Appendix A. Rent Reform Demonstration: Long-Term Follow-Up Survey
CATI: RECORD START DATE (SECQSTDT) AND TIME (SECQSTTM)
QLANG. CHOOSE LANGUAGE
1 ENGLISH
2 SPANISH
QTYPE. INTERVIEWER: IS THIS A FIELD LOCATOR-INITIATED INTERVIEW?
1 YES, FIELD LOCATOR-INITIATED
2 NO, RESPONDENT CALLED IN (GO TO QLINTRO)
3 NO, CALL INITIATED BY PHONE CENTER (GO TO INT01)
4 ANSWERING MACHINE (GO TO QANSW)
QINTID.
INTERVIEWER: ENTER THE FIELD LOCATOR’S 4-6-DIGIT ID NUMBER.
______ ______ ______ ______ ______ ______
CATI: ALL GO TO QLINTRO
QANSW.
ANSWERING MACHINE SCRIPT
Hello, my name is Alex/Amy Williams and I am calling from Decision Information Resources for the // NAME OF SURVEY//. I am trying to reach [FLNAME] for a short paid interview.
Please have [FLNAME] call us at XXX-XXX-XXXX. Thank you.
QLINTRO.
Hello, my name is Alex/Amy Williams.
INTERVIEWER: PLEASE PRESS “NEXT” TO CONTINUE.
CATI: IF QTYPE=2, GO TO SRCE1; ELSE GO TO INT02
SRCE1. Are you...
1 Responding to a ‘Sorry I Missed You’ card that was left at your door? OR
2 Responding to a letter or postcard you received in the mail or voice mail message from Alex/Amy Williams or someone else?
7 DON’T KNOW
8 REFUSED
CATI: ALL GO TO INT02
INT01.
Hello, my name is Alex/Amy Williams and I work at Decision Information Resources, Inc.; we are working on a study of people’s experiences with the Department of Housing and Urban Development’s Rent Reform Demonstration. May I please speak to [FLNAME]?
INTERVIEWER: IF NECESSARY, READ:
“[FLNAME] has agreed to help with a study about the HUD Rent Reform Demonstration.”
1 RESPONDENT AVAILABLE – CONTINUE
19 RESPONDENT NOT AVAILABLE – ARRANGE CALLBACK AND ENTER CALL NOTE (GO TO RCONU)
22 SOFT REFUSAL (GO TO END INTERVIEW)
8 REFUSED – ENTER DISPOSITION CODE AND CALL NOTE DESCRIBING SITUATION IN THE CALL RECORD TEXT BOX (GO TO END INTERVIEW)
INT02.
Thank you for taking the time to speak with me today.
INTERVIEWER: IF R INDICATES READINESS TO PARTICIPATE AFTER THIS POINT OR SEEMS TO BECOME IMPATIENT WITH THE SCRIPT, STOP READING AND CONTINUE ON.
Decision Information Resources is conducting a long-term follow-up survey with families who are participating in the HUD Rent Reform Demonstration study. You started the study in [RAMY]. You may have received a letter recently to let you know that the survey started and we might be calling soon.
The survey should take about [DURATION] minutes. We will mail you a $[INCENTIVE] gift card as a “thank you” for completing the survey.
CATI: GOTO SCRN1
SCRN1.
Before we begin, I’d like to confirm that I am speaking with the correct person. In order to do so, could you please tell me your date of birth?
____ ____ ____ ____
7 DON’T KNOW (GOTO INT3)
8 REFUSED (GOTO INT3)
CATI:
IF SCRN1= DOB FROM SAMPLE FILE GO TO INT4. RMNCONF = 1
IF (SCRN1 ≠ DOB) RMNCONF = 2; GOTO INT3
INT3.
There seems to be a technical problem with your file. Thank you for your time and patience. We will contact you as soon as we resolve this problem. Your information is important to us and to the success of this study. Have a nice day/evening.
(PRESS ANY KEY TO END SURVEY)
RCONU.
IF R IS CONFIRMED BUT UNAVAILABLE, READ:
Could you tell me a good time to reach her?
RECORD CALLBACK TIME.
Thank you, I will call back then.
IF SPEAKING WITH R, READ:
What is the best time for us to call you back to complete the survey?
RECORD CALLBACK TIME.
Thank you, I will call back then.
IF R NO LONGER LIVES THERE, READ:
Is there a number where [FLNAME] can be reached? May I have it please?
INTERVIEWER: MAKE NOTE OF NEW NUMBER AND MAKE PERMANENT MESSAGE.
Thank you for your assistance.
THEN TRY NEW NUMBER.
ENTER NEXT AND SET APPOINTMENT.
INT4.
CATI: Thank you for confirming this information with me.
The U.S. Department of Housing and Urban Development contracted with Decision Information Resources (DIR) to conduct a study on the Housing Choice Voucher program and new rent rules model that was implemented as part of the Rent Reform Demonstration. As part of this study, we would like to ask you a few questions. Before we begin, I would like to assure you that all of your responses on will be kept private to the full extent provided by law; the research staff has been trained in protecting private information and your name will not appear in any written reports we produce. The information requested under this collection is protected and held private in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C.552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974) and OMB Circular No. A-130. Your responses will be combined with about 6,000 other participants and will be reported for groups of individuals; no results will be analyzed or reported for individuals.
Your responses to these questions are also completely voluntary. That means you may choose not to answer any question, or you may stop the interview if you wish at any time. Your participation in the survey will not affect your participation in the HUD Rent Reform Demonstration OR any benefits you may receive now or in the future. Your responses will in no way affect your eligibility for housing assistance or the way your rent amount is calculated by [LOCAL PHA]. We will also obtain data from administrative records.
These questions have been reviewed by the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995. Public reporting burden for this collection of information is estimated to average 30 minutes per response. HUD may not conduct or sponsor, and a person is not required to respond to, a collection information unless that collection displays or reports a valid OMB control number. The OMB control number for this collection is 2528-0306, and it expires XX-XX-XXXX.
And finally, this interview might be monitored or recorded for quality control purposes.
Do I have your consent to continue with this interview?
1 YES
2 NOT NOW (GO TO RCONU)
97 DON’T KNOW (GO TO RCONU)
98 REFUSED (GO TO END INTERVIEW)
Basic Education/Regular High School
A1. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR -1], have you taken part in any Adult Basic Education (ABE) classes, English as a second language (ESL), GED classes, or classes to prepare for a regular high school diploma?
INTERVIEWER: IF NECESSARY, READ: “Adult Basic Education (ABE) classes are for improving your basic reading and math skills. GED stands for General Educational Development, and these classes help prepare for the GED test.”
INTERVIEWER: IF R ASKS AND ATTENDANCE STARTED MORE THAN 12 MONTHS AGO AND CONTINUED INTO THIS 12-MONTH PERIOD, RECORD “1” (YES), BUT IF ATTENDANCE ENDED MORE THAN 12 MONTHS AGO, RECORD “2” (NO).
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
College Courses
A2. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR -1], have you taken any college courses for credit? These are courses that lead to a 2-year Associate’s degree or 4-year Bachelor’s degree or Graduate degree.
INTERVIEWER: IF R ASKS AND ATTENDANCE STARTED MORE THAN 12 MONTHS AGO AND CONTINUED INTO THIS 12-MONTH PERIOD, RECORD “1” (YES), BUT IF ATTENDANCE ENDED MORE THAN 12 MONTHS AGO, RECORD “2” (NO).
1 YES
2 NO (GO TO A3)
97 DON’T KNOW (GO TO A3)
98 REFUSED (GO TO A3)
A2a. What type of degree are you working towards?
INTERVIEWER: PLEASE READ LIST
1 2-Year/Associate’s degree
2 4-Year/Bachelor’s degree
3 Graduate degree, or
4 Some other type (Specify _____________)
97 DON’T KNOW
98 REFUSED
CATI: IF A2a = 4, ASK A2a_O, ELSE GO TO A3.
A2a_O. What type of degree are you working towards?
___________________________________________
97 DON’T KNOW
98 REFUSED
Vocational Training
A3. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR – 1], have you taken any vocational training courses for a specific job, trade, or occupation [CATI: IF A2 = 1 (YES) INSERT “other than the college courses you just mentioned”]? Please don’t include on-the-job training or unpaid work experience.
INTERVIEWER: IF R ASKS AND ATTENDANCE STARTED MORE THAN 12 MONTHS AGO AND CONTINUED INTO THIS 12-MONTH PERIOD, RECORD “1” (YES), BUT IF ATTENDANCE ENDED MORE THAN 12 MONTHS AGO, RECORD “2” (NO).
1 YES
2 NO (GO TO B1)
97 DON’T KNOW (GO TO B1)
98 REFUSED (GO TO B1)
A3a. What kind of occupation or type of job was the vocational training for?
___________________________________________
97 DON’T KNOW
98 REFUSED
B1. What, from this list, is the highest level of education that you have completed?
INTERVIEWER: READ LIST
Did not complete high school or receive GED (GO TO B2)
GED certificate
High school diploma
Some college
Associate’s degree/2-year college
Four-year college degree, or
Graduate degree?
DON’T KNOW
REFUSED
B1a. Did you receive your highest educational degree or certificate before ///[REF DATE] or after ///[REF DATE]?
INTERVIEWER: IF NECESSARY, READ: This is around when you would have gone in for recertification at //PHA// in //YEAR//?
BEFORE
AFTER
DON’T KNOW
REFUSED
B2. Do you have any type of trade license or training certification?
1 YES
2 NO (GO TO C1)
97 DON’T KNOW (GO TO C1)
98 REFUSED (GO TO C1)
B2a. What type of license or certification is it?
PROBE: What type of trade or work does it qualify you to do?
INTERVIEWER: IF RESPONDENT HAS MULTIPLE LICENSES/CERTIFICATES ASK ONLY ABOUT MOST RECENT.
___________________________________________
97 DON’T KNOW
98 REFUSED
B2b. Did you receive your trade license or training certification before ///[REF DATE] or after ///[REF DATE]?
INTERVIEWER: DATE IS MONTH AND YEAR R RECERTIFIED RENT WITH PHA IN //YEAR//.
BEFORE
AFTER
DON’T KNOW
REFUSED
C1. The next questions are about any paid work that you may be doing currently or have done at different times during the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1]. This includes working for a private employer, school or hospital, or government agency; or picking up temporary, seasonal, or odd jobs.
Please also include any type of self-employment or running your own business, such as providing child care or in-home nursing care, making home repairs, doing taxes for people, housecleaning, cooking and catering, sewing, doing nails or hair; or doing other paid work.
Please do not count volunteer work or unpaid internships or work experience jobs. Again, I would like to remind you that your answers will remain entirely confidential.
In the last 12 months, that is since [CATI: INSERT NAME OF THIS MONTH AND LAST YEAR], have you worked for pay or were self-employed? Please don't count unpaid work experience or unpaid volunteer work.
1 YES (GO TO C1b)
2 NO
97 DON’T KNOW
98 REFUSED
C1a. A lot of people have irregular, odd, or side jobs, or do extra work to make ends meet. Have you ever done any work like that for pay in the last 12 months?
1 YES
2 NO (GO TO C24)
97 DON’T KNOW (GO TO C25)
98 REFUSED (GO TO C25)
C1b. How many jobs have you held during the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1]?
INTERVIEWER: SELF-EMPLOYMENT OR TEMPORARY OR "TEMP" WORK IN THE SAME FIELD COUNTS AS ONE JOB.
INTERVIEWER INSTRUCTION: IF GREATER THAN 10, CODE THE RESPONSE AS 10
________ [RANGE 1- 10]
NUMBER
97 DON’T KNOW
98 REFUSED
CATI: IF C1 or C1a= 1 AND C1b=0 PROVIDE INTERVIEWER WITH SCREEN SHOWING BOTH C1b AND C1c TO RESOLVE THE INCONSISTENCY. SHOW Earlier you said you have had a job in the past 12 months and now you are saying no jobs in the past 12 months. Can you help me with this? INTERVIEWER: RESOLVE INCONSISTENCY.
C1c. Since [CURRENT MONTH] [CURRENT YEAR -1], about how many months were you working for pay or self-employed?
PROBE: Your best estimate is fine.
INTERVIEWER: ROUND UP IF RESPONSE IS NOT IN WHOLE MONTHS
________ [RANGE 1 -12]
MONTHS
97 DON’T KNOW (GO TO C2)
98 REFUSED (GO TO C2)
CATI: IF C1c=ZERO, PROVIDE INTERVIEWER WITH SCREEN SHOWING BOTH C1b AND C1c TO RESOLVE THE INCONSISTENCY. SHOW: Earlier you said you had worked in the past 12 months and now you are saying you haven’t worked in the past 12 months. Can you help me with this? INTERVIEWER: RESOLVE INCONSISTENCY.
C1d. During these [C1c] months did you usually work full-time—that is, 35 or more hours a week?
YES
NO
DON’T KNOW
REFUSED
C2. Are you currently working for pay, or self-employed?
1 YES
2 YES, CURRENTLY ON LEAVE, TEMPORARY LAY-OFF, OR VACATION
3 NO (GO TO C3)
97 DON’T KNOW (GO TO C3)
98 REFUSED (GO TO C3)
C2a. How many jobs do you currently have?
INTERVIEWER: SELF-EMPLOYMENT OR TEMPORARY OR "TEMP" WORK IN THE SAME FIELD COUNTS AS ONE JOB.
INTERVIEWER INSTRUCTION: IF GREATER THAN 10, CODE THE RESPONSE AS 10
________ [RANGE 1-10]
NUMBER
97 DON’T KNOW
98 REFUSED
[CATI: IF C2a = 1, 97, 98, GO TO C3 (WORKING 1 JOB OR DID NOT ANSWER)]
C2b. Thinking about all your current jobs, how many hours per week do you work?
INTERVIEWER INSTRUCTION: IF GREATER THAN 84, CODE THE RESPONSE AS 84
________ [RANGE 1 – 84]
NUMBER
97 DON’T KNOW
98 REFUSED
C3. I'd like to ask you some questions about your [current/most recent] job.
[CATI: IF C2a=2-10, ADD: “Please focus on the job at which you work the most hours.”
IF C2 = 3, 97, OR 98, ADD: “Please focus on the most recent job for which you worked for pay or were self-employed during the last 12 months.”]
C3a. What kind of work [do/did] you do on this job?
INTERVIEWER: ENTER VERBATIM RESPONSE. PROBE AS NEEDED.
______________________________________________________
97 DON’T KNOW
98 REFUSED
C3b. How would you best describe this job? Would you say you…
[work/worked] for an employer ,
[are/were] self-employed, or
[are/were] working at a seasonal, temporary, or odd job?
DON’T KNOW
REFUSED
C4. What month and year did you start [CATI: IF C2 = 3, 97, or 98, INSERT: “and end”] this job?
INTERVIEWER: PROBE FOR SEASON IF DON’T KNOW MONTH. IF R CAN ONLY PROVIDE SEASON, SPRING = 05, SUMMER = 08, FALL = 11, WINTER = 02. IF STILL WORKING, ENTER 77/7777 FOR END DATE OF JOB.
C4a. START: ___ ___/___ ___ ___ ___
MONTH YEAR
97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR
98 REFUSED MONTH 9998 REFUSED YEAR
[CATI: IF C2 = 1, 2, GO TO C5]
C4b. END: ___ ___/___ ___ ___ ___
MONTH YEAR
77 STILL WORKING 7777 STILL WORKING
97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR
98 REFUSED MONTH 9998 REFUSED YEAR
C5. [Now/Just before you left], including overtime, how many hours per week [do/did] you usually work on this job?
INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.
INTERVIEWER INSTRUCTION: IF GREATER THAN 84, CODE THE RESPONSE AS 84
[RANGE: 1- 84] (GO TO C6)
HOURS/WEEK
97 DON’T KNOW
98 REFUSED
C5a. Would you say that you usually [work/worked]…
1 to 20 hours per week,
21 to 34 hours per week, or
35 or more hours per week?
DON’T KNOW
REFUSED
C6. How many days per week [do/did] you usually work?
[RANGE: 1- 7]
DAYS/WEEK
97 DON’T KNOW
98 REFUSED
C7. What [are/were] your earnings from your job or income from self-employment [now/just before you left], before taxes? Please include tips, commissions, and regular overtime pay.
INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.
$ ___ ___ ___, ___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]
AMOUNT
999999.97 DON’T KNOW (GO TO C10)
999999.98 REFUSED (GO TO C10)
C8. [Is/Was] that…
INTERVIEWER: PLEASE READ LIST
1 Per hour,
2 Per week,
3 Every 2 weeks,
4 Twice a month,
5 Once a month,
6 Per year,
7 Per day, or
8 Some other way?
97 DON’T KNOW
98 REFUSED
CATI: IF C8=8, ASK C8_O, ELSE GO TO C9
C8_O. How often did you receive that amount?
________________________________________
97 DON’T KNOW
98 REFUSED
C9. [Is/Was] that before or after taxes?
1 BEFORE
2 AFTER
3 DON’T KNOW
4 REFUSED
CATI: IF C3b=2, GO TO C11.
C10. [Does/Did] your employer offer any of the following benefits?
INTERVIEWER: SELECT “YES” IF R REPORTS THAT R WILL BE OFFERED BENEFITS AT A FUTURE TIME UPON REACHING A MILESTONE, SUCH AS COMPLETING A PROBATION PERIOD FOR NEW EMPLOYEES OR TRANSITIONING FROM PART-TIME TO FULL-TIME HOURS.
|
YES |
NO |
DON’T KNOW |
REFUSED |
C10a. Any sick days with full pay? |
1 |
2 |
3 |
4 |
C10b. Any vacation days with full pay? |
1 |
2 |
3 |
4 |
C10c. Paid overtime? |
1 |
2 |
3 |
4 |
C10d. A plan that gives you money for retirement? |
1 |
2 |
3 |
4 |
C10e. A health plan or medical insurance, including any offered at a cost to you? |
1 |
2 |
3 |
4 |
C11. Which of the following best describes your usual weekly work schedule at your job or business [now/during the last month you worked]? [Do/Did] you work a…
INTERVIEWER: PLEASE READ LIST
Regular daytime shift,
Regular evening shift,
Regular night shift,
Rotating shift (one that changes every few days or weeks),
Split shift (one consisting of two distinct periods each day),
An irregular schedule (one that changes from day to day), or
Something else?
DON’T KNOW
REFUSED
CATI: IF C11=7, ASK C11_O, ELSE GO TO CATI INSTRUCTIONS BELOW C11_O.
C11_O. What is your usual weekly work schedule like at this job?
________________________________________
97 DON’T KNOW
98 REFUSED
CATI:
IF C2=97 OR 98 GO TO C25.
IF C2=3 GO TO C24.
IF C2=1 OR 2 AND C2A=1 OR 97 OR 98 GO TO C25.
IF C2=1 OR 2 AND C2A=2-10 ASK C12 INTRO.
C12 INTRO: Let’s talk about your second current job, the job with the second most hours per week.
C12. What month and year did you start this job?
INTERVIEWER: PROBE FOR SEASON IF DON’T KNOW MONTH. IF R CAN ONLY PROVIDE SEASON, SPRING = 05, SUMMER = 08, FALL = 11, WINTER = 02.
C12a. START: ___ ___/___ ___ ___ ___
MONTH YEAR
97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR
98 REFUSED MONTH 9998 REFUSED YEAR
C13. Including overtime, how many hours per week do you usually work on this job?
INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.
INTERVIEWER INSTRUCTION: IF GREATER THAN 84, CODE THE RESPONSE AS 84
[RANGE: 0- 84]
HOURS/WEEK
97 DON’T KNOW
98 REFUSED
C14. What are your earnings or income from this job, before taxes? Please include tips, commissions, and regular overtime pay.
INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.
$ ___ ___ ___, ___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]
AMOUNT
999999.97 DON’T KNOW (GO TO C17)
999999.98 REFUSED (GO TO C17)
C15. [Is/Was] that…
INTERVIEWER: PLEASE READ LIST
1 Per hour,
2 Per week,
3 Every 2 weeks,
4 Twice a month,
5 Once a month,
6 Per year,
7 Per day, or
8 Some other way?
97 DON’T KNOW
98 REFUSED
CATI: IF C15=8, ASK C15_O, ELSE GO TO C16
C15_O. How often did you receive that amount?
________________________________________
97 DON’T KNOW
98 REFUSED
C16. [Is/Was] that before or after taxes?
1 BEFORE
2 AFTER
3 DON’T KNOW
4 REFUSED
C17. Does your employer make available a health plan or medical insurance, including any offered at a cost to you?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
CATI: IF C2a = 2 (WORKING 2 JOBS), GO TO C25. IF C2a =3-10, DISPLAY C18.
C18 INTRO: Let’s talk about your third current job, the job with the third most hours per week.
C18. What month and year did you start this job?
INTERVIEWER: PROBE FOR SEASON IF DON’T KNOW MONTH. IF R CAN ONLY PROVIDE SEASON, SPRING = 05, SUMMER = 08, FALL = 11, WINTER = 02.
C18a. START: ___ ___/___ ___ ___ ___
MONTH YEAR
97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR
98 REFUSED MONTH 9998 REFUSED YEAR
C19. Now, including overtime, how many hours per week do you usually work on this job?
INTERVIEWER: IF LESS THAN 10 HOURS OR MORE THAN 60 HOURS, VERIFY ANSWER IS HOURS PER WEEK.
INTERVIEWER INSTRUCTION: IF GREATER THAN 84, CODE THE RESPONSE AS 84
[RANGE: 0- 84]
HOURS/WEEK
97 DON’T KNOW
98 REFUSED
C20. What are your earnings or income from this job, before taxes? Please include tips, commissions, and regular overtime pay.
INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.
$ ___ ___ ___, ___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]
AMOUNT
999999.97 DON’T KNOW (GO TO C23)
999999.98 REFUSED (GO TO C23)
C21. [Is/Was] that…
INTERVIEWER: PLEASE READ LIST
1 Per hour,
2 Per week,
3 Every 2 weeks,
4 Twice a month,
5 Once a month,
6 Per year,
7 Per day, or
8 Some other way?
97 DON’T KNOW
98 REFUSED
CATI: IF C21=8, ASK C21_O, ELSE GO TO C22
C21_O. How often do you receive that amount?
________________________________________
97 DON’T KNOW
98 REFUSED
C22. [Is/Was] that before or after taxes?
1 BEFORE
2 AFTER
97 DON’T KNOW
98 REFUSED
C23. Does your employer make available a health plan or medical insurance, including any offered at a cost to you?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
cati: all c23 go to c25.
C24. Some people may not be able to get a job even if they want to work. Other people may have personal or other reasons for not working for pay. What is the main reason you are not working for pay?
INTERVIEWER: DO NOT READ LIST; SELECT ONLY ONE RESPONSE.
ILLNESS, DISABILITY, SELF
ILLNESS, DISABILITY OTHER
Taking care of home or family MEMBERS
Unable to find (adequate) AND/OR Affordable child care
going to school, in training
unable to find work
Pregnancy
criminal record makes finding work hard
Poor Credit Score Makes Finding Work Hard
TEMPORARILY LAID OFF/ TEMPORARY LEAVE
Inadequate transportation options
RETIRED OR TOO OLD
other SPECIFY
97. DON’T KNOW
98. refUSED
CATI: IF C24=13 ASK C24_O, ELSE GO TO C25
C24_O. What is the main reason you are not working for pay?
_______________________________
97 DON’T KNOW
98 REFUSED
C25. In the last four weeks, have you looked for a full-time or part-time job?
1 YES
2 NO (GO TO SECTION D)
97 DON’T KNOW (GO TO SECTION D)
98 REFUSED (GO TO SECTION D)
C25a. Were you looking for full-time work or part-time work?
Full-time
Part-time
Both
DON’T KNOW
REFUSED
Job Search Assistance
C26. In the last 12 months, that is since [CATI: INSERT NAME OF THIS MONTH AND LAST YEAR], have you attended any workshops or received any assistance with [finding a job or a better job]? Assistance could include help in preparing a resume, finding job openings, calling employers, interviewing for a job, or completing a job application?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
[CATI: C1 or C1a=1, ELSE GO TO D1]
Post-Employment Assistance
C27. In the last 12 months have you received any assistance with keeping a job, solving a problem at work, increasing your hours of employment, or getting a raise or promotion?
1 YES
2 NO (GO TO C28)
97 DON’T KNOW (GO TO C28)
98 REFUSED (GO TO C28)
C27a. {Original} What kind of assistance have you received? From the following list, please indicate the kinds of assistance you have received. Was it from
1. a friend or family member
2. a colleague at work
3 a counselor or social worker from a government program or agency
3. someone from a neighborhood or community organization
5. Or from someone else (Please specify:____________)
97 DON’T KNOW
98 REFUSED
Job Satisfaction
C28. In general, how satisfied [are/were] you with your [current/most recent] [job/jobs]? Would you say you were…(original)
1 Not at all satisfied
2 Somewhat satisfied
3 Satisfied
4 Very satisfied
5 Completely satisfied
97 DON”T KNOW
98 REFUSED
D1. Now I’m going to ask you some questions about you and your household.
Which situation best describes your marital status. Are you currently…
INTERVIEWER: READ LIST
Married, living with spouse (GO TO D2)
Single, never married
Separated or living apart from your spouse
Divorced
Widow/Widower
DON’T KNOW
REFUSED
D1a. Are you currently living with a partner?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
D2. Now I’m going to ask you about the people who lived in your household at least two nights a week last month.
How many adults age 18 years or older lived in your household for at least two nights a week during the month of [PRIOR MONTH]? Please include yourself, [CATI: IF D1 = 1, INSERT “your spouse” IF D1a = 1, INSERT “ your partner”], adult family members, and any other adults age 18 years or older who lived in your household for at least two nights a week during the month of [PRIOR MONTH]?
INTERVIEWER: IF R SAYS ZERO, REMIND R TO INCLUDE SELF IN THE COUNT.
INTERVIEWER INSTRUCTION: IF GREATER THAN 20, CODE THE RESPONSE AS 20
_________ [RANGE 1-20]
# ADULTS
97 DON’T KNOW
98 REFUSED
CATI: IF D2=1 AND (D1=1 OR D1a=1), PROVIDE INTERVIEWER WITH SCREEN SHOWING D1, D1a AND D2 TO RESOLVE THE INCONSISTENCY. SHOW:
Earlier you said you lived with a spouse or partner but now you are saying only 1 adult, you, live in your household. Can you help me with this? INTERVIEWER: RESOLVE INCONSISTENCY.
D3. How many children, age 17 or younger lived in your household for at least two nights a week during the month of [PRIOR MONTH]? Please include your own children and any other children who lived in your household?
INTERVIEWER INSTRUCTION: IF GREATER THAN 20, CODE THE RESPONSE AS 20
_________________ [RANGE 0-20]
# ANY CHILDREN
97 DON’T KNOW
98 REFUSED
CATI: CREATE VARIABLE “OHHMBR” WHERE
IF D2=2-20 OR D3=1-20, OHHMBR=1 (YES OTHERS IN HHLD)
ELSE OHHMBR=0 (NO OTHERS IN HHLD OR UNKNOWN)
CATI: IF D3 = 0, 97, OR 98, GO TO SECTION E. ELSE, CONTINUE WITH D3a.
D3a. Of these children you just mentioned, how many were children of your own who were age 17 or younger in [PRIOR MONTH]? Please include biological, adopted, step, foster children, or children for whom you are their parent or guardian.
INTERVIEWER INSTRUCTION: IF GREATER THAN 20, CODE THE RESPONSE AS 20
_________________ [RANGE 0-20]
# OWN CHILDREN
97 DON’T KNOW
98 REFUSED
CATI: IF D3a=0-20 AND D3a >D3, PROVIDE INTERVIEWER WITH SCREEN SHOWING D3 AND D3a TO RESOLVE THE INCONSISTENCY. SHOW:
Earlier you said that, including children that are not your own, fewer children lived with you than you report here. Can you help me with this? INTERVIEWER: RESOLVE INCONSISTENCY.
E1. INTRO: Now, I am going to ask you some questions about the income that came into your household in [PRIOR MONTH].
CATI: OHHMBR=1, ADD:
Unless the question concerns income for a specific person, like you, please include any income from all adults and children who lived together in your household for at least two nights a week in [PRIOR MONTH].
CONTINUE, ALL: Again, I want to assure you that none of your answers will be discussed with anyone.
Monthly Income
During [PRIOR MONTH]:
E1. Did you work for pay?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
CATI: IF OHHMBR=1, ASK E1a. ELSE GO TO E2.
E1a. Did any other adults or children who lived in your household work for pay or were self-employed?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
E2. In [PRIOR MONTH], did you [CATI: IF OHHMBR=1, INSERT “or anyone else in your household”] receive:
|
YES |
NO |
DON’T KNOW |
REFUSED |
E2a. SNAP, also known as Food Stamps, including EBT cards from the government that can be used at the store to buy food? |
1 |
2 |
7 |
8 |
E2b. Child Support? |
1 |
2 |
7 |
8 |
E2c. TANF or [insert state program name] or any cash assistance, not including child support money or child care payments? |
1 |
2 |
7 |
8 |
E2d. Unemployment Insurance Benefits or UI? |
1 |
2 |
7 |
8 |
E2e. Social Security Disability Insurance benefits, or SSDI |
1 |
2 |
7 |
8 |
E2f. Supplemental Security Income benefits, or SSI |
1 |
2 |
7 |
8 |
E2g. The Special Supplemental Nutrition Program for Women, Infants, and Children or WIC? |
1 |
2 |
7 |
8 |
E2h. Heating or Cooling Assistance? |
1 |
2 |
7 |
8 |
E2i. Free or reduced-price school lunch? |
1 |
2 |
7 |
8 |
E2j. Alimony? |
1 |
2 |
7 |
8 |
E3. In [PRIOR MONTH] did you [CATI: IF OHHMBR=1, INSERT “or anyone else in your household”] receive money from any other source, such as rent from boarders, a pension, other government benefits, or any other income we have not already talked about?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
E4. What was the total monthly income for you [CATI: IF OHHMBR=1, INSERT: “and everyone else living together in your household”] in [PRIOR MONTH]? Please include income from all of the sources that you just mentioned, plus any other income.
PROBE:
Your best estimate is fine.
$ ___ ___ ___ ,___ ___ ___. [RANGE = 0 – 999996]
AMOUNT
999997 DON’T KNOW
999998 REFUSED
CATI:
IF E4 IS LESS THAN OR EQUAL TO $10,000, GO TO E5.
IF E4 IS GREATER THAN $10,000 AND LESS THAN 999997, ASK E4_confirm.
IF E4 = 999997 OR 999998, GO TO E4a.
E4_confirm. Just to confirm, you said that the total monthly income for you [CATI: IF OHHMBR=1, INSERT: “and everyone else living together in your household”] in [PRIOR MONTH] was [INSERT E4]. Is that correct?
1 YES (GOTO E5)
2 NO
97 DON’T KNOW (GO TO E4a)
98 REFUSED (GO TO E4a)
E4_revised. What would you say was the correct amount of total monthly income for everyone living together in your household?
$ ___ ___ ___ ,___ ___ ___. [RANGE = 0 – 999996]
AMOUNT
999997 DON’T KNOW
999998 REFUSED
CATI: IF E4_revised IS LESS THAN 999997, GO TO E5. ELSE, CONTINUE WITH E4a.
E4a. Would you say it was more or less than $1,500?
INTERVIEWER: DO NOT READ LIST
1 MORE THAN $1,500 (GO TO E4b)
2 EXACTLY $1,500 (GO TO E5)
3 LESS THAN $1,500 (GO TO E4c)
97 DON’T KNOW (GO TO E5)
98 REFUSED (GO TO E5)
E4b. Would you say it was:
INTERVIEWER: READ LIST
1 More than $1,500 but less than $2,000,
2 At least $2,000 but less than $2,500, or
3 $2,500 or more?
97 DON’T KNOW
98 REFUSED
CATI: ALL E4b GO TO E5
E4c. Would you say it was:
INTERVIEWER: READ LIST
1 At least $1,200 but less than $1,500,
2 At least $800 but less than $1,200,
3 At least $500 but less than $800, or
4 Less than $500?
97 DON’T KNOW
98 REFUSED
Taxes
E5. What is your current situation concerning filing a federal tax return for the 2018 tax year? Would you say…
INTERVIEWER: READ LIST AND SELECT ONE.
PROBE: This is the return that most people file on or before April 17 of this year.
Your tax return has been filed,
Your tax return will be filed later this year, or
You won’t be filing a tax return this year? (GO TO E6)
DON’T KNOW (GO TO E6)
REFUSED (GO TO E6)
E5a. When you [filed/file] your 2018 federal tax return, [did/will] you use a free or paid tax preparer service to prepare your taxes?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
BANKING / USE OF FINANCIAL SERVICES
E6. Do you currently have a checking or savings account of any kind at a bank or a credit union?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
Savings
E7. Do you [CATI: IF D1 = 1 , INSERT “or your spouse”. IF D1a = 1, INSERT “or your partner”] have any money in savings that you keep in a safe place at home or elsewhere, such as money in a savings account?
INTERVIEWER: IF NECESSARY, READ: This would include money at home, in a savings account, savings bond, money market fund, credit union, retirement account, Individual Development Account or IDA, pension fund, stocks or bonds, or certificates of deposit.
1 YES
2 NO (GO TO E8)
97 DON'T KNOW (GO TO E8)
98 REFUSED (GO TO E8)
E7a. How much, altogether, do you [CATI: IF D1 = 1 , INSERT “and your spouse” IF D1a = 1, INSERT “and your partner”] have in savings? Your best estimate is fine.
INTERVIEWER INSTRUCTION: IF GREATER THAN 50,000, CODE THE RESPONSE AS 50,000
$ ___ ___ ___ ___ ___ [RANGE = 1-50,000]
SAVINGS AMOUNT
99997 DON’T KNOW (GO TO E7b)
99998 REFUSED (GO TO E7b)
CATI: IF E7a IS GREATER THAN 0 AND LESS THAN OR EQUAL TO $50,000, GO TO E8.
E7b. Would it be…
Up to $200
$201 to $500
$501 to $1,000
$1,001 to $1,500
$1,501 to $2,000, or
More than $2,000?
DON'T KNOW
REFUSED
Debt
E8. Next, I’d like to ask you about loans and any debt or money you might owe,
Right now, do you have any debt where you owe money for things like medical bills, credit card bills, student loans, store accounts, and so on? Please do not count any mortgages or home loans that you may have.
1 YES
2 NO (GO TO E10)
97 DON’T KNOW (GO TO E10)
98 REFUSED (GO TO E10)
E9. When you think about all your outstanding loans and debts, what is the total amount you owe? If you have a mortgage, do not count that in the total amount.
PROBE:
Your best estimate is fine.
$ ___ ___ ___ ,___ ___ ___. [RANGE = 1 – 999996] (GO TO E10)
DEBT AMOUNT
999997 DON’T KNOW (GO TO E9a)
999998 REFUSED (GO TO E9a)
E9a. When you think about all your outstanding loans and debts, not including a mortgage if you have one, would you say that the total amount is …
1 $1 to $500,
2 $501 to $1,000,
3 $1,001 to $5,000,
4 $5,001 to $10,000,
5 $10,001 to $20,000, or
6 More than $20,000?
97 DON’T KNOW
98 REFUSED
Financial Strain
E10. How much do you agree or disagree with each of the following statements? Would you say you Strongly Agree, Agree Somewhat, Neither Agree nor Disagree, Disagree Somewhat, or Strongly Disagree?
|
Strongly Agree |
Agree Some what |
Neither Agree nor Disagree |
Disagree Somewhat |
Strongly Disagree |
Don’t Know |
Refused |
E10a. My financial situation is better than it was last year at this time. Do you… |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
E10b. I worry about having enough money in the future. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
CATI: IF OHHMBR=0, USE FIRST TEXT. ELSE USE SECOND.
E10c. These days I can generally afford to buy the things (I/we) need. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
E10d. There never seems to be enough money to buy something or go somewhere just for fun. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
Material Hardship Scale
E11a. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1], was there ever a time when, because of cost, [you/you or your household] were not able to pay your portion of the rent?
YES
NO (GO TO E11b)
DON’T KNOW (GO TO E11b)
REFUSED (GO TO E11b)
E11a.1 In the last 12 months, about how many months has this happened?
1
2-3
4-6
7 OR MORE
DON’T KNOW
REFUSED
E11b. In the last 12 months, was there ever a time when, because of cost, [you/you or your household] were not able to pay your utility bills?
YES
NO (GO TO E11c)
DON’T KNOW (GO TO E11c)
REFUSED (GO TO E11c)
E11b.1 In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1], about how many months has this happened?
1
2-3
4-6
7 OR MORE
DON’T KNOW
REFUSED
E11c. In the last 12 months, was there ever a time when, because of cost, [you/you or your household] were not able to pay your telephone bill?
YES
NO (GO TO E11d)
DON’T KNOW (GO TO E11d)
REFUSED (GO TO E11d)
E11c.1 In the last 12 months, about how many months has this happened?
1
2-3
4-6
7 OR MORE
DON’T KNOW
REFUSED
E11d. In the last 12 months, was there ever a time when, because of cost, [you/you or your household] were not able to buy food?
YES
NO (GO TO E11e)
DON’T KNOW (GO TO E11e)
REFUSED (GO TO E11e)
E11d.1 In the last 12 months, about how many months has this happened?
1
2-3
4-6
7 OR MORE
DON’T KNOW
REFUSED
CATI: THE NEXT TWO QUESTIONS DO NOT HAVE A FOLLOW-UP QUESTION IF R ANSWERS “YES.”
E11e. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1], was there ever a time when, because of cost, [you/you or your household] were not able to buy prescription medicine?
YES
NO
DON’T KNOW
REFUSED
E11f. In the last 12 months, was there ever a time when, because of cost, [you/you or your household] were not able to see a doctor or get medical assistance?
YES
NO
DON’T KNOW
REFUSED
Assistance/Services & Transportation Assistance
E12a.In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1], have you received assistance in buying a car or paying for transportation for employment, school, or other reasons?
1 YES
2 NO (GO TO E13a)
97 DON’T KNOW (GO TO E13a)
98 REFUSED (GO TO E13a)
E12a.1 {Original} From whom did you received this assistance? Was it from..
INTERVIEWER: SELECT ALL THAT APPLY?
1. a friend or family member
2. a colleague at work
3 a counselor or social worker from a government program or agency
3. someone from a neighborhood or community organization
5. Or from someone else (Please specify:____________)
97 DON’T KNOW
98 REFUSED
Child Care Assistance
E13a. In the last 12 months, have you received assistance in finding a child care provider or paying for child care?
1 YES
2 NO (GO TO E13b)
97 DON’T KNOW (GO TO E13b)
98 REFUSED (GO TO E13b)
E13a1 {Original} From whom did you received this assistance? Was it from..
INTERVIEWER: SELECT ALL THAT APPLY?
1. a friend or family member
2. a colleague at work
3 a counselor or social worker from a government program or agency
3. someone from a neighborhood or community organization
5. Or from someone else (Please specify:____________)
97 DON’T KNOW
98 REFUSED
E13b. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR-1], have you ever received any assistance regarding financial literacy or counseling services?
1 YES
2 NO (GO TO E13c)
97 DON’T KNOW (GO TO E13c)
98 REFUSED (GO TO E13c)
E13b1 {Original} Where did you received this of assistance or services? Was it from
INTERVIEWER: SELECT ALL THAT APPLY?
1. a friend or family member
2. a colleague at work
3 a counselor or social worker from a government program or agency
3. someone from a neighborhood or community organization
5. Or from someone else (Please specify:____________)
97 DON’T KNOW
98 REFUSED
E13c. In the last 12 months, have you ever received any assistance regarding homeownership?
1 YES
2 NO (GO TO E13d)
97 DON’T KNOW (GO TO E13d)
98 REFUSED (GO TO E13d)
E13c1 {Original} Where did you received this of assistance or services? Was it from
INTERVIEWER: SELECT ALL THAT APPLY?
1. a friend or family member
2. a colleague at work
3 a counselor or social worker from a government program or agency
3. someone from a neighborhood or community organization
5. Or from someone else (Please specify:____________)
97 DON’T KNOW
98 REFUSED
E13d. Are you currently signed-up for or receiving services from the Family Self-Sufficiency (FSS) program?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
Food Insufficiency
E14. Which of these statements best describes the food eaten by [you/you and the people in your household who usually ate with you] in [PRIOR MONTH]: Did you have…
1 Enough of the kinds of food you wanted,
2 Enough but not always the kinds of food you wanted to eat,
3 Sometimes not enough to eat, or
4 Often not enough to eat?
97 DON’T KNOW
98 REFUSED
Overall Financial Well-Being
E15. In general, how do [your/your household] finances usually work out at the end of the month? Is there…
1 Some money left over,
2 Just enough to make ends meet, or
3 Not enough money to make ends meet?
97 DON’T KNOW
98 REFUSED
E15a. Do you ever borrow from family and/or friends to get cash when you need it?
1 YES
2 NO (GO TO E15c)
7 DON’T KNOW (GO TO E15c)
8 REFUSED (GO TO E15c)
E15b. How often do you do this?
1 Every week
2 A couple times a month
3 Every month
4 A couple times a year
5 Once a year
7 DON’T KNOW
8 REFUSED
E15c. Suppose [you/you and your household] had an emergency expense that costs $400. Based on your current financial situation, how would you pay for this expense? Please choose the most likely method of payment, if any. Would you…
INTERVIEWER: READ LIST, CHECK ONLY ONE.
IF R PROVIDES AN UNLISTED METHOD OF PAYMENT, CODE IT AS DK.
Put it on your credit card
Use money in your checking or savings account or use cash on hand
Take out a bank loan or line of credit
Borrow from a friend or family member
Use a payday loan, deposit advance, or overdraft
Sell something, or
Would you be unable to pay for the expense right now?
DON’T KNOW
REFUSED
E16. In general, how would you rate your credit? Would you say it was…
1 Very bad,
2 Bad,
3 About average,
4 Good, or
5 Very good?
97 DON’T KNOW
98 REFUSED
E17. The next questions are about how you handle problems in life and work.
For each of the following statements, please indicate how much you agree or disagree that it describes you.
|
Strongly disagree |
Disagree |
Neither Agree nor Disagree |
Agree |
Strongly agree |
DON’T KNOW |
REFUSED |
E17a. At this time I am meeting the goals I set for myself. Would you say you… |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
E17b. I can think of many ways to reach my current goals. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
E17c. Right now, I see myself as pretty successful. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
E17d. There are lots of ways around any problems I am facing now. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
E17e. At the present time I am energetically pursuing my goals. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
E17f. If I should find myself in a jam, I could think of many ways to get out of it. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
E18. In [PRIOR MONTH], were you covered by any health insurance plan including Medicaid or [State Medicaid plan name], private insurance, an employer-paid plan, or a private HMO?
INTERVIEWER IF NECESSARY, READ: A Health Maintenance Organization (HMO) is a medical insurance group that provides health services for a fixed annual fee.
PROBE: Did you have one of these kinds of insurance?
YES
NO
DON’T KNOW
REFUSED
Health Status
E19. In general, how would you rate your overall health now? Is it…
Excellent,
Very good,
Good,
Fair, or
Poor?
DON’T KNOW
REFUSED
HOPE/HAPPINESS
E20. Taken all together, how would you say things are these days would you say that you are
very happy, pretty happy, or not too happy?
1 Very Happy
2 Pretty Happy
3 Not Too Happy
97 DON’T KNOW
98 REFUSED
Depression – WAITING FOR MDRC TO SEND ITEMS FROM CESD
F1. These questions are about your housing and your neighborhood. Do you currently:
INTERVIEWER: READ ALL OF THE FOLLOWING OPTIONS EVEN IF RESPONDENT INTERRUPTS WITH ANSWER.
Own your own home or apartment, (GO TO F6)
Rent your home or apartment
Live with family or friends and pay part of the rent or mortgage payment,
Live with family or friends and not pay rent (GO TO F6)
Live in a group shelter (GO TO F6)
Live in some other arrangement? (GO TO F6)
INTERVIEWER: DO NOT READ. CODE IF RESPONDENT VOLUNTEERS THE INFORMATION.
7 HOMELESS AND LIVING ON THE STREET (GO TO F6)
8 JAIL (GO TO F6)
9 ALONE AND RENT-FREE (GO TO F6)
97 DON’T KNOW (GO TO F6)
98 REFUSED (GO TO F6)
F1a. Do you live in:
1 Public housing—that is, housing owned by a federal, state or local government agency, such as [RASITE]
2 Private housing for which part of your rent bill is paid by the government, such as Section 8 or vouchers, or
3 Private housing paid for by you with no help from the government. [You pay/you and your household pays] the entire rent bill without any help from the government.)?
97 DON’T KNOW
98 REFUSED
Assistance with Housing/Landlord Issues
F2. In the last 12 months, have you received assistance in dealing with housing issues or problems with your landlord?
INTERVIEWER: IF NECESSARY, READ: Housing issues could include, for example, repairs/maintenance or pest control.
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
Residential Moves and Housing/Neighborhood Quality
F3. In the past 12 months, have you been threatened with eviction or told you were at risk for eviction from your home for any reason?
1 Yes
2 No (SKIP TO F5)
8 DON’T KNOW (SKIP TO F5)
9 REFUSED (SKIP TO F5)
F4. Why were you threatened with eviction or told you were at risk? Was it because of… [INTERVIEWER: PLEASE READ LIST. CHECK ALL THAT APPLY]
1. Nonpayment of rent or late rent,
2. Nonpayment of mortgage by you or someone else
3. Absent from unit for 90 or more days,
4. Problems with visitors (stayed more than 7 days or behavior),
5. Damaging unit,
6. Housekeeping violations,
7. One-strike violation,
8. Income increase, or
97. Some other reason, SPECIFY____________________
98. DON’T KNOW
99. REFUSED
F5. In the past 12 months, have you been evicted from your home for any reason?
1. Yes
2. No
8. DON’T KNOW
9. REFUSED
F6. Have you moved at all since ///[REF DATE]?
1 YES
2 NO (GO TO F7)
97 DON’T KNOW (GO TO F7)
98 REFUSED (GO TO F7)
F6a. How many times have you moved since ///[REF DATE]?
INTERVIEWER INSTRUCTION: IF GREATER THAN 10, CODE THE RESPONSE AS 10
_________________ [RANGE: 1 to 10]
NUMBER OF TIMES MOVED
97 DON’T KNOW
98 REFUSED
F6b. (CATI: IF F6a= 1): What month and year did you move?
(CATI: IF F6a=2-10, 97, 98): What month and year did you move the last time?
INTERVIEWER: PROBE FOR SEASON IF DON’T KNOW MONTH. IF R CAN ONLY PROVIDE SEASON, SPRING = 05, SUMMER = 08, FALL = 11, WINTER = 02.
F6b1. MOVE: ___ ___/___ ___ ___ ___
MONTH YEAR
97 DON’T KNOW MONTH 9997 DON’T KNOW YEAR
98 REFUSED MONTH 9998 REFUSED YEAR
F6c. (CATI: IF F6a= 1): What was the main reason you moved?
(CATI: IF F6a> 1, INCLUDING 97 OR 98): What was the main reason you moved the last time?
INTERVIEWER: DO NOT READ LIST
EVICTION FOR NONPAYMENT OF RENT
EVICTION BECAUSE OF DISPUTE WITH LANDLORD
RENT WENT UP AT OLD PLACE
WANTED A CHEAPER PLACE
WANTED A SMALLER PLACE
WANTED A BIGGER PLACE
WANTED A NICER PLACE
WANTED MY OWN PLACE
WANTED A SAFER NEIGHBORHOOD
WANTED A PLACE CLOSER TO WORK/CLOSER TO SCHOOL
WANTED TO MOVE CLOSER TO FAMILY OR FRIENDS
WANTED A NEIGHBORHOOD WITH BETTER SCHOOLS
OTHER REASON (SPECIFY ______)
DON’T KNOW
REFUSED
CATI: IF F6c=13 (OTHER) ASK F6_O; ELSE GO TO F7
F6_O. What was the main reason you moved?
____________________________________
97 DON’T KNOW
98 REFUSED
F7. Overall, how satisfied are you with your current home? Would you say you are…
Very satisfied,
Somewhat satisfied,
Neither satisfied nor dissatisfied,
Somewhat dissatisfied, or
Very dissatisfied?
DON’T KNOW
98 REFUSED
F8. Overall, how satisfied are you with conditions in your neighborhood? Would you say you are…
Very satisfied,
Somewhat satisfied,
Neither satisfied nor dissatisfied,
Somewhat dissatisfied, or
Very dissatisfied?
DON’T KNOW
REFUSED
ADD QUESTIONS ON EXPERIENCE WITH PHAs, HCV EXITS.
Now we have a few questions about your experience with [PHA].
G1. Do you understand the …
|
YES |
NO |
DON’T KNOW |
REFUSED |
G1a. triennial recertification process? |
1 |
2 |
7 |
8 |
G1b. minimum rent rules? |
1 |
2 |
7 |
8 |
G1c. restrictions on interims? |
1 |
2 |
7 |
8 |
G1d. hardship policies? |
1 |
2 |
7 |
8 |
G1e. safeguards? |
1 |
2 |
7 |
8 |
G2. Have you ever checked in with [PHA] after your initial recertification about whether or not you met the criteria for interims or hardship remedies?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
G3. Have you ever checked in with [PHA] after your initial recertification to seek clarification about new rules?
1 YES
2 NO
97 DON’T KNOW
98 REFUSED
G4. Overall, do you prefer the new rent rules or old rent rules?
1 NEW RENT RULES
2 OLD RENT RULES
97 DON’T KNOW (GO TO G5)
98 REFUSED (GO TO G5)
G4a. Can you explain why you prefer the [G4 RESPONSE]?
CATI: INCLUDE TEXT BOX
G5. Do you feel that the minimum rent policy is fair?
1 FAIR
2 NOT FAIR
97 DON’T KNOW (GO TO Z1)
98 REFUSED (GO TO Z1)
G5a. Can you explain why you think the minimum rent policy is [G5 RESPONSE]?
CATI: INCLUDE TEXT BOX
Z1. Those are all the questions I have to ask you today. Thank you for the time you’ve spent talking with me and for your participation in this study. In order to send your gift card, I need to confirm your name and address.
I have your name listed as [FLNAME] and spelled as (INTERVIEWER: SPELL NAME). Is that correct?
1 YES (GO TO Z4)
2 NO (GO TO Z3)
8 REFUSED (GO TO Z2)
Z2. In order to send your gift card, I am required to verify the spelling of your name. I have your name listed as [FLNAME] and spelled as INTERVIEWER: SPELL NAME. Is that correct?
1 YES (GO TO Z4)
2 NO (GO TO Z3)
8 REFUSED (GO TO Z4)
CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED NAME WHILE ORIGINAL NAME IS DISPLAYED FOR COMPARISON PURPOSES
Z3. INTERVIEWER: ENTER CORRECTED NAME.
[FLNAME]
Z4. Is this your current address? [FULLADD, RCITY, RSTATE, RZIP]
INTERVIEWER: READ ADDRESS TO R, SPELLING EACH WORD.
INTERVIEWER, IF R REFUSES SAY: We won’t be able to send your gift card without an address.
1 YES (GO TO Z6)
2 NO (GO TO Z5)
8 REFUSED (GO TO Z6)
CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED ADDRESS WHILE ORIGINAL ADDRESS IS DISPLAYED FOR COMPARISON PURPOSES
CATI: CREATE CDMO USING DATA ENTERED AT Z5 TO REPLACE:
FULLADD – FULL ADDRESS
RCITY – CITY
RSTATE – STATE
RZIP – ZIP
Z5. Please tell me your address.
ADDRESS _________________________
CITY _________________________
STATE _________________________
ZIP _________________________
8 REFUSED
INTERVIEWER: ENTER CORRECTED ADDRESS. READ BACK THE ADDRESS INFORMATION TO R, SPELLING THE WORDS.
INTERVIEWER, IF R REFUSES SAY: We won’t be able to send your gift card without an address.
Z6. Is there another address you would like me to use to send your $[INCENTIVE] gift card?
1 YES
2 NO (GO TO Z8)
8 REFUSED (GO TO Z8)
CATI: PROVIDE TEXT BOX FOR ENTRY OF SUPPLEMENTAL ADDRESS
Z7. What address would you like me to use?
Street: __________________________
City: __________________________
State: __________________________
Zip: __________________________
Z8. I also need to confirm your phone number in case we have any questions about the interview.
CATI: DISPLAY RPHONE1
INTERVIEWER: READ THE PHONE NUMBER. Is this correct?
1 YES (GO TO Z10)
2 NO (GO TO Z9)
8 REFUSED (GO TO THANK)
CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED PHONE NUMBER. DISPLAY ORIGINAL PHONE NUMBER FOR COMPARISON PURPOSES
Z9. INTERVIEWER: ENTER CORRECTED PHONE NUMBER. READ BACK TO R TO CONFIRM.
Z10. Is this a home, work, or cell phone number?
1 Home
2 Work
3 Cell
8 REFUSED
GO TO THANK
THANK. Thank you very much for your time and assistance. You should receive your gift card in about 3 weeks. If you have any questions about the study or your gift card, you can contact XXX at DIR, the company in charge of conducting this survey. The toll-free number is XXX-XXX-XXXX.
INTERVIEWER: PRESS “NEXT” TO END SURVEY.
END INTERVIEW.
Thank you for taking the time to speak with me today. I’m sorry that you aren’t able to participate in our study. If you change your mind and decide you would like to participate, please call XXX-XXX-XXXX.
INTERVIEWER: PLEASE PAUSE A MOMENT TO GIVE R TIME TO WRITE NUMBER DOWN AND REPEAT IF NEEDED
INTERVIEWER: PRESS “NEXT” TO END SURVEY.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Cynthia Walsh |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |