User Experience Survey (2020 Census)
Start of Block: Block 1
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Q1 Thank you
for agreeing to share your experience completing the 2020 Census
questionnaire online. We estimate that this survey will take about 10
minutes. The results of this study will be used to evaluate the 2020
Census online questionnaire and to make future online questionnaires
better.
Q2
AUTHORITY
AND CONFIDENTIALITY
By law, the Census Bureau is
required to keep your answers confidential (Title 13, United States
Code, Section 9). We are conducting this voluntary survey
under the authority of Title 13, United States Code, Sections 6(c),
141 and 193. This collection has been approved by the Office of
Management and Budget (OMB). This eight-digit OMB approval number,
0607-0971, confirms this approval. We are required to display this
number to conduct this survey. We estimate that this survey will take
about 10 minutes. Send comments regarding this estimate or any other
aspect of this survey, including suggestions for reducing the time it
takes to complete this survey to adrm.pra@census.gov.
By proceeding with this study, you give your consent to participate
in this study. The Privacy Act of 1974 (5 U.S.C. Section 552a) allows
the sharing of information you provided with Census Bureau staff for
the work-related purposes identified in this statement and the
Privacy Act System of Records Notice (SORN) COMMERCE/CENSUS-5,
Decennial Census Programs.
End of Block: Block 1
Start of Block: Default Question Block
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Q3 How satisfied were you with the experience of filling out your 2020 Census questionnaire online?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied
I don't remember
Someone else filled out my census questionnaire
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Display This Question:
If How satisfied were you with the experience of filling out your 2020 Census questionnaire online? = Someone else filled out my census questionnaire
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Q4 We’d
like to contact the person who filled out your Census questionnaire
to ask a few follow-up questions about their satisfaction with
completing the census online.
What is the cell phone
number of the person who filled out your census questionnaire?
###-###-#### ________________________________________________
I'd rather not provide that information
Skip To: End of Survey If We’d like to contact the person who filled out your Census questionnaire to ask a few follow-up q... = ###-###-####
Skip To: End of Survey If We’d like to contact the person who filled out your Census questionnaire to ask a few follow-up q... = I'd rather not provide that information
Skip To: End of Survey If We’d like to contact the person who filled out your Census questionnaire to ask a few follow-up q... != ###-###-####
Skip To: End of Survey If We’d like to contact the person who filled out your Census questionnaire to ask a few follow-up q... != I'd rather not provide that information
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Display This Question:
If How satisfied were you with the experience of filling out your 2020 Census questionnaire online? = Somewhat dissatisfied
Or How satisfied were you with the experience of filling out your 2020 Census questionnaire online? = Very dissatisfied
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Q5 Why were you dissatisfied? Select all that apply.
I had problems answering some of the questions
I had technical problems
It took too long to fill out
I tried to use my Census ID and it didn’t work
I couldn’t find my Census ID
I didn’t want to share this information with the government
I didn’t want to fill out this information about other people in my household
Other, specify ________________________________________________
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Display This Question:
If Why were you dissatisfied? Select all that apply. = I had problems answering some of the questions
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Q6 Which questions did you have problems with? Select all that apply.
Home address
Owner or renter
Number of people who live with you
Names
Phone number
Sex
Date of birth
Hispanic/Latino/Spanish ethnicity
Race
How household members are related to each other
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Home address
And Device = P
And Response = ND
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Q7 Here is an
example of the address screen:
What were the
problems with the home address question? Select all that
apply.
My address did not fit into the spaces provided
My residence has a non-standard address
I couldn’t find how to enter my rural route address
My home doesn’t have an address
I started typing my street address into the house number space and had to correct it
I wasn’t sure which address to enter (for example, I sometimes live or stay more than one place)
Other, specify ________________________________________________
Page Break |
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Home address
And Device = M
And Response = ND
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Q8 Here is an
example of the address screen:
What were the problems
with the home address question? Select all that apply.
My address did not fit into the spaces provided
My residence has a non-standard address
I couldn’t find how to enter my rural route address
My home doesn’t have an address
I started typing my street address into the house number space and had to correct it
I wasn’t sure which address to enter (for example, I sometimes live or stay more than one place)
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Home address
And Response = ID
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Q9 Here is an
example of an address screen with a made up address:
What were the problems with the home address question? Select
all that apply.
The address on the paper materials I received in the mail did not match with the address I saw on the online form
The street address was wrong
The zip code was wrong
The state was wrong
It did not have the correct apartment/unit/lot number
I could not correct the address
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Owner or renter
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Q10
Here
is an example of the owner/renter question with a made up address.
What were the problems with the owner/renter question? Select
all that apply.
I did not understand the question
I live alone. Why do you ask about someone else in this household
I wasn’t sure how to answer the question
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Number of people who live with you
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Q11
Here
is an example of the number of people question with a made up
address.
What were the problems with the question about
the number of people who live with you? Select all that
apply.
I wasn’t sure whether to include young children or babies
I wasn’t sure whether to include college students
I wasn’t sure whether to include people who moved into or out of the home
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Names
And Device = P
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Q12
Here
is an example of the name question.
What were the
problems with the name question? Select all that apply.
I didn’t know everyone’s full name
It was unclear if I could leave middle name blank or only use initials
One or more names didn’t fit in the space available
There were not enough name spaces
I had a spelling error and I could not correct it
I wanted to change, add, or remove a name and I could not do it
Other, specify ________________________________________________
Page Break |
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Names
And Device = M
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Q13
Here
is an example of the name question.
What were the
problems with the name question? Select all that apply.
I didn’t know everyone’s full name
It was unclear if I could leave middle name blank or only use initials
One or more names didn’t fit in the space available
There were not enough name spaces
I had a spelling error and I could not correct it
I wanted to change, add, or remove a name and I could not do it
Other, specify ________________________________________________
Page Break |
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Phone number
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Q14
Here
is an example of the phone number question.
What were
the problems with the phone number question? Select all that
apply.
I didn’t know whether to list my landline or my cell phone number
I didn’t want to give the Census Bureau my phone number
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Sex
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Q15
Here
is an example of the sex question with a made up name.
What
were the problems with the sex question? Select all that
apply.
I wanted a response choice other than male or female
I thought I had already given this information
I didn’t want to answer this question for someone else in my household
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Date of birth
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Q16
Here
is an example of the date of birth question with a made up name.
What were the problems with the date of birth question? Select
all that apply.
I didn’t know the date of birth
I wasn’t sure if I could estimate the date of birth
I wanted to leave it blank and it wouldn’t let me move forward
The calculated age was incorrect
I tried to answer on my phone and I couldn’t find the dates
The instructions in the link “If you do not know the date of birth, click here” were confusing
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Hispanic/Latino/Spanish ethnicity
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Q17
Here
is an example of the Hispanic/Latino/Spanish ethnicity question with
a made up name.
What were the problems with the
Hispanic/Latino/Spanish ethnicity question? Select all that
apply.
My race/ethnicity wasn’t listed
My country wasn’t listed
I did not like that the question separated Hispanics and Latinos from other groups
My children were born in the U.S. and I didn’t know how to answer this question for them
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = Race
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Q18
Here
is an example of the race question with a made up name.
What were the problems with the race question? Select
all that apply.
My race wasn’t listed
I received an error message and I wasn’t sure what I did wrong
I wanted to select multiple races and I wasn’t sure if I could
I do not identify with a particular ancestry or heritage
I had to type something into the heritage/ancestry question space to get to the next screen
I don’t know my ancestry or heritage
I wasn’t sure how far back to go with my heritage
I don’t like separating people by race
Other, specify ________________________________________________
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Display This Question:
If Which questions did you have problems with? Select all that apply. = How household members are related to each other
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Q19
Here
is an example of the household relationships question with made up
names.
What were the problems with the question about
how household members are related to each other? Select all
that apply.
The list was too long
I did not like the response choices
I could not find a correct response choice
Other, specify ________________________________________________
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Display This Question:
If Why were you dissatisfied? Select all that apply. = I didn’t want to share this information with the government
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Q20 Which questions asked for information that you didn’t want to share with the government? Select all that apply.
Home address
Owner or renter
Number of people who live with you
Names
Phone number
Sex
Date of birth
Hispanic/Latino/Spanish ethnicity
Race
How household members are related to each other
None of these
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Display This Question:
If Why were you dissatisfied? Select all that apply. = I didn’t want to fill out this information about other people in my household
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Q21 Which questions did you not want to fill out about other people in your household? Select all that apply.
Home address
Owner or renter
Number of people who live with you
Names
Phone number
Sex
Date of birth
Hispanic/Latino/Spanish ethnicity
Race
How household members are related to each other
None of these
Page Break |
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Display This Question:
If Why were you dissatisfied? Select all that apply. = I had technical problems
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Q22 What kind of technical difficulties did you have? Select all that apply.
I got an error message that I couldn’t fix
I got logged out of the questionnaire before I was finished
The questions loaded on the screen slowly
I wasn’t sure if my answers were submitted
My address was wrong and I could not correct it
Other, specify ________________________________________________
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Display This Question:
If How satisfied were you with the experience of filling out your 2020 Census questionnaire online? = Very satisfied
Or How satisfied were you with the experience of filling out your 2020 Census questionnaire online? = Somewhat satisfied
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Q23 Why were you satisfied? Select all that apply.
The questionnaire was short
I liked that I could fill it out online
The website was easy to use
I knew the answers to the questions
I was glad to be counted
I liked the design
I liked that I could fill it out on my phone
Other, specify ________________________________________________
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Display This Question:
If Response = ND
And Device = P
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Q24
The
next question is about the screen where you entered your address.
An example of that screen is below to remind you of what it looked
like.
How easy or difficult was it for you to enter
your address on that screen?
Very easy
Somewhat easy
Neither easy nor difficult
Somewhat difficult
Very difficult
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Display This Question:
If Response = ND
And Device = M
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Q25
The
next question is about the screen where you entered your address.
An example of that screen is below to remind you of what it looked
like.
How easy or difficult was it for you to enter
your address on that screen?
Very easy
Somewhat easy
Neither easy nor difficult
Somewhat difficult
Very difficult
Page Break |
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Display This Question:
If The next question is about the screen where you entered your address. An example of that screen i... = Somewhat difficult
Or The next question is about the screen where you entered your address. An example of that screen i... = Very difficult
And Which questions did you have problems with? Select all that apply. != Home address
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Q26 What made entering the address on this screen difficult? Select all that apply.
My address did not fit into the spaces provided
My residence has a non-standard address
I couldn’t find how to enter my rural route address
My home doesn’t have an address
I wasn’t sure which address to enter (for example, I sometimes live or stay more than one place)
I started typing my street address into the house number space and had to correct it
Other, specify ________________________________________________
Page Break |
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Display This Question:
If The next question is about the screen where you entered your address. An example of that screen i... = Somewhat difficult
Or The next question is about the screen where you entered your address. An example of that screen i... = Very difficult
And Which questions did you have problems with? Select all that apply. = Home address
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Q27 Earlier
you reported: ${Q7/ChoiceGroup/SelectedChoices}.
Did you have any other difficulty with the address screen?
Yes
No
Display This Question:
If Earlier you reported: ${q://QID6/ChoiceGroup/SelectedChoices}. Did you have any other difficulty... = Yes
Q28 What was that?
________________________________________________________________
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Display This Question:
If Response = ND
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Q29
After
you entered your address, it was reformatted based on U.S. postal
standards. Here is an example of a reformatted address.
In your opinion was your address reformatted correctly?
Yes
No
I don't remember the screen
Display This Question:
If After you entered your address, it was reformatted based on U.S. postal standards. Here is an ex... = No
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Q30 What was wrong with the reformatted address the survey showed you? Select all that apply.
The city was incorrect
ZIP Code was incorrect
The apartment number was incorrect
Other, specify ________________________________________________
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Display This Question:
If Device = P
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Q31
The
first screen of the census questionnaire asked you to log in. Here is
an example of the log in screen.
How did
you log in?
I entered an ID that was mailed to me or left at my door
I clicked on, “If you do not have a Census ID, click here”
I don’t remember
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Display This Question:
If Device = M
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Q32
The
first screen of the census questionnaire asked you to log in. Here is
an example of the log in screen.
How did you log in?
I entered an ID that was mailed to me or left at my door
I clicked on, “If you do not have a Census ID, click here”
I don’t remember
Page Break |
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Display This Question:
If The first screen of the census questionnaire asked you to log in. Here is an example of the log i... = I entered an ID that was mailed to me or left at my door
Or The first screen of the census questionnaire asked you to log in. Here is an example of the log i... = I entered an ID that was mailed to me or left at my door
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Q33 Where did you find your Census ID?
On a postcard
On a letter
On the paper questionnaire
On the notice of visit
I don’t remember
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Display This Question:
If The first screen of the census questionnaire asked you to log in. Here is an example of the log i... = I entered an ID that was mailed to me or left at my door
Or The first screen of the census questionnaire asked you to log in. Here is an example of the log i... = I entered an ID that was mailed to me or left at my door
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Q34 How easy or difficult was it for you to find your Census ID?
Very easy
Somewhat easy
Neither easy nor difficult
Somewhat difficult
Very difficult
Page Break |
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Display This Question:
If The first screen of the census questionnaire asked you to log in. Here is an example of the log i... = I clicked on, “If you do not have a Census ID, click here”
Or The first screen of the census questionnaire asked you to log in. Here is an example of the log i... = I clicked on, “If you do not have a Census ID, click here”
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Q35 What were your reason(s) for not entering a Census ID? Select all that apply.
I never received a Census ID
I responded before I received a Census ID in the mail
The Census ID was too small to read
I couldn’t find the Census ID on the letters or postcard
I no longer had the letters or postcard with my Census ID
I was away from home and didn’t have my letters or postcard with me
I thought if I clicked on the link I could get my Census ID
Someone else in my household used my Census ID
I tried to use my Census ID and it didn’t work
I don’t remember
Other, specify ________________________________________________
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Q36 How many times did you fill out or attempt to fill out a census questionnaire?
Only one time
More than one time
I don't remember
Display This Question:
If How many times did you fill out or attempt to fill out a census questionnaire? = More than one time
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Q37 What were your reasons for filling out or attempting to fill out the Census questionnaire more than once?
I was helping a family member or friend with their form
I was trying to report a vacant property
My property has multiple homes on it
I wasn't sure if the Census Bureau received my answers
My answers were not saved, so I had to start over
I was trying to report that a unit/apartment no longer exits
I had problems with the Census questionnaire. Specify: ________________________________________________
Some other reason. Specify: ________________________________________________
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Q38 Did you include everyone living in your household on your questionnaire or did you only include some of the people?
I live alone and filled it out for myself
I live with others and I included everyone
I live with others but only included myself
I live with others but only included some of the people I live with
I don’t remember
Display This Question:
If Did you include everyone living in your household on your questionnaire or did you only include s... = I live with others but only included myself
Or Did you include everyone living in your household on your questionnaire or did you only include s... = I live with others but only included some of the people I live with
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Q39 Did the other people also complete their Census form?
Yes
No
I don't know
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Q40 In the end, were you able to finish your Census questionnaire online?
Yes, I finished and submitted my questionnaire online
No, I had a problem with the questionnaire online and wasn’t able to fix it
No, I wanted a way to save my answers and come back, but I couldn’t
No, I was too busy and decided not to finish
No, I didn’t know the answers to some of the questions
No, I didn't want to answer some of the questions
No, some other reason. Specify ________________________________________________
I don’t remember
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Display This Question:
If In the end, were you able to finish your Census questionnaire online? = No, I didn’t know the answers to some of the questions
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Q41 Which questions didn’t you know the answer to? Select all that apply.
Home address
Owner or renter
Number of people who live with you
Names
Phone number
Sex
Date of birth
Hispanic/Latino/Spanish ethnicity
Race
How household members are related to each other
Page Break |
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Display This Question:
If In the end, were you able to finish your Census questionnaire online? = No, I didn't want to answer some of the questions
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Q42 Which questions did you not want to answer? Select all that apply.
Home address
Owner or renter
Number of people who live with you
Names
Phone number
Sex
Date of birth
Hispanic/Latino/Spanish ethnicity
Race
How household members are related to each other
Page Break |
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Display This Question:
If How satisfied were you with the experience of filling out your 2020 Census questionnaire online? = Very satisfied
Or How satisfied were you with the experience of filling out your 2020 Census questionnaire online? = Somewhat satisfied
Or How satisfied were you with the experience of filling out your 2020 Census questionnaire online? = Neither satisfied nor dissatisfied
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Q43 Do you have any comments on any of the questions asked in the Census online questionnaire? If so, select the topic you wish to comment on below. If you have no additional comments, select no comments below.
Home address
Owner or renter
Number of people who live with you
Names
Phone number
Sex
Date of birth
Hispanic/Latino/Spanish ethnicity
Race
How household members are related to each other
No comments
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Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Home address
And Device = P
And Response = ND
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Q44 Here is an
example of the address screen:
What are your
comments with the home address question? Select all that
apply.
My address did not fit into the spaces provided
My residence has a non-standard address
I couldn’t find how to enter my rural route address
My home doesn’t have an address
I started typing my street address into the house number space and had to correct it
I wasn’t sure which address to enter (for example, I sometimes live or stay more than one place)
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Home address
And Device = M
And Response = ND
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Q45 Here is an
example of the address screen:
What are your comments
with the home address question? Select all that apply.
My address did not fit into the spaces provided
My residence has a non-standard address
I couldn’t find how to enter my rural route address
My home doesn’t have an address
I started typing my street address into the house number space and had to correct it
I wasn’t sure which address to enter (for example, I sometimes live or stay more than one place)
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Home address
And Response = ID
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Q46 Here is an
example of an address screen with a made up address:
What are your comments with the home address question? Select
all that apply.
The address on the paper materials I received in the mail did not match with the address I saw on the online form
The street address was wrong
The zip code was wrong
The state was wrong
It did not have the correct apartment/unit/lot number
I could not correct the address
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Owner or renter
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Q47
Here
is an example of the owner/renter question with a made up address.
What are your comments with the owner/renter question? Select
all that apply.
I did not understand the question
I live alone. Why do you ask about someone else in this household
I wasn’t sure how to answer the question
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Number of people who live with you
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Q48
Here
is an example of the number of people question with a made up
address.
What are your comments with the question about
the number of people who live with you? Select all that
apply.
I wasn’t sure whether to include young children or babies
I wasn’t sure whether to include college students
I wasn’t sure whether to include people who moved into or out of the home
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Names
And Device = P
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Q49
Here
is an example of the name question.
What are your
comments with the name question? Select all that apply.
I didn’t know everyone’s full name
It was unclear if I could leave middle name blank or only use initials
One or more names didn’t fit in the space available
There were not enough name spaces
I had a spelling error and I could not correct it
I wanted to change, add, or remove a name and I could not do it
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Names
And Device = M
|
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Q50
Here
is an example of the name question.
What are your
comments with the name question? Select all that apply.
I didn’t know everyone’s full name
It was unclear if I could leave middle name blank or only use initials
One or more names didn’t fit in the space available
There were not enough name spaces
I had a spelling error and I could not correct it
I wanted to change, add, or remove a name and I could not do it
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Phone number
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Q51
Here
is an example of the phone number question.
What are
your comments with the phone number question? Select all that
apply.
I didn’t know whether to list my landline or my cell phone number
I didn’t want to give the Census Bureau my phone number
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Sex
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Q52
Here
is an example of the sex question with a made up name.
What
are your comments with the sex question? Select all that
apply.
I wanted a response choice other than male or female
I thought I had already given this information
I didn’t want to answer this question for someone else in my household
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Date of birth
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Q53
Here
is an example of the date of birth question with a made up name.
What are your comments with the date of birth question? Select
all that apply.
I didn’t know the date of birth
I wasn’t sure if I could estimate the date of birth
I wanted to leave it blank and it wouldn’t let me move forward
The calculated age was incorrect
I tried to answer on my phone and I couldn’t find the dates
The instructions in the link “If you do not know the date of birth, click here” were confusing
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Hispanic/Latino/Spanish ethnicity
|
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Q54
Here
is an example of the Hispanic/Latino/Spanish ethnicity question with
a made up name.
What are your comments with the
Hispanic/Latino/Spanish ethnicity question? Select all that
apply.
My race/ethnicity wasn’t listed
My country wasn’t listed
I did not like that the question separated Hispanics and Latinos from other groups
My children were born in the U.S. and I didn’t know how to answer this question for them
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = Race
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Q55
Here
is an example of the race question with a made up name.
What are your comments with the race question? Select
all that apply.
My race wasn’t listed
I received an error message and I wasn’t sure what I did wrong
I wanted to select multiple races and I wasn’t sure if I could
I do not identify with a particular ancestry or heritage
I had to type something into the heritage/ancestry question space to get to the next screen
I don’t know my ancestry or heritage
I wasn’t sure how far back to go with my heritage
I don’t like separating people by race
Other, specify ________________________________________________
Display This Question:
If Do you have any comments on any of the questions asked in the Census online questionnaire? If so,... = How household members are related to each other
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Q56
Here
is an example of the household relationships question with made up
names.
What are your comments with the question about
how household members are related to each other? Select all
that apply.
The list was too long
I did not like the response choices
I could not find a correct response choice
Other, specify ________________________________________________
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Q57 Is there anything else about filling out the 2020 Census that you would like to share with us?
Yes
No
Display This Question:
If Is there anything else about filling out the 2020 Census that you would like to share with us? = Yes
Q58 What else would you like to tell us?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
End of Block: Default Question Block
Page
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | User Experience Survey (2020 Census) |
Author | Qualtrics |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |