Appendix C - Focus Group Screening Questionnaires by Audience
First
Name, |
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Unique ID |
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Address |
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City, State, Zip |
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Phone (H/C/W) |
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Reason for Termination
|
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SECTION 1: WILLINGNESS
Hello, my name is
______ and I’m from ______, a focus group facility working on
behalf of the U.S. Census Bureau to help improve communications to
communities across the country.
The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
2 |
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> Terminate |
Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: MARKET RESEARCH EXPERIENCE
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
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Never |
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2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Service Industry |
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Other (specify: ) |
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SECTION 3: AUDIENCE SPECIFIC CRITERIA
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
> Check Quotas |
25 – 34 |
|
> Check Quotas |
35 – 44 |
|
> Check Quotas |
45 – 54 |
|
> Check Quotas |
55+ |
|
> Check Quotas |
3b. Are you…
Male |
|
> Check Quotas |
Female |
|
> Check Quotas |
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race? You may provide more than one group. MUST RESPOND AMERICAN INDIAN ONLY
White |
|
> TERMINATE |
|
Black or African American |
|
> TERMINATE |
|
Asian |
|
> TERMINATE |
|
American Indian |
|
|
|
Alaska Native |
|
> TERMINATE |
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
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Some other race (specify: ) |
|
> TERMINATE |
|
3e-h. Please respond yes or no to the following. MUST ANSWER YES TO 2 OF 4 TO QUALIFY. RANDOMIZE LIST:
3e. |
Are you a member of a Tribe? |
Yes |
No |
3f. |
Do you consider yourself knowledgeable about your native culture? |
Yes |
No |
3g. |
Do you participate in traditional native cultural events or ceremonies? |
Yes |
No |
3h. |
Do you live in or regularly communicate with people from your home village or tribe? |
Yes |
No |
TOTAL # OF YES: _____________________ MUST ANSWER YES TO 2 OF 4 TO QUALIFY
3i. What is your tribe? For example, Navajo Nation, Blackfeet Tribe, Bay Mills, Klamath, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX.
Navajo Nation |
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Blackfeet Tribeg |
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Bay Mills |
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Klamath |
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Other (specify: ) |
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Not a member of any Tribe (federal or state recognized) |
|
> TERMINATE |
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
> Check Quotas |
25 – 34 |
|
> Check Quotas |
35 – 44 |
|
> Check Quotas |
45 – 54 |
|
> Check Quotas |
55+ |
|
> Check Quotas |
3b. Are you…
Male |
|
> Check Quotas |
Female |
|
> Check Quotas |
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race? You may provide more than one group. MUST RESPOND ALASKA NATIVE ONLY
White |
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> TERMINATE |
|
Black or African American |
|
> TERMINATE |
|
Asian |
|
> TERMINATE |
|
American Indian |
|
> TERMINATE |
|
Alaska Native |
|
|
|
Native Hawaiian or Pacific Islander |
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> TERMINATE |
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Some other race (specify: ) |
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> TERMINATE |
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3e-h. Please respond yes or no to the following. MUST ANSWER YES TO 2 OF 4 TO QUALIFY. RANDOMIZE LIST:
3e. |
Are you a Shareholder of an Alaska Native Corporation? |
Yes |
No |
3f. |
Do you consider yourself knowledgeable about your native culture? |
Yes |
No |
3g. |
Do you participate in traditional native cultural events or ceremonies? |
Yes |
No |
3h. |
Do you live in or regularly communicate with people from your home village or tribe? |
Yes |
No |
TOTAL # OF YES: _____________________ MUST ANSWER YES TO 2 OF 4 TO QUALIFY
3i. What is your Alaska Native Corporation? For example, Native Village of Barrow, Arctic Slope Corporation, Tlingit, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX.
Native Village of Barrow |
|
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Arctic Slope Corporation |
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Tlingit |
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Other (specify: ) |
|
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Not a member of an Alaska Native Corporation |
|
> TERMINATE |
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
3b. Are you…
Male |
|
|
Female |
|
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Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
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No |
|
|
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3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND BLACK/AFRICAN AMERICAN ONLY.
White |
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> Terminate |
Black or African American |
|
|
Asian |
|
> Terminate |
American Indian |
|
> Terminate |
Alaska Native |
|
> Terminate |
Middle Eastern or North African |
|
> Terminate |
Native Hawaiian or Pacific Islander |
|
> Terminate |
Some other race (specify: ) |
|
> Terminate |
3e. What is the highest grade or year of schooling you have completed?
Less than High school |
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|
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High School graduate or equivalent |
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|
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Some college |
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|
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College graduate or postgraduate degree |
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> Terminate |
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3f. What is your total annual household income?
Less than $14,999 |
|
|
$15,000 to $29,999 |
|
|
$30,000 to $34,999 |
|
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$35,000 to $74,999 |
|
> Terminate |
$75,000 to $149,999 |
|
> Terminate |
More than $150,000 |
|
> Terminate |
3g. In what country were you born?
United States |
|
|
Other |
|
> TERMINATE |
ENGLISH-DOMINANT LATINOS, U.S. MAINLAND
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
> TERMINATE |
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
|
|
No |
|
> TERMINATE |
|
3d. What is your race? You may provide more than one group.
White |
|
|
|
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Black or African American |
|
|
|
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Asian |
|
|
|
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American Indian |
|
|
|
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Alaska Native |
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|
|
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Native Hawaiian or Pacific Islander |
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|
|
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Some other race (specify: _____) |
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3e. What languages do you speak at home? DO NOT READ RESPONSE OPTIONS / MULTIPLE RESPONSES PERMITTED / MUST SPEAK ENGLISH AND SPANISH
English only |
|
>TERMINATE |
Spanish only |
|
>TERMINATE |
Spanish and English |
|
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Other (specify: ) |
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> TERMINATE |
3f. How well do you speak English?
Very well |
|
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Well |
|
> Terminate |
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3g. How well do you speak Spanish?
Very well |
|
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Well |
|
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Not well |
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Not at all |
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> TERMINATE |
3g1. In what language do you consume most TV, magazines, newspapers, music and/or radio?
Spanish only |
|
> Terminate > Terminate |
More Spanish than English |
|
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Spanish and English about equally |
|
> RECRUIT A MIX |
More English than Spanish |
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> RECRUIT A MIX |
English only |
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> RECRUIT A MIX |
Some other language |
|
> Terminate |
3h. What is your country of origin? RECRUIT A MIX.
Mexico |
|
> mexican check quotas |
El Salvador, Guatemala, Honduras, or other Central American country |
|
> central american check quotas |
Puerto Rico, Cuba, Dominican Republic |
|
> Caribbean check quotas |
Colombia, Venezuela, Argentina, or other South American country |
|
> south american check quotas |
Puerto Rican |
|
> Puerto rican check quotas |
Cuban |
|
> Cuban check quotas |
3i. In what country or territory were you born?
United States |
|
> 2nd GenerATION |
Other (specify: _______) |
|
> ask Q3j |
ONLY ASKED IF OTHER (C2 @ Q3I)
3j. How old were you when you first came to the United States?
IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.
Record Verbatim: ________ [please capture age]
17 or older |
|
> TERMINATE |
16 or younger |
|
> 1.5 GENERATION |
3k. In what country or territory were your parents born?
Both parents were born in the U.S. |
|
> Terminate |
One parent was born in the U.S.; the other was born outside of the U.S. |
|
> Terminate |
Both parents were born outside of the U.S. |
|
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Don’t know |
|
> Terminate |
READ TO ALL
Next, I’d like to ask you a question about the U.S. census. The U.S. census is the count of all the people who live in the United States. It happens every 10 years, and the next census is in 2020. The Census plans to ask questions such as how many people live at your address or place and their age, gender, race, ethnicity, relationships, and citizenship.
3l. If the census were held today, how likely would you be to complete the census form?
Not at all likely |
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Not too likely |
|
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Somewhat likely |
|
>HOLD |
Very likely |
|
> Terminate |
Extremely likely |
|
> Terminate |
Unsure/Have not decided yet |
|
> HOLD |
MIDDLE EASTERN OR NORTH AFRICAN (MENA)
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
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No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND MENA ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
> TERMINATE |
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
|
|
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Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
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Some other race (specify: ) |
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> TERMINATE |
|
|
3e. Earlier, you reported you were MIDDLE EASTERN OR NORTH AFRICAN. What are your detailed MIDDLE EASTERN OR NORTH AFRICAN ethnicities? For example, Lebanese, Iranian, Egyptian, Syrian, Moroccan, Israeli, etc. MULTIPLE RESPONSES PERMITTED. TERMINATE IF THEY PROVIDE “OTHER” RESPONSE.
Lebanese |
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Iranian |
|
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Egyptian |
|
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Moroccan |
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Iraqi |
|
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Yemeni |
|
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Other (specify: ) |
|
> TERMINATE |
3f. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3g. In what country or territory were you born?
In the United States |
|
> skip to SECTION 4 |
Outside of the United States (specify: ) |
|
> ask q3h |
ONLY ASK IF NOT BORN IN THE UNITEd STATES
3h. How old were you when you first came to the United States?
IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.
17 or older |
|
|
16 or younger |
|
|
NATIVE HAWAIIAN OR PACIFIC ISLANDER (NHPI)
3a. How old are you?
17 or under |
1 |
> ask for someone in household ages 18+ |
18 – 24 |
2 |
|
25 – 34 |
3 |
|
35 – 44 |
4 |
|
45 – 54 |
5 |
|
55+ |
6 |
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race? You may provide more than one group. MUST RESPOND NHPI ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
> TERMINATE |
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
Some other race (specify: ) |
|
> TERMINATE |
|
|
3e. Earlier, you reported you were NATIVE HAWAIIAN OR PACIFIC ISLANDER. What are your NATIVE HAWAIIAN OR PACIFIC ISLANDER ethnicities? For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc. MULTIPLE RESPONSES PERMITTED. RECRUIT A MIX.
Native Hawaiian |
|
> native hawaiian |
Samoan |
|
> Polynesian/ melanesian |
Chamorro |
|
> micronesian |
Fijian |
|
> Polynesian/ melanesian |
Tongan |
|
> Polynesian/ melanesian |
Marshallese |
|
> micronesian |
Other (specify: ) |
|
|
3f. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3g. In what country or territory were you born?
In the continental United States, Alaska, or Hawaii |
|
> skip to SECTION 4 |
Outside of the United States (specify: ) |
|
> ask q3h |
ASK IF NOT BORN IN THE UNITEd STATES (INCLUDING HAWAII):
3h. How old were you when you first came to the United States? IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.
17 or older |
|
|
16 or younger |
|
|
3i. Is there a language besides English that you are fluent in? RECRUIT A MIX.
Yes (specify: ) |
|
|
Native Hawaiian |
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Micronesian |
|
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Polynesian/Melanesian |
|
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No |
|
> IF Micronesian OR Polynesian/ MELANESIAN, TERMINATE. > IF Native Hawaiian, skip to section 4 |
3j. How many hours of media in [OTHER] language do you consume per week? This can include TV, print, radio, digital media, and social media.
HOURS: ________________________________________
PEOPLE LIVING IN RURAL LOCATIONS
3a. How old are you?
17 or under |
1 |
> ask for someone in household ages 18+ |
18 – 24 |
2 |
|
25 – 34 |
3 |
|
35 – 44 |
4 |
|
45 – 54 |
5 |
|
55+ |
6 |
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group.
White |
|
|
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
> TERMINATE |
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. What is your ZIP code? RECRUIT FROM A LIST OF ZIP CODES PROVIDED BY TEAM Y&R. IF ZIP CODE DOES NOT MATCH LIST, TERMINATE.
RECORD ZIP CODE:_______________________
PEOPLE WITH YOUNG CHILDREN LIVING IN HOUSEHOLD
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
|
|
No |
|
|
|
3d. What is your race? You may provide more than one group.
White |
|
> terminate |
|
Black or African American |
|
|
|
Asian |
|
|
|
American Indian |
|
|
|
Alaska Native |
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
Some other race (specify: ) |
|
|
|
3e. Are there any children under the age of 18 currently live in your household?
Yes |
|
|
No |
|
> terminate |
3f. What are the ages of each child currently living in your home? ONLY PROCEED IF AT LEAST 1 CHILD IS 4 YEARS OLD OR YOUNGER
Child 1 |
|
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Child 2 |
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Child 3 |
|
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Child 4 |
|
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Child 5 |
|
|
3g. Thinking about the [child/children] who are four years or younger, what is your relationship with [the child/each child]? MULTIPLE RESPONSES PERMITTED.
Parent |
|
|
Grandparent |
|
|
Other relative (specify: ) |
|
|
Not related |
|
|
3h. Besides yourself, how many adults live in your home?
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
|
3i. What is your total annual household income?
Less than $14,999 |
|
|
|
$15,000 to $29,999 |
|
|
|
$30,000 to $34,999 |
|
|
|
$35,000 to $74,999 |
|
|
|
$75,000 to $149,999 |
|
|
|
More than $150,000 |
|
|
|
ONLY PROCEED IF LIVING IN A LARGE HOUSEHOLD (C4 @ Q3H) OR HAVING LOW INCOME (C1-C3 @ Q3I)
SECTION 4: HARD-TO-COUNT DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children (0-4 years old)
Multi-unit or mobile home structure
4a. What is the highest grade or year of schooling you have completed?
Less than High school |
|
1 point Check quotas |
|
High School graduate or equivalent |
|
|
|
Some college |
|
|
|
College graduate or postgraduate degree |
|
> Terminate |
|
4b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
4c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q4d |
No |
|
> skip to q4e |
4d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
ASK ALL PARTICIPANTS
4e. Besides yourself, how many adults live in your home?
RECORD NUMBER: ______________________________________
FEMALE HOUSEHOLDER
1 Point IF ALL OF FOLLOWING:
Female (Code 2 @ Q3B)
Unmarried (Code 2-5 @ Q4B)
Lives with another adult (Q4E > 0)
LARGE HOUSEHOLD:
CODE NUMBER OF PEOPLE IN HOUSEHOLD = nUMBER OF CHILDREN (4C) + NUMBER OF ADULTS (4E)
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
4f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:_________________________________ _) |
|
|
|
4g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached from any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
4h. How many years ago did you move into the home you are currently living in?
Moved within the past year |
|
1 point |
Moved more than a year ago |
|
|
4i. What is your total annual household income?
Less than $14,999 |
|
1 point |
|
$15,000 to $29,999 |
|
1 poinT |
|
$30,000 to $34,999 |
|
1 point |
|
$35,000 to $74,999 |
|
|
|
$75,000 to $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 5: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to Ketzirah.Lesser@YR.com. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM DETAILS & SCHEDULE
PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to Ketzirah.Lesser@YR.com.
First
Name, |
|
Unique ID |
|
Address |
|
City, State, Zip |
|
Phone (H/C/W) |
|
Reason for Termination |
|
SECTION 1: WILLINGNESS
Hello, my name is
______ and I’m from ______, a focus group facility working on
behalf of the U.S. Census Bureau to help improve communications to
communities across the country.
The focus group will take about 90 minutes, and you will receive $75 for your time. If you are still interested in participating and if you are available the evening of [DATE], I will ask you a few questions to see if you qualify. The questions I will ask on this call will take about 5 minutes.
1a. May we proceed?
Yes |
|
|
No |
|
> Terminate |
1b. If you are eligible, are you available on [DATE] at [TIME] to participate in a focus group? The focus group will be held in [PLACE].
Yes |
|
|
No |
|
> Terminate |
Before we start, I want to tell you a few things about the focus group and the questions I will be asking you now. Your participation is voluntary, but your responses are important. You can choose not to answer any or all questions. The questions I am about to ask you, and those asked during the focus group itself, have been authorized for collection by U.S. Office of Management and Budget, approval number 0607-0987, expiring on 08/31/2020.
1c. Are you willing to participate?
Yes |
|
|
No |
|
> Terminate |
SECTION 2: MARKET RESEARCH EXPERIENCE
Great, I have a few questions to see if you qualify for this study.
2a. When, if ever, was the last time you participated in a marketing research study, such as a consumer interview or a group discussion?
Within the past three months |
|
> hold |
Over three months ago |
|
|
Never |
|
2b. Do you or an immediate family member work in any of the following fields? RANDOMIZE LIST
Advertising or public relations |
|
> terminate |
Marketing or market research |
|
> terminate |
Federal government |
|
> terminate |
Journalism |
|
> terminate |
Education |
|
|
Medicine |
|
|
Engineering |
|
|
Service Industry |
|
|
Other (specify: ) |
|
|
SECTION 3: AUDIENCE SPECIFIC CRITERIA
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 54 |
|
|
55+ |
|
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND MENA ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
> TERMINATE |
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
|
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. Earlier, you reported you were MIDDLE EASTERN OR NORTH AFRICAN. What are your detailed MIDDLE EASTERN OR NORTH AFRICAN ethnicities? For example, Lebanese, Iranian, Egyptian, Syrian, Moroccan, Israeli, etc. MULTIPLE RESPONSES PERMITTED. TERMINATE IF THEY RESPOND OTHER.
Lebanese |
|
|
Iranian |
|
|
Egyptian |
|
|
Moroccan |
|
|
Iraqi |
|
|
Yemeni |
|
|
Other (specify: ) |
|
> TERMINATE |
3f. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK ARABIC
English |
|
|
Arabic |
|
|
French |
|
|
Other (specify: ) |
|
> TERMINATE |
3g. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3h. How well do you speak Arabic?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND ASIAN ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
|
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. Earlier, you reported you were ASIAN. What are your detailed ASIAN ethnicities? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. MUST BE CHINESE
Chinese |
|
|
Filipino/Tagalog |
|
> TERMINATE |
Asian Indian |
|
> TERMINATE |
Vietnamese |
|
> TERMINATE |
Korean |
|
> TERMINATE |
Japanese |
|
> TERMINATE |
Other (specify: ) |
|
> TERMINATE |
3f. In what country or territory were you born?
In the United States |
|
> TERMINATE |
Outside of the United States (specify: ) |
|
> ask q3G |
3g. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK CHINESE
English |
|
|
Chinese (Cantonese) |
|
|
Other (specify: ) |
|
> TERMINATE |
3h. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3i. How well do you speak Chinese (Cantonese)?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND ASIAN ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
|
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. Earlier, you reported you were ASIAN. What are your detailed ASIAN ethnicities? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. MUST BE CHINESE
Chinese |
|
|
Filipino |
|
> TERMINATE |
Asian Indian |
|
> TERMINATE |
Vietnamese |
|
> TERMINATE |
Korean |
|
> TERMINATE |
Japanese |
|
> TERMINATE |
Other (specify: ) |
|
> TERMINATE |
3f. In what country or territory were you born?
In the United States |
|
> TERMINATE |
Outside of the United States (specify: ) |
|
> ask q3G |
3g. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK CHINESE
English |
|
|
Chinese (Mandarin) |
|
|
Other (specify: ) |
|
> TERMINATE |
3h. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3i. How well do you speak Chinese (Mandarin)?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND ASIAN ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
|
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. Earlier, you reported you were ASIAN. What are your detailed ASIAN ethnicities? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. MUST BE FILIPINO
Chinese |
|
> TERMINATE |
Filipino |
|
|
Asian Indian |
|
> TERMINATE |
Vietnamese |
|
> TERMINATE |
Korean |
|
> TERMINATE |
Japanese |
|
> TERMINATE |
Other (specify: ) |
|
> TERMINATE |
3f. In what country or territory were you born?
In the United States |
|
> TERMINATE |
Outside of the United States (specify: ) |
|
> ask q3G |
3g. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK FILIPINO/TAGALOG
English |
|
|
Tagalog |
|
|
Other (specify: ) |
|
|
3h. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
|
Not at all |
|
|
3i. How well do you speak Filipino/Tagalog?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND BLACK/AFRICAN AMERICAN ONLY.
White |
|
> Terminate |
Black or African American |
|
|
Asian |
|
> Terminate |
American Indian |
|
> Terminate |
Alaska Native |
|
> Terminate |
Middle Eastern or North African |
|
> Terminate |
Native Hawaiian or Pacific Islander |
|
> Terminate |
Some other race (specify: ) |
|
> Terminate |
3e. In what country or territory were you born?
United States |
|
> Terminate |
Haiti |
|
|
Other |
|
> Terminate |
3f. How old were you when you first came to the United States?
IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.
17 or older |
|
> 1ST GENERATION |
16 or younger |
|
> 1.5 GENERATION |
3g. In what country or territory were your parents born?
Both parents were born in the U.S. |
|
> Terminate |
One parent was born in the U.S.; the other was born outside of the U.S. |
|
> Terminate |
Both parents were born outside of the U.S. |
|
|
Don’t know |
|
> Terminate |
3h. What languages do you speak at home? MULTIPLE RESPONSES PERMITTED / MUST SPEAK HAITIAN CREOLE
English |
|
|
Haitian Creole |
|
|
Other (specify: ) |
|
> TERMINATE |
3i. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3j. How well do you speak Haitian Creole?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND ASIAN ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
|
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. Earlier, you reported you were ASIAN. What are your detailed ASIAN ethnicities? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. MUST BE JAPANESE
Chinese |
|
> TERMINATE |
Filipino/Tagalog |
|
> TERMINATE |
Asian Indian |
|
> TERMINATE |
Vietnamese |
|
> TERMINATE |
Korean |
|
> TERMINATE |
Japanese |
|
|
Other (specify: ) |
|
> TERMINATE |
3f. In what country or territory were you born?
In the United States |
|
> TERMINATE |
Outside of the United States (specify: ) |
|
> ask q3G |
3g. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK JAPANESE
English |
|
|
Japanese |
|
|
Other (specify: ) |
|
> TERMINATE |
3h. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3i. How well do you speak Japanese?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND ASIAN ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
|
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. Earlier, you reported you were ASIAN. What are your detailed ASIAN ethnicities? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. MUST BE KOREAN
Chinese |
|
> TERMINATE |
Filipino/Tagalog |
|
> TERMINATE |
Asian Indian |
|
> TERMINATE |
Vietnamese |
|
> TERMINATE |
Korean |
|
|
Japanese |
|
> TERMINATE |
Other (specify: ) |
|
> TERMINATE |
3f. In what country or territory were you born?
In the United States |
|
> TERMINATE |
Outside of the United States (specify: ) |
|
> ask q3G |
3g. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK KOREAN
English |
|
|
Korean |
|
|
Other (specify: ) |
|
> TERMINATE |
3h. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3i. How well do you speak Korean?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND White ONLY.
White |
|
|
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
> TERMINATE |
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. What is your ancestry or ethnic origin? DO NOT READ RESPONSE OPTIONS. MUST BE POLISH.
Poland / Polish |
|
Other |
|
3f. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK POLISH
English |
|
|
Polish |
|
|
Other (specify: ) |
|
> TERMINATE |
3g. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3h. How well do you speak Polish?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
|
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group.
White |
|
|
|
|
Black or African American |
|
|
|
|
Asian |
|
|
|
|
American Indian |
|
|
|
|
Alaska Native |
|
|
|
|
Middle Eastern or North African |
|
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
Some other race or ethnicity (specify: ) |
|
|
|
|
3e. What is your country of origin? DO
NOT READ RESPONSE OPTIONS. MUST BE BRAZILIAN.
Brazil |
|
Other |
|
3f. What languages do you speak at home? You may provide more than one language. MUST SPEAK PORTUGUESE
English |
|
> TERMINATE |
Portuguese |
|
|
Other (specify: ) |
|
> TERMINATE |
3g. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3h. How well do you speak Portuguese?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND White ONLY.
White |
|
|
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
> TERMINATE |
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. What is your ancestry or ethnic origin? DO NOT READ RESPONSE OPTIONS. MUST BE RUSSIAN.
Russia / Russian |
|
Other |
|
3f. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK RUSSIAN
English |
|
|
Russian |
|
|
Other (specify: ) |
|
|
3g. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3h. How well do you speak Russian?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
|
|
No |
|
> TERMINATE |
|
3d. What is your race? You may provide more than one group.
White |
|
|
|
|
Black or African American |
|
|
|
|
Asian |
|
|
|
|
American Indian |
|
|
|
|
Alaska Native |
|
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
Some other race (specify: _____) |
|
|
|
|
3e. FOR NON-DOMINCAN GROUPS: Earlier, you reported you were HISPANIC OR LATINO. What are your detailed HISPANIC OR LATINO ethnicities? For example, Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, etc.? MULTIPLE RESPONSES PERMITTED / MUST RESPOND PUERTO RICAN
Mexican or Mexican American |
|
> TERMINATE |
Central American |
|
> TERMINATE |
Puerto Rican |
|
|
Dominican |
|
> TERMINATE |
Cuban |
|
> TERMINATE |
South American |
|
> TERMINATE |
Other (specify: ) |
|
> TERMINATE |
3f. FOR NON-DOMINCAN GROUPS: In what country or territory were you born?
In the United States |
|
|
Outside of the United States (specify: ) |
|
|
3g. FOR DOMINICAN GROUPS ONLY In what country or territory were you born?
Dominican Republic |
|
|
Outside of the United States (specify: ) |
|
> TERMINATE |
3h. FOR DOMINICAN GROUPS ONLY: How long have you been living in Puerto Rico?
Since 2011 (8 years) |
|
|
Before 2011 (9+ years) |
|
|
3ij. What languages do you speak at home? MULTIPLE RESPONSES PERMITTED / MUST SPEAK SPANISH
Spanish |
|
|
Other (specify: ) |
|
> TERMINATE |
3j. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3k. How well do you speak Spanish?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3l. Do you rent or own your house or apartment?
Owned or being bought by you or someone in your household |
|
|
Rented by you or someone in your household |
|
|
Occupied without payment of rent |
|
|
3m. FOR HOMEOWNER GROUPS ONLY Do you live in a gated community or condominium, that is, a collection of homes accessible only to residents and their guests?
Yes |
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|
No |
|
3n. FOR UTUADO GROUPS ONLY What part of Utuado do you live in?
Rural (Bario) |
|
|
Neighborhood (Urbanización) |
|
|
Downtown (El pueblo) |
|
|
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
|
|
No |
|
> TERMINATE |
|
3d. What is your race? You may provide more than one group.
White |
|
|
|
|
Black or African American |
|
|
|
|
Asian |
|
|
|
|
American Indian |
|
|
|
|
Alaska Native |
|
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
Some other race (specify: _____) |
|
|
|
|
3e. What languages do you speak at home? MULTIPLE RESPONSES PERMITTED / MUST SPEAK SPANISH
Spanish |
|
|
Other (specify: ) |
|
> TERMINATE |
3f. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3g. How well do you speak Spanish?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3h. What is your country of origin? RECRUIT A MIX.
Mexico |
|
> mexican check quotas |
El Salvador, Guatemala, Honduras, or other Central American country |
|
> central american check quotas |
Puerto Rico, Cuba, Dominican Republic |
|
> Caribbean |
Colombia, Venezuela, Argentina, or other South American country |
|
> south american |
Puerto Rican |
|
> Puerto rican |
Cuban |
|
> Cuban |
3i. In what country or territory were you born?
United States |
|
> Terminate |
Other |
|
> ask Q3j |
ONLY ASKED IF OTHER (C2 @ Q3I)
3j. How old were you when you first came to the United States?
IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.
17 or older |
|
> 1ST GENERATION |
16 or younger |
|
> 1.5 GENERATION |
3k. In what country or territory were your parents born?
Both parents were born in the U.S. |
|
> Terminate |
One parent was born in the U.S.; the other was born outside of the U.S. |
|
> Terminate |
Both parents were born outside of the U.S. |
|
|
Don’t know |
|
> Terminate |
3l. FOR YAKIMA GROUPS ONLY. What best describes your primary field of work? OPEN ENDED RESPONSE - DO NOT READ ANSWER CHOICES.
Agriculture or farming |
|
|
Other |
|
> Terminate |
SUB-SAHARAN AFRICA DIASPORA (FRENCH SPEAKING)
3a. How old are you?
17 or under |
|
> ask for someone in household ages 18+ |
18 – 24 |
|
|
25 – 34 |
|
|
35 – 44 |
|
|
45 – 54 |
|
|
55+ |
|
|
3b. Are you…
Male |
|
|
Female |
|
|
Other (specify: ) |
|
|
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND BLACK/AFRICAN AMERICAN ONLY.
White |
|
> Terminate |
Black or African American |
|
|
Asian |
|
> Terminate |
American Indian |
|
> Terminate |
Alaska Native |
|
> Terminate |
Middle Eastern or North African |
|
> Terminate |
Native Hawaiian or Pacific Islander |
|
> Terminate |
Some other race (specify: ) |
|
> Terminate |
3e. In what country or territory were you born? RECRUIT A MIX.
Benin |
|
|
|
Burkina Faso |
|
|
|
Burundi |
|
|
|
Cameroon |
|
|
|
Central African Republic |
|
|
|
Chad |
|
|
|
Comoros |
|
|
|
Republic of Congo |
|
|
|
Democratic Republic of Congo (D.R.C) |
|
|
|
Cote d’Ivoire |
|
|
|
Djibouti |
|
|
|
Gabon |
|
|
|
Guinea |
|
|
|
Madagascar |
|
|
|
Mali |
|
|
|
Niger |
|
|
|
Senegal |
|
|
|
Togo |
|
|
|
Other |
|
> TERMINATE |
|
3f. What languages do you speak at home? MULTIPLE RESPONSES PERMITTED / MUST SPEAK FRENCH
English |
|
|
French |
|
|
Other (specify: ) |
|
> TERMINATE |
3g. How well do you speak English?
Very well |
|
|
Well |
|
|
Not well |
|
|
Not at all |
|
|
3h. How well do you speak French?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
3i. How old were you when you first came to the United States?
IF ASKED, THIS INFORMATION IS BEING ASKED TO ENSURE A BROAD RANGE OF EXPERIENCES ARE REPRESENTED IN THE DISCUSSION. ANSWERS WILL NOT BE SHARED FOR MARKETING OR ANY OTHER PURPOSE.
17 or older |
|
> 1ST GENERATION |
16 or younger |
|
> 1.5 GENERATION |
3j. In what country or territory were your parents born?
Both parents were born in the U.S. |
|
> Terminate |
One parent was born in the U.S.; the other was born outside of the U.S. |
|
> Terminate |
Both parents were born outside of the U.S. |
|
|
Don’t know |
|
> Terminate |
3c. Do you consider yourself to be of Latino or Hispanic origin?
Yes |
|
> TERMINATE |
|
No |
|
|
|
3d. What is your race or ethnicity? You may provide more than one group. MUST RESPOND ASIAN ONLY.
White |
|
> TERMINATE |
|
|
Black or African American |
|
> TERMINATE |
|
|
Asian |
|
|
|
|
American Indian |
|
> TERMINATE |
|
|
Alaska Native |
|
> TERMINATE |
|
|
Middle Eastern or North African |
|
> TERMINATE |
|
|
Native Hawaiian or Pacific Islander |
|
> TERMINATE |
|
|
Some other race or ethnicity (specify: ) |
|
> TERMINATE |
|
|
3e. Earlier, you reported you were ASIAN. What are your detailed ASIAN ethnicities? For example, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc. MUST BE Vietnamese
Chinese |
|
> TERMINATE |
Filipino/Tagalog |
|
> TERMINATE |
Asian Indian |
|
> TERMINATE |
Vietnamese |
|
|
Korean |
|
> TERMINATE |
Japanese |
|
> TERMINATE |
Other (specify: ) |
|
> TERMINATE |
3f. In what country or territory were you born?
In the United States |
|
> TERMINATE |
Outside of the United States (specify: ) |
|
> ask q3G |
3g. What languages do you speak at home? You may provide more than one language. MULTIPLE RESPONSES PERMITTED / MUST SPEAK VIETNAMESE
English |
|
|
Vietnamese |
|
|
Other (specify: ) |
|
> TERMINATE |
3h. How well do you speak English?
Very well |
|
> TERMINATE |
Well |
|
|
Not well |
|
|
Not at all |
|
|
3i. How well do you speak Vietnamese?
Very well |
|
|
Well |
|
|
Not well |
|
> TERMINATE |
Not at all |
|
> TERMINATE |
SECTION 4: HARD-TO-COUNT DEMOGRAPHICS
NOTE: MUST MEET AT LEAST TWO OF THE FOLLOWING CRITERIA:
Renters
Living in a large household (with 6 or more people)
Less than high school diploma
Female householder, no husband present
Low income (less than $35,000 per year)
Move within the past year
Household with young children (0-4 years old)
Multi-unit or mobile home structure
4a. What is the highest grade or year of schooling you have completed?
Less than high school |
|
1 point Check quotas for group |
|
High school graduate or equivalent |
|
|
|
Some college |
|
|
|
College graduate or postgraduate degree |
|
> Terminate |
|
4b. What is your marital status?
Married |
|
|
Widowed |
|
|
Divorced |
|
|
Separated |
|
|
Never married |
|
|
4c. Are there any children currently living in your household?
Yes (specify number of children: ) |
|
> ask q4d |
No |
|
> skip to q4e |
4d. What is the age of the youngest child in your home?
0–4 years old |
|
YOUNG children |
1 point |
5–9 years old |
|
|
|
10–17 years old |
|
|
|
ASK ALL PARTICIPANTS
4e. Besides yourself, how many adults live in your home?
RECORD NUMBER: ______________________________________
FEMALE HOUSEHOLDER
1 Point IF ALL OF FOLLOWING:
Female (Code 2 @ Q3B)
Unmarried (Code 2-5 @ Q4B)
Lives with another adult (Q4E > 0)
LARGE HOUSEHOLD:
CODE NUMBER OF PEOPLE IN HOUSEHOLD = nUMBER OF CHILDREN (4C) + NUMBER OF ADULTS (4E)
None, just myself |
|
|
One other person |
|
|
Two other people |
|
|
Three other people |
|
|
Four other people |
|
|
Five or more other people |
|
1 point |
4f. Do you rent or own your own house or apartment?
Rent |
|
1 point |
|
Own |
|
|
|
Other (specify:_________________________________ _) |
|
|
|
4g. Which describes the building of your primary residence?
A mobile home |
|
1 point |
|
A one-family house detached from any other house |
|
|
|
A one-family house attached from any other house |
|
1 point |
|
A building with 2 or more apartments |
|
1 point |
|
Boat, RV, van, etc. |
|
1 point |
|
4h. How many years ago did you move into the home you are currently living in?
Moved within the past year |
|
1 point |
Moved more than a year ago |
|
|
4i. What is your total annual household income?
Less than $14,999 |
|
1 point |
|
$15,000 to $29,999 |
|
1 poinT |
|
$30,000 to $34,999 |
|
1 point |
|
$35,000 to $74,999 |
|
|
|
$75,000 to $149,999 |
|
|
|
More than $150,000 |
|
|
|
record TOTAL POINTS ALLOCATED THROUGHOUT SCREEneR: _________ (enter number here)
2 OR MORE POINTS |
|
|
LESS THAN 2 POINTS |
|
> TERMINATE |
SECTION 5: INVITATION TO PARTICIPATE
READ TO ALL QUALIFYING PARTICIPANTS
Thank you! You are eligible to participate in the focus group on [DATE] starting at [TIME] taking place at [LOCATION]. If you have any questions or comments about this study, you may send them to Ketzirah.Lesser@YR.com. May we schedule you to participate?
Yes |
|
|
No |
|
> Terminate |
CONFIRM DETAILS & SCHEDULE
PARTICIPANT
READ TO ALL NON-QUALIFYING PARTICIPANTS
Thank you! It’s important we include a variety of backgrounds in our discussions, at this time we have reached our quota for individuals who match your characteristics, so you are not eligible to participate in this study. If you have any questions or comments about this study, you may send them to Ketzirah.Lesser@YR.com
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | 2020 Census REsearch Study Plan Template DRAFT |
| Author | douglass Abramson |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |