and quality assurance purposes, this call may be monitored.
(This is a scientific research study and the quality of data is essential. We monitor our
interviewer’s work in several ways. One very important check is to call some of the
residences that were contacted to ensure the interviewer followed proper procedures and
behaved professionally.)
ENTER (1) TO CONTINUE… [A1]
>A1<

{ADULTBA; ADULT1A=1; UND18CB; UND18CA}
Did you complete an interview for this study?
<1>
<2>

>A1A<

YES [A1A3]
NO [A1A]
{A1=2}

You would have answered questions on topics such as tobacco, alcohol, and health care and you would
have used a laptop computer that the interviewer supplied. Does this sound familiar?
<1>
<2>
>A1B<

YES [A1A3]
NO [A1B]
{A1A=2}

Were you ever contacted by one of our interviewers?
<1>
<2>
<3>
>A1C<

YES, BUT RESPONDENT DOES NOT REMEMBER COMPLETING INTERVIEW [A1A3]
YES, AND RESPONDENT DOES REMEMBER COMPLETING INTERVIEW [A1A3]
NO [A1C]
{A1B= 3}

Our interviewer is (FI Description), and would have been wearing a white badge with a picture I.D. (FI
Pronoun) may have been carrying a computer. Did this person ever contact you?
<1>
<2>
<3>
<4>

YES, BUT RESPONDENT DOES NOT REMEMBER COMPLETING INTERVIEW [IF
UNKONWNA=1 OR 2, GO TO A8; OTHERWISE GO TO A1A3]
YES, AND RESPONDENT DOES REMEMBER COMPLETING INTERVIEW [IF
UNKONWNA=1 OR 2, GO TO A2A; OTHERWISE GO TO A1A3]
NO [IF UNKONWNA=1 OR 2, GO TO A8; OTHERWISE GO TO A1A3]
YES, BUT SPEAKING TO ANOTHER HH MEMBER (NOT INTERVIEW RESPONDENT)
[IF UNKONWNA=1 OR 2, GO TO A8; OTHERWISE GO TO A1A3]

>A1A3<

{A1C=1, 2 or 4; A1B=1 or 2; A1A=1: A1=1}
It is important that the interviewer visited the correct address. Can you please provide the street number
and street name for the address where you lived when the interviewer contacted you? Please include the
apartment or unit number as well.
TI NOTE: DO NOT READ ADDRESS TO RESPONDENT. IF THE STREET NUMBER AND NAME
MATCH THIS INFORMATION, SELECT CORRECT. IF THEY DO NOT MATCH SELECT
INCORRECT.
(address)
TI NOTE: IF RESPONDENT PROVIDES THE CORRECT STREET NUMBER AND NAME BUT NOT
THE UNIT NUMBER OR STREET INDENTIFIER, YOU SHOULD PROVIDE THE MISSING
INFORMATION TO THE RESPONDENT TO CONFIRM IT IS ACCURATE.
<1>
<2>

>A1A4<

CORRECT [A1B1]
INCORRECT [A1A4]
DON’T KNOW [IF A1B=1 or A1C=1, 3, 4, GO TO A8; OTHERWISE GOT TO A2A]
REFUSE [IF A1B=1 or A1C=1, 3, 4, GO TO A8; OTHERWISE GOT TO A2A]
{A1A3=2}

(Can you please repeat that?)
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ADDRESS VERBATIM. [A1B1]
>A1B1<

{A1A3=1}
Is this address located in (city, state, and zip code)?
TI NOTE: IF THE CITY, STATE, AND ZIPCODE MATCH THIS INFORMATION, SELECT YES. IF
THEY DO NOT MATCH SELECT NO.
<1>
<2>

>A1B2<

YES [IF A1B=1 or A1C=1, 3, 4, GO TO A8; OTHERWISE GO TO A2A]
NO [A1B2]
DON’T KNOW [IF A1B=1 or A1C=1, 3, 4, GO TO A8; OTHERWISE GO TO A2A]
REFUSE [IF A1B=1 or A1C=1, 3, 4, GO TO A8; OTHERWISE GO TO A2A]
{A1B1=2}

Would you please provide the correct city, state and zip code?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ADDRESS VERBATIM. [IF A1B=1 or A1C=1, 3, 4, GO TO A8;
OTHERWISE GO TO A2A]
>A2A<

{A1C=2; A1B=2; A1A=1: A1=1}
Was the interview done entirely in person, over the phone, or by intercom?
IF YOU ARE SPEAKING TO A RESPONDENT THAT DOES NOT KNOW WHAT AN INTERCOM
IS, CONTINUE TO READ THE FOLLOWING SENTENCE

(An intercom is a device outside a home (usually an apartment building) that visitors can use to talk with a
person inside the home by pushing a button
TI NOTE: IF RESPONDENT SAYS IT WAS DONE ON A COMPUTER, PROBE BY ASKING IF THE
INTERVIEWER WAS THERE IN PERSON FOR THE ENTIRE INTERVIEW.
<1>
<2>
<3>
<4>
>A2AELB1<

ENTIRELY IN PERSON [A2C]
OVER THE PHONE [A2B]
BY INTERCOM [A2B1]
SOME OTHER WAY [A2AELB1]
{A2A=4}

Would you please tell me more about that?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM.
IF IT BECOMES APPARENT THAT THE INTERVIEW WAS COMPLETED EITHER ENTIRELY IN
PERSON OR OVER THE PHONE, USE THE BACKUP KEY AND RE-CODE A2A [A3A]
>A2B<

{A2A=2}
When the interviewer called you by telephone, did (FI Pronoun) make an appointment to see you or did (FI
Pronoun) complete our survey by telephone -- asking questions about mental health and other healthrelated issues over the telephone?
<1>
<2>

>A2B1<

MADE APPOINTMENT ONLY [A2C]
COMPLETED SURVEY QUESTIONS [A8]
DON’T KNOW [A2C]
REFUSE [A2C]
{A2A=3}

When the interviewer contacted you by intercom, did (FI Pronoun) make an appointment to see you or did
(FI Pronoun) complete our survey over the intercom -- asking questions about mental health and other
health-related issues over the intercom?
<1>
<2>

>A2C<

MADE APPOINTMENT ONLY [A2C]
COMPLETED SURVEY QUESTIONS [A7]
DON’T KNOW [A2C]
REFUSE [A2C]
{A2A=1; A2B=1 OR F3 OR F4; A2B1=1 OR F3 OR F4}

Was the interview conducted in your home?
IF THE RESPONDENT STATES THAT THE INTERVIEW WAS CONDUCTED ON HIS/HER
PORCH, FRONT YARD, OR BACK YARD CODE THIS AS RESPONSE 1 ‘YES’
<1>
<2>
>A2C2<

YES [A3A]
NO [A2C2]
{A2C=2}

Where was the interview conducted?
<1>
<2>
<3>
<4>
<5>
<6>
>A2CELAB1<

AT THE RESPONDENT’S WORKPLACE [A3A]
AT THE HOME OF THE RESPONDENT’S RELATIVE OR FRIEND [A3A]
IN SOME TYPE OF CONFERENCE ROOM IN A RESIDENCE HALL, SCHOOL OR
APARTMENT COMPLEX [A3A]
AT A LIBRARY [A3A]
IN SOME TYPE OF COMMON AREA, SUCH AS A LOBBY, HALLWAY, STAIRWELL, OR
LAUNDRY ROOM [A3A]
SOME OTHER PLACE [A2CELAB1]
{A2C2=6}

Would you please tell me more about the location in which your interview was conducted?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM.
IF IT BECOMES APPARENT THAT THE INTERVIEW WAS COMPLETED IN ONE OF THE ABOVE
SPECIFIED LOCATIONS USE THE BACKUP KEY TO BACK-UP AND RE-CODE A2C2 [A3A]
>A3A<

{A2C=1; A2C2=1 OR 2 OR 3 OR 4 OR 5; A2CELAB1}
Did our interviewer provide you with a computer for you to enter some of your responses?
<1>
<2>

>A3A1<

YES [A4]
NO [A3A1]
{A3A=2}

Did the interviewer give you the option of entering your answers into a computer?
<1>
<2>

>A3B<

YES [A3B]
NO [A3B]
DON’T KNOW [A3B]
{A3A1=1 OR 2 OR F3}

Was there a specific reason why you could not enter your own responses in the computer if asked to do so?
<1>
<2>
>A3BELB1<

YES [A3BELB1]
NO [A7]
{A3B = 1}

Would you please tell me more about that?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM.
IF NO COMMENTS, ENTER “NONE”.
IF, AS THE RESPONDENT IS ELABORATING, IT BECOMES APPARENT THAT THE
INTERVIEWER DID GIVE THE R THE COMPUTER, BACKUP TWO QUESTIONS AND CHANGE
THE RESPONSE TO A3A. [A7]
>A4<

{A3A=1}

At the beginning of the interview, did you complete practice questions that showed you how to enter your
responses into the computer?
TI NOTE: IF THE RESPONDENT NEEDS CLARIFICATION YOU MAY READ THE FOLLOWING
STATEMENT; (For example, One of the questions asked you what color your eyes are.)
<1>
<2>

YES [A5]
NO [A5]
DON’T KNOW [A5]

>A5<

{A4=1 OR 2 OR F3}
Did the interviewer offer you a set of headphones to use during the interview?
<1>
<2>

YES [A7]
NO [A7]
DON’T KNOW [A7]

>A7<

{A5=1, 2, OR F3; A3B=2; A3BEL1 }
According to our interviewer, including yourself, (number rostered) (HH Count Noun) age 13 or older
(will live/lived) in your household for most of the time during the months of (3-month quarter field period).
Is this correct?\
<1>
<2>

YES [GENDER]
NO [DESROS]
DON’T KNOW [A8]
REFUSE [A8]

>GENDER<

{A7=1}

Thinking about (this/these) (number rostered) (HH Count Noun), including yourself, could you please tell
me (HH Count Noun 2)?
TI NOTE: DO NOT READ ROSTER DATA TO RESPONDENT. IF THE NUMBER OF MALES AND
FEMALES IS CORRECT, SELECT CORRECT. IF THEY DO NOT MATCH SELECT INCORRECT
AND RECORD THE RESPONDENT’S ANSWER IN THE FOLLOWING QUESTION.
(Roster data)
<1>
<2>

CORRECT [A8]
INCORRECT [DESROS]
DON’T KNOW [A8]
REFUSE [A8]

>DESROS<

{ A7=2; GENDER=2}

According to our interviewer, the following (HH Count Noun) age 13 or older (will live/lived) in your
household for most of the time during the months of (3-month quarter field period)?
(Roster data)
Would you please describe what is incorrect about the information?
TI NOTE: ROSTER AGES DO NOT NEED TO BE EXACT. AN AGE DISCREPANCY OF

BETWEEN 1 & 2 YEARS IS ACCEPTABLE AS CORRECT. CHILDREN AGE 12 OR YOUNGER
SHOULD NOT BE INCLUDED ON THE ROSTER
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS. IF IT BECOMES CLEAR THE
RESPONDENT WAS CONFUSED BY THE PREVIOUS QUESTION, GO BACK TO THE QUESTION
AND REREAD/PROBE FOR CLARITY.
ENTER RESPONDENT’S ANSWER VERBATIM [IF A1C = 3 OR ADULTA1A = 4,5 OR UND18B1A
= 3, 4 OR UND18B1B = 3, 4 GO TO DONEA, OTHERWISE GO TO IPRFA)]
{A1B=1; A1C=1; UNKNOWNA=1 or 2 and A1C= 3; A7=F3, F4; GENDER=1, F3, F4}

>A8<

According to our interviewer, the following (HH Count Noun) age 13 or older (will live/lived) in your
household for most of the time during the months of (3-month quarter field period)?
(Roster data)
Is this information correct?
TI NOTE: ROSTER AGES DO NOT NEED TO BE EXACT. AN AGE DISCREPANCY OF
BETWEEN 1 & 2 YEARS IS ACCEPTABLE AS CORRECT. CHILDREN AGE 12 OR YOUNGER
SHOULD NOT BE INCLUDED ON THE ROSTER
<1>
<2>

>DESROS2<

YES [IF A1C = 3, 4 OR UND18B1A = 3, 4 OR UND18B1B = 3, 4 GO TO DONEA,
OTHERWISE GO TO IPRFA)]
NO [DESROS2]
DON’T KNOW [IF A1C = 3, 4 OR UND18B1A = 3, 4 OR UND18B1B = 3, 4 GO TO DONEA,
OTHERWISE GO TO IPRFA)]
REFUSE [IF A1C = 3, 4 OR UND18B1A = 3, 4 OR UND18B1B = 3, 4 GO TO DONEA,
OTHERWISE GO TO IPRFA)]
{A8=2}

Would you please describe what is incorrect about the information?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM [IF A1C = 3, 4 OR UND18B1A = 3, 4 OR
UND18B1B = 3, 4 GO TO DONEA, OTHERWISE GO TO IPRFA)]
>IPRFA<

{A8=1; DESROS: DESROS2}

Was the interviewer polite and did the interviewer treat you professionally?
<1>
<2>
>ELB1A<

YES [If A1B=1 or A1C=1 GO TO DONEA; OTHERWISE GO TO MPAY]
NO [ELB1A]
{IPRFA=2}

Would you please tell me more about that?
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM. IF NO COMMENTS, ENTER “NONE” [If A1B=1
or A1C=1 GO TO DONEA; OTHERWISE GO TO MPAY]
>MPAY<

{IPRFA=1; ELB1A}

Did you receive anything for your participation?
<1>
<2>
<3>

YES (RECEIVED MONEY) [MPAYAMT]
YES (NOT MONEY, BUT INSTEAD OFFERED OR GIVEN A SERVICE OR A GIFT)
[MPAYDES1]
NO [MPAY2]
DON’T KNOW [MPAY2]

NOTES TO TI: REPORTS OF INTERVIEWERS GIVING
PRINTED PROJECT MATERIALS SUCH AS CERTIFICATES FOR COMPLETING
THE SURVEY ARE NOT CONSIDERED INCENTIVES. CODE AS RESPONSE 3 “NO”
REPORTS OF BEING GIVEN BOTH MONEY AND A CERTIFICATE SHOULD BE CODED AS
RESPONSE 1 “YES”
>MPAY2<

{MPAY=3}

It is important to know if our interviewer followed the correct procedures. It would be very helpful if you
could take another moment to think back to the time of the interview, then answer this question. Did you
receive anything for your participation?
<1>
<2>
<3>

YES (RECEIVED MONEY) [MPAYAMT]
YES (NOT MONEY, BUT INSTEAD OFFERED OR GIVEN A SERVICE OR A GIFT)
[MPAYDES1]
NO [DONEA]
DON’T KNOW [DONEA]

NOTE TO TI : REPORTS OF INTERVIEWERS GIVING PRINTED PROJECT MATERIALS SUCH
AS CERTIFICATES FOR COMPLETING THE SURVEY ARE NOT CONSIDERED INCENTIVES.
CODE AS RESPONSE 3 “NO”
REPORTS OF BEING GIVEN BOTH MONEY AND A CERTIFICATE SHOULD BE CODED AS
RESPONSE 1 “YES”
>MPAYAMT<

{MPAY=1 OR MPAY2=1}

How much did you receive? DO NOT READ AMOUNTS.
<1>
<2>

$40 [PAYCHG]
OTHER AMOUNT [MPAYDES1]

>MPAYDES1<

{MPAY=2; MPAY2=2; MPAYAMT=2}

Please describe
ENTER ADDITIONAL COMMENTS UP TO 150 CHARACTERS.
ENTER RESPONDENT’S ANSWER VERBATIM. IF IT BECOMES CLEAR THAT THE
RESPONDENT RECEIVED THE CORRECT AMOUNT ($40.00) THEN BACK UP TO MPAYAMT
AND CHANGE THAT RESPONSE TO <1>. [DONEA]
>PAYCHG<

{MPAYAMT=1}

How much did the $40 incentive influence your decision to participate?
<1>

a lot [DONEA]

<2>
<3>

>DONEA<

a little [DONEA]
not at all [DONEA]

{MPAY2 =3; PAYCHG}

Those are all of the questions I have. Thank you very much for your time.
Have a good (evening/day).
ENTER <1> TO CONTINUE

Answering Machine Script for Code 70
General Information:
Messages will be left after the first, sixth, and fourteenth call attempts.

Answering Machine Script:
>NOANSWER<
Hello, I am calling from RTI International regarding a study sponsored by the US Department of Health
and Human Services. Our records indicate that someone at this number was contacted by one of our field
interviewers and I am calling to verify the quality of our interviewer’s performance. This call will take just
a few minutes of your time. A RTI International representative will try to reach you over the next few days
to ask a few brief questions. Thank you in advance for your participation.

This page intentionally left blank.

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