Follow-up survey for adults (Instrument 11)

STREAMS

Adult Follow Up Survey

June 2018

CONTENTS

Section Page

i. INTRODUCTION 1

A. DEMOGRAPHICS 23

B. RELATIONSHIP ATTITUDES AND SKILLS 31

C. CURRENT RELATIONSHIPS 36

D. CHILDREN 46

E. EMPLOYMENT AND FINANCES 61

F. WELL BEING 69

G. PROGRAM EXPERIENCES 74

PROGRAMMER:

PRELOAD program NAMES.

PROGRAMMER BOX IN0.

IF DIAL OUT, GO TO IN1;

IF FIELD CALL IN, GO TO IN2;

IF RESPONDENT CALL IN, GO TO IN3.

CALL OUT

IN1. May I please speak with [NAME]? My name is [FILL INTERVIEWER NAME] and I’m calling from Mathematica Policy Research, a research company in Princeton, New Jersey.

SPEAKING TO [NAME] 1 GO TO IN13

[NAME] COMES TO PHONE 2 GO TO IN13

PERSON ASKS WHAT CALL IS ABOUT 3 GO TO IN4

[NAME] IS NOT AVAILABLE 4 GO TO IN6

[NAME] IS INCARCERATED 5 GO TO IN8

[NAME] HAS MOVED/HAS A DIFFERENT NUMBER 6 GO TO IN9

NEVER HEARD OF [NAME] / WRONG NUMBER 7 IN24, STATUS 1530

[NAME] IS DECEASED 8 GO TO IN12

[NAME] DOES NOT SPEAK ENGLISH 9 IN24, STATUS 1401

HUNG UP 10 STATUS 1240

REFUSED r STATUS 1220

FIELD CALL IN

IN2. May I have your first name?

(STRING 20)

FIELD INTERVIEWER FIRST NAME

IN2 = ANSWERED (FIELD CALL IN)

IN2a. And your last name?

(STRING 30)

FIELD INTERVIEWER LAST NAME

IN2a = ANSWERED (FIELD CALL IN)

IN2b. May I have your field interviewer ID number?

| | | | | |

(0000 - 99999)

IN2b = ANSWERED (FIELD CALL IN)

IN2c. CODE PURPOSE OF FIELD CALL IN

CALLED TO COMPLETE INTERVIEW 1 GO TO IN13

CALLED TO SAY [NAME] IS DECEASED 2 GO TO IN12

CALLED TO SAY [NAME] IS INCARCERATED 3 GO TO IN8

RESPONDENT CALL IN

IN3. Thank you for calling. My name is [FILL INTERVIEWER NAME] from Mathematica Policy Research. May I have your name?

SPEAKING TO RESPONDENT ([NAME]) 1 GO TO IN13

SOMEONE ELSE CALLED TO COMPLETE INTERVIEW 2 GO TO IN5

CALLED TO ASK WHY WE CALLED 3 GO TO IN4

CALLED TO SET APPOINTMENT 4 GO TO IN6

CALLED TO REFUSE 5 GO TO IN24

STATUS 1240

CALLED TO SAY [NAME] MOVED/HAS A DIFFERENT NUMBER 6 GO TO IN9

CALLED TO SAY [NAME] IS DECEASED 7 GO TO IN12

CALLED TO SAY [NAME] IS INCARCERATED 8 GO TO IN8

CALLED TO SAY NEVER HEARD OF [NAME] / WRONG NUMBER 9 GO TO IN24

STATUS 1530

HUNG UP 10 STATUS 1240

IN1 = 3 OR IN3 = 3 (WHAT IS CALL ABOUT)

IF BL A1C=1 FILL HE/HIM

IF BL A1C=2 FILL SHE/HER

FILL RESPONDENT NAME

IN4. I would like to speak with [NAME] about a research study [he/she] joined about a year ago when [he/she] consented to join the study. I want to ask [NAME] some questions about how [he/she] has been doing since [we last spoke with [him/her]. [NAME] will be provided $25 for [his/her] participation.

May I please speak with [NAME]?

SPEAKING TO [NAME] 1 GO TO IN13

[NAME] COMES TO PHONE 2 GO TO IN13

[NAME] IS NOT AVAILABLE 3 GO TO IN6

[NAME] IS INCARCERATED 4 GO TO IN8

[NAME] HAS MOVED/HAS A DIFFERENT NUMBER 5 GO TO IN9

NEVER HEARD OF [NAME] / WRONG NUMBER 6 GO TO IN24

STATUS 1530

[NAME] IS DECEASED 7 GO TO IN12

[NAME] DOES NOT SPEAK ENGLISH 8 GO TO IN24

STATUS 1401

HUNG UP 9 STATUS 1240

REFUSED r STATUS 1220

PROGRAMMER SKIP BOX IN4 =6 or in4=8

Interviewer: Thank you for taking time to speak with me. Goodbye.

If in4=6 STATUS CASE 1530

if in4=8 status case 1401

IN3 = 2 (SOMEONE ELSE CALLED IN TO COMPLETE INTERVIEW)

IN5. I’m sorry, but I need to speak to [NAME]. May I please speak with [NAME]?

[NAME] COMES TO PHONE 1 GO TO IN13

[NAME] IS NOT AVAILABLE 2 GO TO IN6

[NAME] IS INCARCERATED 3 GO TO IN8

[NAME] HAS MOVED/HAS A DIFFERENT NUMBER 4 GO TO IN9

NEVER HEARD OF [NAME] / WRONG NUMBER 5 GO TO IN24

STATUS 1530

[NAME] IS DECEASED 6 GO TO IN12

[NAME] DOES NOT SPEAK ENGLISH 7 GO TO IN24

STATUS 1401

HUNG UP 8 STATUS 1240

REFUSED r STATUS 1220

PROGRAMMER SKIP BOX IN5 =5 or in5=7

Interviewer: Thank you for taking time to speak with me. Goodbye.

If in5=5 STATUS CASE 1530

if in5=7 status case 1401

IN1 = 4 OR IN3 = 4 OR IN4 = 3 OR IN5 = 2 (NOT AVAILABLE; SET APPOINTMENT)

IN6. When would be a good time to call back?

[NAME] COMES TO PHONE 1 GO TO IN13

SET APPOINTMENT 2 GO TO IN7

IN6 = 2 (SET APPOINTMENT)

IN7. When would be a good time to reach [NAME]?

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

INSTRUCTION: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK.

INSTRUCTION: USE THE ‘APPOINTMENT’ TAB OR PRESS <CTRL-S> TO INVOKE THE APPOINTMENT MAKING DIALOG.

(STRING 20)

IN1 = 5 OR IN2c = 3 OR IN3 = 8 OR IN4 = 4 OR IN5 = 3 (INCARCERATED)

IN8. What is the name of the place where [NAME] is being held?

(STRING 200)

NAME OF PRISON

DON’T KNOW d

REFUSED r GO TO BOX IN8d.1

IN8 = ANSWERED, d

IN8a. In what city or town is that located?

(STRING 50)

NAME OF CITY/TOWN

DON’T KNOW d

REFUSED r

IN8 = ANSWERED, d

IN8b. In what state is that located?

(STRING 20)

NAME OF STATE

DON’T KNOW d

REFUSED r

IN8 = ANSWERED, d

IN8c. When is [NAME] expected to be released?

PROBE: I just need a month and year. Your best estimate is fine.

INTERVIEWER: ENTER MONTH ON NEXT SCREEN OR CODE DON’T KNOW

programmer:

ENTER DATE ON NEXT SCREEN 1

SERVING A LIFE SENTENCE 2 GO TO IN8d

IN8c_month & IN8c_year When is [NAME] expected to be released?

PROBE: I just need a month and year. Your best estimate is fine.

| | | / | | | | |

(1-12) (2012- 2099)

DON’T KNOW d

REFUSED r

IN8 = ANSWERED, d

IN8d. And do you know [NAME]’s inmate number?

INTERVIEWER: ENTER NUMBER OR CODE DON’T KNOW

(STRING 20)

INMATE NUMBER

DON’T KNOW d

REFUSED r

PROGRAMMER Box

IF IN5=3 GO TO IN24 & STATUS CASE 1541 (PRISON).

Else go to in9 or in13

IN1 = 6 OR IN3 = 6 OR IN4 = 5 OR IN5 = 4 (MOVED; HAS DIFFERENT PHONE)

IN9. Do you or does anyone there know how we can reach [NAME]?

YES 1 GO TO IN10

NO 0 STATUS 1530

if in9=0

Interviewer: Thank you for taking time to speak with me. Goodbye.

If in5=5 and in9=0 STATUS CASE 1530

IN9 = 1

IN10. May I please have [his/her] telephone number?

INTERVIEWER: ENTER NUMBER ON NEXT SCREEN OR CODE DON’T KNOW

ENTER NUMBER 1

DON’T KNOW d GO TO IN11

REFUSED r GO TO IN11

IN10 = 1

IN10_phone. Please give me the phone number, area code first.

| | | | - | | | | - | | | | |

SOFT CHECK: IF IN10_phone IS NOT 10 NUM DIGITS; THE PHONE NUMBER SHOULD BE 10 NUMERIC DIGITS, NO SPACES, DASHES, PARENTHESES OR OTHER PUNCTUATION. THE FIELD SHOULD ALSO NOT BE EMPTY.

SOFT CHECK: USE STANDARD PHONE NUMBER CHECKS.

IN9 = 1 or IN10=DK OR R

IN11. May I have [his/her] address?

INTERVIEWER: ENTER ADDRESS ON NEXT SCREEN OR CODE DON’T KNOW

ENTER ADDRESS 1

DON’T KNOW d GO TO IN24

REFUSED r GO TO IN24

IN11 = 1

IN11_address. What is [NAME]’s address?

STREET 1

STREET 2

STREET 3

CITY

STATE

ZIP

if in11=1 GO TO IN24.

IF IN10 = 1 (NEW NUMBER), STATUS CASE 1899

IN1 = 8 OR IN2c = 2 OR IN3 = 7 OR IN4 = 7 OR IN5 = 6 (RESPONDENT IS DECEASED)

I was calling about… IF IN1 = 8 (CALL OUT)

IN12. I am very sorry to hear that. [I was calling about a research study on behalf of the U.S. Department of Health and Human Services] When did [NAME] pass away?

Thank you. Please accept my condolences. Goodbye.

programmer:

ENTER DATE ON NEXT SCREEN 1

DON’T KNOW d

REFUSED r

IN12_month & IN12_day & IN12_year

Thank you. Please accept my condolences. Goodbye.

| | | / | | | / | | | | |

(1-12) (1 - 31) (2012- 2099)

DON’T KNOW d

REFUSED r

STATUS CASE 1440 (DECEASED).

ALL

IF BL INTRO1 = 1, fill the MotherWise program

IF BL INTRO1 = 2, fill the Career STREAMS program at the MET Center

IF BL INTRO1 = 3, fill the Empowering Families program at The Parenting Center

IN13. [Hello, my name is [FILL INTERVIEWER NAME] and I’m calling from Mathematica Policy Research, a research company in Princeton, New Jersey.] I’m calling you about the STREAMS study you joined when you applied to [the MotherWise program/the Career STREAMS program at the MET Center/the Empowering Families program at The Parenting Center] about a year ago. Before we get started I would like to make sure we have your name recorded correctly.

Can you verify your first name?

BSF 36 Month Follow-up

PROBE: Can you spell that for me please?

(STRING 20)

FIRST NAME

ALL

BSF 36 Month Follow-up

IN14. And your middle name please?

PROBE: Can you spell that for me please?

(STRING 20)

MIDDLE NAME

ALL

BSF 36 Month Follow-up

IN15. And your last name please?

PROBE: Can you spell that for me please?

(STRING 20)

LAST NAME

ALL

Fill [RESP FIRST name] from IN15.

IN16. Are you usually called [RESP FIRST NAME] or do you go by another name?

BSF 15 Month Follow-up

INSTRUCTION: IF SAME JUST HIT ENTER.

PROBE: Can you spell that for me please?

(STRING 20)

FIRST NAME

[IN1=1 OR 2] OR IN2C=1 OR [IN4=1 OR 2] OR IN5=1 OR IN6=1

IN17. You may have received a letter recently to let you know that we would be calling you for a follow-up interview for our study. I’d like to interview you today.

The interview will take about 45 minutes and you will receive $25 for completing the interview. Your participation in the survey is voluntary. You do not have to answer any questions that make you uncomfortable.

We are conducting this survey for the U.S. Department of Health and Human Services. A federal agency may not conduct or sponsor a collection of information unless it has a currently valid OMB control number. The OMB number for this information collection is 0970-0481 and the expiration date is July 31, 2019.

The information you provide will be kept private to the extent permitted by law.

Because we want to get your opinion, it is important that you answer the questions without help from anyone else. Of course, you can share what you said with others after we have completed the interview.

This interview may be recorded so my supervisor can monitor the interview and make sure that the questions are asked correctly. These recordings will be destroyed when the study is completed.

Is now a good time to start?

YES 1 GO TO IN19

NO 0

IN17=0

IN18. When would be a good time to do the interview?

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

INSTRUCTION: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK.

INSTRUCTION: USE THE ‘APPOINTMENT’ TAB OR PRESS <CTRL-S> TO INVOKE THE APPOINTMENT MAKING DIALOG.

(STRING 20)

IN17=1

BSF 15 month follow up

IN19. First we’d like to verify that we are speaking with the correct person. We are going to ask you some questions that we asked when we last spoke with you.

When you were growing up—that is before you turned 18—did you live most of the time with . . .

PROBE: In which of these living situations did you spend most of your time before you turned 18?

both your biological mother and your biological father, 1

your biological mother only, 2

your biological father only, or 3

neither of your biological parents? 4

DON’T KNOW d

REFUSED r

IN17=1

IN20. What is your date of birth?

| | | / | | | / | | | | |

MONTH DAY YEAR

(1-12) (1-31) (1900-1996)

DON’T KNOW d

REFUSED r

PROGRAMMER:

IF IN19 = MATCH WITH BL F6 AND IN20 = EXACT MATCH ON BL A2 (DOB), GO TO A1

IF EITHER IN19 OR IN20 ARE NOT MATCHES, GO TO IN21

IN17=1 and mismatch on in19 AND/OR IN20

BL INTRO1 = 2 OR 3

IN21. And what are the last 4-digits of your Social Security Number?

| | | | | LAST FOUR IF MATCH GO TO A1

(0000-9999)

DON’T KNOW d GO TO IN22

REFUSED r GO TO IN22

IN17=1 and mismatch on in19, IN20, and/or in21

IN22. Can you tell me the name of the street that you lived on when you first enrolled in the program on [RA DATE]?

(STRING 20)

INSTRUCTION: Record address given by respondent

IF MATCH GO TO A1

DON’T KNOW d GO TO IN23

REFUSED r GO TO IN23

IN22 = MISMATCH, D, OR R

IN23. I’m sorry. I need to check my records before I can interview you. Is this the best time to reach you in the future?

YES 1

NO, CALL BACK INFO 0

(STRING 20)

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

IN11=D OR R OR IN18=answer

IN24. Thank you for taking time to speak with me. Goodbye.

INSTRUCTION: STATUS THIS CASE 1380 FOR SUPERVISOR REVIEW.

IF IN11=D OR R STATUS CASE 1530.

All

FaMLE

A1. Are you currently enrolled in school or college?

INTERVIEWER: IF YES, PROBE FOR HIGH SCHOOL OR COLLEGE. FOR GED PROGRAMS, CODE 3.

YES, HIGH SCHOOL 1 GO TO A2

YES, GED PROGRAM 5 GO TO A3

YES, COLLEGE 2 GO TO A3

YES, OTHER TYPE OF SCHOOL 3 GO TO A3

NO, NOT IN SCHOOL 4 GO TO A3

DON’T KNOW d GO TO A3

REFUSED r GO TO A3

a1=1

FaMLE

A2. What is your current grade?

LESS THAN 9TH GRADE 1

9TH GRADE 2

10TH GRADE 3

11TH GRADE 4

12TH GRADE 5

DON’T KNOW d

REFUSED r

a1 NE 1

A3. What is the highest level of education you have completed?

ACS

INTERVIEWER: IF RESPONDENT SAYS “HIGH SCHOOL,” PROBE: Did you receive a diploma or GED?

INTERVIEWER: IF RESPONDENT SAYS “COLLEGE,” PROBE: Did you receive an associates or a bachelor’s degree?

DID NOT COMPLETE HIGH SCHOOL OR GED 1

HIGH SCHOOL: DIPLOMA 2

HIGH SCHOOL: GENERAL EDUCATION DEVELOPMENT OR GED 3

SOME COLLEGE 4

2-YEAR OR 3-YEAR COLLEGE DEGREE (ASSOCIATE’S DEGREE) 5

VOCATIONAL/TECHNICAL SCHOOL DIPLOMA/CERTIFICATION 6

4-YEAR COLLEGE DEGREE (BACHELOR’S DEGREE) 7

GRADUATE OR PROFESSIONAL DEGREE (e.g., MA, MBA, Ph.D., JD, MD) 8

DON’T KNOW d

REFUSED r

ALL

B1. Next I’m going to read you some statements about relationships. For each, tell me whether you strongly agree, agree, disagree, or strongly disagree. [FILL A-M]. Do you strongly agree, agree, disagree, or strongly disagree?

Stanley and Rhoades

Child Trends 3M Project

Stanley and Rhoades

Stanley and Rhoades

PREP

PREP

Stanley and Rhoades

Stanley and Rhoades

INTERVIEWER INSTRUCTION: IF NEEDED READ RESPONSE CATEGORIES FOR B-M

	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DON’T KNOW	REF
a. A good couple relationship is based on mutual respect.	1	2	3	4	d	r
b. In a good couple relationship, you don’t always get your own way.	1	2	3	4	d	r
c. Relationships go better if partners make decisions together.	1	2	3	4	d	r
d. People are more likely to succeed in their relationships if they take things slowly.	1	2	3	4	d	r
e. It is important to know a person well before having sex with them.	1	2	3	4	d	r
f. Having a casual sexual relationship with someone is no big deal.	1	2	3	4	d	r
g. If you are really in love, you can stop working on your relationship.	1	2	3	4	d	r
h. Ending a bad romantic relationship is a good thing.	1	2	3	4	d	r
i. There are times when hitting or pushing between people who are a couple is okay.	1	2	3	4	d	r
j. Violence between partners can improve a couple’s relationship.	1	2	3	4	d	r
k. Some couples need to use violence to solve their problems.	1	2	3	4	d	r
l. Sometimes violence is the only way to express your feelings.	1	2	3	4	d	r
m. Violence in a couple’s relationship is a personal matter and people should not interfere.	1	2	3	4	d	r

Foshee et al 1992

Foshee et al 1992

Foshee et al 1992

Foshee et al 1992

Foshee et al 1992

ALL

B2. Next I’m going to read you some statements about how you think about romantic relationships. For each statement, tell me whether you strongly agree, agree, disagree, or strongly disagree. [FILL A-G]. Do you strongly agree, agree, disagree, or strongly disagree?

INTERVIEWER INSTRUCTION: IF NEEDED READ RESPONSE CATEGORIES FOR B-F

Venum and Fincham, 2011

Venum and Fincham, 2011

Venum and Fincham, 2011

Baylor evaluation of ARYA

Venum and Fincham, 2011

Venum and Fincham, 2011

Venum and Fincham, 2011

	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DON’T KNOW	REF
a. I believe I will be able to effectively deal with conflicts that arise in my relationships.	1	2	3	4	d	r
b. I feel good about my ability to make a romantic relationship last.	1	2	3	4	d	r
c. I can recognize the signs of a violent or unhealthy relationship.	1	2	3	4	d	r
d. I am very confident when I think of having a stable, long term relationship.	1	2	3	4	d	r
e. I have the skills needed for a lasting stable romantic relationship.	1	2	3	4	d	r
f. I am able to recognize early on the warning signs in a bad relationship.	1	2	3	4	d	r
g. I know what to do when I recognize the warning signs in a bad relationship.	1	2	3	4	d	r

ALL

FaMLE

B3. Do you strongly agree, agree, disagree, or strongly disagree with the following statements. [FILL a-b] Do you strongly agree, agree, disagree, or strongly disagree.

	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DON’T KNOW	REF
a. Living together is just the same as being married.	1	2	3	4	d	r
b. It is better for children if their parents are married.	1	2	3	4	d	r

ALL

Buhrmester et al. 1988

B4. The following questions are about how you might deal with different situations. For each situation, tell me whether you are extremely good at this, good at this, okay at this, or bad at this. [FILL A-E]. Would you say you are extremely good at this, good at this, okay at this, or bad at this?

INTERVIEWER INSTRUCTION: IF NEEDED READ RESPONSE CATEGORIES FOR B-E

	EXTREMELY GOOD	GOOD	OKAY	BAD	DON’T KNOW	REF
a. Admitting that you might be wrong during an argument.	1	2	3	4	d	r
b. Avoiding saying things that could turn a disagreement into a fight.	1	2	3	4	d	r
c. Accepting another person’s point of view even if you don’t agree with it.	1	2	3	4	d	r
d. Listening to another person’s opinion during a disagreement.	1	2	3	4	d	r
e. Working through problems without arguing.	1	2	3	4	d	r

Next, I’m going to ask you some questions about your relationships.

if (BL c3 = 1 or 2) OR (BL c4 = 1 or 2), In a relationship at Baseline go to c1.

if (BL c3 ne 1 or 2) and (BL c4 ne 1 or 2) not in a relationship at baseline, go to c9.

fill [bl partner] from bl c5

if bl c3 = 1, fill engaged to

if bl c3 = 2, fill married to

if bl c4 = 1 or 2, fill in a romantic relationship with

STREAMS

C1. When you completed our first survey, you told us you were [engaged to/married to/in a romantic relationship with] [BL PARTNER].

Are you and [BL PARTNER] currently…

engaged, 1 GO TO C16

married, 2

divorced, 3

separated, or 4

have you never been married to each other? 5

WIDOWED/PARTNER DIED 6 GO TO C9

DON’T KNOW d

REFUSED r

IF C1=6 SAY: I’m very sorry to hear that. Our condolences for your loss.

c1=1

BSF 15 month follow-up

C2. When are you planning to get married?

INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR. IF NO MONTH GIVEN, MARK AS MISSING.

PROGRAMMER NOTE: ALLOW REFUSAL IN MM/YYYY

| | | / | | | | | DATE PLANNING TO MARRY

(01-12) (2014-2100)

MONTH YEAR

INTERVIEWER INSTRUCTION: IF NO DATE IS GIVEN, DO NOT PROBE

NO DATE HAS BEEN SET 0

DON’T KNOW d

REFUSED r

C1 ne 2

FaMLE

C3. Which of the following best describes your relationship with [BL PARTNER]?

We are romantically involved on a steady basis, 1 GO TO C7

We are involved in an on-again and off-again relationship, or 2 GO TO C7

We are not in a romantic relationship 3 GO TO C4

DON’T KNOW d GO TO C7

REFUSED r GO TO C12

c3=3

BSF 15 month follow-up

C4. When did your relationship with [BL PARTNER] end?

| | | / | | | | | DATE RELATIONSHIP ENDED GO TO C5

(01-12) (2012-2100)

MONTH YEAR

PARTNER DIED 0 GO TO C9

DON’T KNOW d GO TO C5

REFUSED r GO TO C5

IF C4=0 SAY: I’m very sorry to hear that. Our condolences for your loss.

C4 NE 0

BSF 36-month follow-up

C5. I am going to read you a list of reasons that people give for why their relationships ended. For each reason, tell me if this is why your relationship with [BL PARTNER] ended.

Was it because…

IF C5a – C5f=1 ASK: Was that you, [BL PARTNER], or both of you?

	CODE ONE PER ROW
			Was that you, [BL PARTNER] or both of you?
a. one of you cheated or was unfaithful?	YES	1	YOU	1
			[BL PARTNER]	2
			BOTH	3
	NO	0
b. one of you went to jail or prison?	YES	1	YOU	1
			[BL PARTNER]	2
			BOTH	3
	NO	0
c. one of you was abusive or violent?	YES	1	YOU	1
			[BL PARTNER]	2
			BOTH	3
	NO	0
d. one of you used drugs or alcohol?	YES	1	YOU	1
			[BL PARTNER]	2
			BOTH	3
	NO	0
e. one of you could not keep a job or contribute enough financially to the family?	YES	1	YOU	1
			[BL PARTNER]	2
			BOTH	3
	NO	0
f. one of you was not a good parent or role model?	YES	1	YOU	1
			[BL PARTNER]	2
			BOTH	3
	NO	0
g. the two of you were not communicating well or were arguing too much?	YES	1
	NO	0
h. of lack of support from family members?	YES	1
	NO	0
i. you and [BL PARTNER] were living too far apart?	YES	1
	NO	0

C4 NE 0

BSF 36 Month Follow-up

C5j. Were there any other reasons why your romantic relationship ended?

YES 1 GO TO C5k

NO 0 GO TO C6

DON’T KNOW d GO TO C6

REFUSED r GO TO C6

c5j=1

BSF 36 Month Follow-up

C5k. What were those other reasons?

____________________________ STRING 100

REASONS RELATIONSHIP ENDED GO TO C6

c4 Ne 0

PACT

C6. Do you think it is a good thing for you that you and [BL PARTNER] broke up? Would you say…

Definitely yes, 1

Maybe yes, 2

Maybe no, or 3

Definitely no? 4

DON’T KNOW d

REFUSED r

C1 NE 6 and c4 ne 0

FaMLE

C7. Do you currently live with [BL PARTNER] in the same household …

all of the time, 1 GO TO C9

most of the time, 2

some of the time, or 3

none of the time? 4

DON’T KNOW d

REFUSED r

C7 NE 1

BSF 15 month FUP

C8. How often do you and [BL PARTNER] see or talk to each other? Is it…

every day or almost every day, 1

a few times a week, 2

a few times a month, 3

about once a month, 4

only a few times in the past year, or 5

hardly ever or never? 6

DON’T KNOW d

REFUSED r

skip if bl c3=2 and c1=2

if [bl partner] from bl c5 ne blank, fill please include [bl partner].]

STREAMS

C9. Since [RA DATE], how many romantic partners have you been involved with?

[Please include [BL PARTNER].]

PROBE: Your best guess is fine.

| | | NUMBER OF PARTNERS

(0-99)

DON’T KNOW d

REFUSED r

PROGRAMMER SKIP BOX C9.1

If c9 = 0, go to C24.

else, go to c10.

[(BL C3 NE 1 OR 2) and (BL C4 NE 1 OR 2)] or [[(bl c3 = 1 or 2) or (BL C4 = 1 or 2)] and [(c1=6 or c3=3, dk or r AND C9 GE 2)]

C10. Are you currently involved in a romantic relationship with someone?

BSF 15-mo FUP

YES 1 GO TO C11

NO 0 GO TO C23

DON’T KNOW d GO TO C23

REFUSED r GO TO C23

C10=1

PACT

C11. Just to be able to refer to [him/her] by name in this interview, what is your current partner’s first name?

INSTRUCTION: IF RESPONDENT INDICATES MORE THAN ONE CURRENT PARTNER, PROBE FOR NAME OF MAIN OR PRIMARY CURRENT PARTNER.

INSTRUCTION: IF RESPONDENT DOES NOT GIVE FULL NAME PROBE FOR A NAME OR INITIALS

____________________________FIRST NAME OF PARTNER

STRING 20

c10=1

fill [NEW partner] from c11. IF [NEW PARTNER] = D OR R, fill your new partner

PACT

C11a. Is [NEW PARTNER] a man or a woman?

MAN 1

WOMAN 2

DON’T KNOW d

REFUSED r

C10=1

FILL [NEW PARTNER] from C11. IF [NEW PARTNER] = D OR R, fill your new partner

BSF 15-mo FUP

C12. Are you currently married or engaged to [NEW PARTNER]?

YES, MARRIED 1

YES, ENGAGED 2

NO 0

DON’T KNOW d

REFUSED r

C12 = 1 or 2

if c12 = 1 Fill did you

IF c12 = 2 FILL are you planning to

BSF 15-mo FUP

C13. When [did you/are you planning to] get married?

INTERVIEWER INSTRUCTION: RECORD ONLY MONTH AND YEAR. IF NO MONTH GIVEN, MARK AS MISSING.

PROGRAMMER NOTE: ALLOW REFUSAL IN MM/YYYY

| | | / | | | | | DATE OF MARRIAGE/PLANNED DATE OF MARRIAGE

(01-12) (2014-2100)

MONTH YEAR

INTERVIEWER INSTRUCTION: IF NO DATE IS GIVEN, DO NOT PROBE

NO DATE HAS BEEN SET 0

DON’T KNOW d

REFUSED r

C10=1 AND C12 NE 1 OR 2

FILL [NEW PARTNER] from C11. IF [NEW PARTNER] = D OR R, fill your new partner.

C14. Which of the following best describes your relationship with [NEW PARTNER]?

FaMLE

We are romantically involved on a steady basis, or 1

We are involved in an on-again and off-again relationship. 2

DON’T KNOW d

REFUSED r

C10=1

FILL [NEW PARTNER] from C11. IF [NEW PARTNER] = D OR R, fill your new partner

FaMLE

C15. Do you currently live with [NEW PARTNER] in the same household …

all of the time, 1

most of the time, 2

some of the time, or 3

none of the time? 4

DON’T KNOW d

REFUSED r

(C1=1 or 2) OR (C3=1 OR 2) OR c10 = 1

if [NEW PARtner] from c11 ne blank, fill [new partner]. If [NEW PARTNER] = D or R, fill your new partner

if not, fill [bl partner] from BL C5

BSF

C16. Now I would like to ask about how you feel about your relationship with [BL PARTNER]/[NEW PARTNER]. On a scale from 0 to 10, where 0 is not at all happy and 10 is completely happy, taking all things together, how happy would you say your relationship with [BL PARTNER]/ [NEW PARTNER] is?

You can choose any number from 0 to 10.

| | |

(0-10)

DON’T KNOW d

REFUSED r

(C1=1 or 2) OR (C3=1 OR 2) OR c10 = 1

if [NEW PARtner] from c11 ne blank, fill [new partner]; If [NEW PARTNER] = D or R, fill your new partner; IF C12 = 1, FILL “marriage” ELSE FILL “relationship”

if no [NEW PARTNER], fill [bl partner] from BL C5; if c1 = 2, fill “MARRIAGE” ELSE fill “relationship

PACT

C17. On a scale from 0 to 10, where 0 is not at all committed and 10 is completely committed, how committed are you to your [marriage/relationship] with [[BL PARTNER]/[NEW PARTNER]]?

| | |

(0-10)

DON’T KNOW d

REFUSED r

(C1=1 or 2) OR (C3=1 OR 2) OR c10 = 1

if [NEW PARtner] from c11 ne blank, fill [new partner]; IF C12 = 1, FILL “marriage” ELSE FILL “relationship”

if no [NEW PARTNER], fill [bl partner] from BL C5 IF ([BL C3=1,2 OR BL C4=1,2] AND [C1=1,2 OR C3=1,2]); if c1 = 2, fill “MARRIAGE” ELSE fill “relationship

PACT

C18. On a scale from 0 to 10, where 0 is not at all committed and 10 is completely committed, how committed would you say [[BL PARTNER]/[NEW PARTNER]] is to your [marriage/relationship]?

| | |

(0-10)

DON’T KNOW d

REFUSED r

(C1=1 or 2) OR (C3=1 OR 2) OR C10 = 1

if [NEW PARtner] from c11 ne blank, fill [new partner]; IF C12 = 1, FILL “marriage” ELSE FILL “relationship”

if no [NEW PARTNER], fill [bl partner] from BL C5 IF ([BL C3=1,2 OR BL C4=1,2] AND [C1=1,2 OR C3=1,2]); if c1 = 2, fill “MARRIAGE” ELSE fill “relationship

I’m going to ask you some questions about [[BL PARTNER]/[NEW PARTNER]].

C19. Tell me whether you strongly agree, agree, disagree, or strongly disagree with the following statements.

[FILL STATEMENT a-i] Do you strongly agree, agree, disagree, or strongly disagree?

PACT

PACT

PACT

BSF

BSF

BSF

BSF

FaMLE

FaMLE

FaMLE

FaMLE

FaMLE

INTERVIEWER INSTRUCTION: IF NEEDED READ RESPONSE CATEGORIES FOR B-I

	CODE ONE PER ROW
	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	REF
a. [[BL PARTNER]/[NEW PARTNER]] is honest and truthful with me.	1	2	3	4	d	r
b. I can trust [[BL PARTNER]/[NEW PARTNER]] completely.	1	2	3	4	d	r
c. [[BL PARTNER]/[NEW PARTNER]] can be counted on to help me.	1	2	3	4	d	r
d. [[BL PARTNER]/[NEW PARTNER]] knows and understands me.	1	2	3	4	d	r
PACT e. [[BL PARTNER]/[NEW PARTNER]] listens to me when I need someone to talk to.	1	2	3	4	d	r
f. [[BL PARTNER]/[NEW PARTNER]] respects me.	1	2	3	4	d	r
g. [[BL PARTNER]/[NEW PARTNER]] shows love and affection.	1	2	3	4	d	r
h. I feel appreciated by [[BL PARTNER]/[NEW PARTNER]].	1	2	3	4	d	r
i. I want my relationship with [[BL PARTNER]/[NEW PARTNER]] to stay strong no matter what rough times we may have.	1	2	3	4	d	r
j. [[BL PARTNER]/[NEW PARTNER]] supports me to do the things that are important to me.	1	2	3	4	d	r
k. [[BL PARTNER]/[NEW PARTNER]] and I often talk about things that happen to each of us during the day.	1	2	3	4	d	r
l. [[BL PARTNER]/[NEW PARTNER]] and I enjoy doing even ordinary, day-to-day things together.	1	2	3	4	d	r

(C1=1 or 2) OR (C3=1 OR 2) OR C9 = 1

if [NEW PARtner] from c11 ne blank, fill [new partner]; IF C12 = 1, FILL “marriage” ELSE FILL “relationship”

if no [NEW PARTNER], fill [bl partner] from BL C5; if c1 = 2, fill “MARRIAGE” ELSE fill “relationship

FOR BASELINE PARTNER IF BL C5a=1, FILL “he”; IF BL C5a=2, FILL “she” ELSE IF BL C5A= DK OR R FILL HE OR SHE

FOR NEW PARTNER IF C11a=1, FILL “he”; IF C11a=2, FILL “she” ELSE IF C10A= DK OR R FILL HE OR SHE

C20. Now I am going to read you some statements about things you and [[BL PARTNER]/[NEW PARTNER]] may experience when you are together. Tell me if this never happens, hardly ever happens, sometimes happens, or often happens. [FILL STATEMENT A-P]…Does this happen never, hardly ever, sometimes, or often?

BSF

PACT

PACT

FaMLE

PACT

FaMLE

PACT

FaMLE

FaMLE

FaMLE

FaMLE

FaMLE

FaMLE

FaMLE

FaMLE

INTERVIEWER INSTRUCTION: IF NEEDED READ RESPONSE CATEGORIES FOR B-P

	NEVER	HARDLY EVER	SOMETIMES	OFTEN	DK	R
a. [[BL PARTNER]/[NEW PARTNER]] and I are good at working out our differences.	1	2	3	4	d	r
b. I feel respected even when [[BL PARTNER]/[NEW PARTNER]] and I disagree.	1	2	3	4	d	r
c. [[BL PARTNER]/[NEW PARTNER]] is rude or mean to me when we disagree.	1	2	3	4	d	r
d. When [[BL PARTNER]/[NEW PARTNER]] and I have a serious disagreement, we work on it together to find a solution.	1	2	3	4	d	r
PACT HM Baseline BSF e. [[BL PARTNER]/[NEW PARTNER]] seems to view my words or actions more negatively than I mean them to be.	1	2	3	4	d	r
f. During arguments, [[BL PARTNER]/[NEW PARTNER]] and I are good at taking breaks when we need them.	1	2	3	4	d	r
g. When [[BL PARTNER]/[NEW PARTNER]] and I argue, past hurts get brought up again.	1	2	3	4	d	r
h. Our arguments become very heated.	1	2	3	4	d	r
i. [[BL PARTNER]/[NEW PARTNER]] is good at calming me when I get upset.	1	2	3	4	d	r
j. Small issues suddenly become big arguments.	1	2	3	4	d	r
k. We are pretty good listeners, even when we have different positions on things.	1	2	3	4	d	r
l. [[BL PARTNER]/[NEW PARTNER]] or I stay mad at one another after an argument.	1	2	3	4	d	r
m. Even when arguing, we can keep a sense of humor.	1	2	3	4	d	r
n. When we argue, one of us withdraws and refuses to talk about it anymore.	1	2	3	4	d	r
o. When we argue I feel personally attacked.	1	2	3	4	d	r

(C1=1 OR 2) OR (C3=1 OR 2) OR C10 = 1

if [NEW PARtner] from c11 ne blank, fill [new partner]

if no [NEW PARTNER], fill [bl partner] from BL C5

PACT

C21. Since [RA DATE], has [BL PARTNER/NEW PARTNER] cheated on you with someone else? Would you say…

Definitely yes, 1

Maybe yes, 2

Maybe no, or 3

Definitely no? 4

DON’T KNOW d

REFUSED r

(C1=1 or 2) OR (C3=1 OR 2) OR C10 = 1

if [NEW PARtner] from c11 ne blank, fill [new partner]

if no [NEW PARTNER], fill [bl partner] from BL C5

PACT

C22. Since [RA DATE], have you cheated on [BL PARTNER/NEW PARTNER] with someone else?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

If (c1=2 or 4) OR (C12=1), fill: “Including your current marriage,”

PACT HM

Baseline

C23. [Including your current marriage,] in total, how many times have you been married?

| | | # OF MARRIAGES

(0-99)

DON’T KNOW d

REFUSED r

Next I’m going to read a list of things that might have happened to you in the past year.

ALL

C24. In the past year, did any romantic partner you’ve been involved with ever…

SHM

SHM

SHM

IF C24a – f=1 ASK: In the past year, did this happen once, twice, 3 to 5 times, 6 to 10 times, 11 to 20 times, or more than 20 times?

	CODE ONE PER ROW
			In the past year, did this happen…
a. try to keep you from seeing or talking with your friends?	YES	1	Once,	1
			Twice,	2
			3 to 5 times,	3
			6 to 10 times,	4
			11 to 20 times, or	5
			More than 20 times?	6
	NO	0
	DK	d
	R	r
b. make you feel stupid?	YES	1	Once,	1
			Twice,	2
			3 to 5 times,	3
			6 to 10 times,	4
			11 to 20 times, or	5
			More than 20 times?	6
	NO	0
	DK	d
	R	r
c. keep money from you or take your money without asking?	YES	1	Once,	1
			Twice,	2
			3 to 5 times,	3
			6 to 10 times,	4
			11 to 20 times, or	5
			More than 20 times?	6
	NO	0
	DK	d
	R	r
d. make you feel afraid that they might hurt you?	YES	1	Once,	1
			Twice,	2
			3 to 5 times,	3
			6 to 10 times,	4
			11 to 20 times, or	5
			More than 20 times?	6
	NO	0
	DK	d
	R	r
e. CTS2S 10	YES	1	Once,	1
			Twice,	2
*** SEE NOTE ON PAGE 34 ***			3 to 5 times,	3
			6 to 10 times,	4
			11 to 20 times, or	5
			More than 20 times?	6
	NO	0
	DK	d
	R	r
f. CTS2S 12	YES	1	Once,	1
			Twice,	2
*** SEE NOTE ON PAGE 34 ***			3 to 5 times,	3
			6 to 10 times,	4
			11 to 20 times, or	5
			More than 20 times?	6
	NO	0
	DK	d
	R	r
g. use threats or force to make you have sex or do sexual things you didn’t want to do?	YES	1	Once,	1
			Twice,	2
			3 to 5 times,	3
			6 to 10 times,	4
			11 to 20 times, or	5
			More than 20 times?	6
	NO	0
	DK	d
	R	r

CTS2S

SHM

BSF

CTS2S

ALL

BSF 15m FUP, modified

C25. In the past year, did you need to see a doctor because of a fight with a romantic partner? Please include times when you needed to see a doctor, even if you didn’t go.

YES 1 GO TO C26

NO 0

DON’T KNOW d

REFUSED r

C25=1

PACT

C26. In the past year, did this happen…

Once, 1

Twice, 2

3 to 5 times, 3

6 to 10 times, 4

11 to 20 times, or 5

More than 20 times? 6

DON’T KNOW d

REFUSED r

ALL

CTS2S

C27. CTS2S 9 *** SEE NOTE ON PAGE 34 ***

YES 1 GO TO C28

NO 0

DON’T KNOW d

REFUSED r

C27=1

CTS2S

C28. CTS2S 9 *** SEE NOTE ON PAGE 34 ***

Once, 1

Twice, 2

3 to 5 times, 3

6 to 10 times, 4

11 to 20 times, or 5

More than 20 times? 6

DON’T KNOW d

REFUSED r

ALL

CTS2S

C29. CTS2S 11 *** SEE NOTE AT BOTTOM OF PAGE ***

YES 1 GO TO C30

NO 0

DON’T KNOW d

REFUSED r

C29=1

CTS2S

C30. CTS2S 11 *** SEE NOTE AT BOTTOM OF PAGE ***

Once, 1

Twice, 2

3 to 5 times, 3

6 to 10 times, 4

11 to 20 times, or 5

More than 20 times? 6

DON’T KNOW d

REFUSED r

** NOTE: The specific wording of items C24e, C25f, C27, C28, C29, C30 is not shown on this copy of the survey because the material is from the Conflict Tactics Scale copyright © 2003 by Western Psychological Services. Authorized research translation reprinted by S. Marsh, Mathematica Policy Research, for specific, limited research use under license of the publisher, WPS, 625 Alaska Avenue, Torrance, California, 90503, U.S.A. (rights@wpspublish.com). No additional reproduction, in whole or in part, by any medium or for any purpose, may be made without the prior written authorization of WPS. All rights reserved.

IF BL INTRO=1 (UNIVERSITY OF DENVER) AND BL D22=1 (PREGNANT AT BASELINE), GO TO D1.

IF BL INTRO=1 (UNIVERSITY OF DENVER) AND BL D22=0,D,R (NOT PREGNANT AT BASELINE), GO TO D5.

IF BL INTRO = 3 (The Parenting Center) GO TO D10.

IF BL INTRO = 2 (FWCA) GO TO D11.

IF BL INTRO = 1 (University of Denver) AND BL D22=1 (pregnant at baseline)

FILL [BL CHILD EXPECTED DATE] FROM BL D23

BSF 15 FUP

D1. Now I have some questions about children you may have had since [RA DATE]. Our records indicate that you were expecting a baby around [BL CHILD EXPECTED DATE].

Did you have a baby around that time?

INSTRUCTION: IF RESPONDENT REPORTS DATE OF BIRTH, ANSWER “YES” AND ENTER DATE OF BIRTH ON NEXT SCREEN.

INSTRUCTION: IF RESPONDENT REPORTS MULTIPLE BIRTHS, ENTER “YES.” YOU WILL ENTER NUMBER OF BABIES ON ANOTHER SCREEN.

IF RESPONDENT ANSWERS NO, PROBE: I’m sorry. What happened?

YES 1

YES, BUT BABY DIED 2 GO TO D11

NO, MISCARRIAGE 3 GO TO D11

NO, ABORTION 4 GO TO D11

NO, BABY DIED 5 GO TO D11

NO, WAS NOT EXPECTING BABY AT BASELINE 6 GO TO D11

DON’T KNOW d GO TO D11

REFUSED r GO TO D11

IF D1=5 SAY: I’m very sorry to hear that. Our condolences for your loss.

D1=1

D1a. For the baby you were expecting on [BL CHILD EXPECTED DATE], what date was the baby born?

BSF 15 month follow-up, modified

INSTRUCTION: ENTER RESPONSE WITHOUT ASKING IF KNOWN.

| | | / | | | / | | | | | BIRTHDATE

BABY DIED 0 GO TO D11

DON’T KNOW d

REFUSED r

IF D1a=0 SAY: I’m very sorry to hear that. Our condolences for your loss.

D1 = 1

BSF 15 month follow-up, modified

D2. ENTER WITHOUT ASKING IF KNOWN: OTHERWISE PROBE:

How many babies did you have on [BIRTHDATE]?

INTERVIEWER INSTRUCTION: ENTER THE NUMBER OF BABIES BORN

INTERVIEWER INSTRUCTION: IF D2=0 (BABY DIED), SAY: “I am sorry for your loss.”

| | | NUMBER OF BABIES BORN GO TO D3

(1-99)

BABY DIED 0 GO TO D11

D1=1

If D2>1, fill Thinking of the youngest baby you had on [BIRTHDATE],

D3. [Thinking of the youngest baby you had on [BIRTHDATE],] What is the baby’s first name?

BSF 15 month follow-up, modified

INSTRUCTION: IF RESPONDENT DOES NOT GIVE FULL NAME PROBE FOR A NAME OR INITIALS

(STRING 25)

FIRST NAME

DON’T KNOW d

REFUSED r

D1=1

Fill [CHILD NAME] from D3

PACT

D4. Is [CHILD NAME] a boy or a girl?

BOY 1

GIRL 2

DON’T KNOW d

REFUSED r

D1=1 OR BL D22=0,D,R

IF BL D22=1, Fill [CHILD NAME] from D3

IF BL D22=0,D,R, FILL [YOUNGEST CHILD NAME] FROM BL D8

IF BL D22=0,D,R then fill INTRO “Now I’d like to ask you some questions about your child, [CHILD NAME], who was born shortly before [RA DATE].”

FaMLE

D5. [Now I’d like to ask you some questions about your child, [CHILD NAME], who was born shortly before [RA DATE].] Does [CHILD NAME] live with you all of the time, most of the time, some of the time, or none of the time?

ALL OF THE TIME 1

MOST OF THE TIME 2

SOME OF THE TIME 3

NONE OF THE TIME 4

DON’T KNOW d

REFUSED r

IF [BL D22=1 AND BL D24=1] OR IF [BL D22=0,D,R AND BL D16=1]

IF BL D22=1 Fill [CHILD NAME] from D3

IF BL D22=0,D,R Fill [CHILD NAME] from BL D8

STREAMS

D6. When you completed our first survey, you told us that [BL PARTNER] was the biological father of [CHILD NAME]. Is that right?

YES 1 GO TO D7

NO, DIFFERENT FATHER 0 GO TO D6a

DON’T KNOW d GO TO D6a

REFUSED r GO TO D6a

IF [BL D22=1 AND BL D24 = 2, D, OR R AND D1=1] OR [BL D22=0,d,r and BL D16 NE 1 AND BL D18=d,r or missing]

Fill [CHILD NAME] from D3

IF BL D22=0,D,R Fill [CHILD NAME] from BL D8

STREAMS

D6a. I’d now like to ask some questions about [CHILD NAME]’s biological father. So I can ask a few questions about him, what is [CHILD NAME]’s father’s name?

(STRING 25)

FATHER NAME

FATHER DECEASED 0

DON’T KNOW d

REFUSED r

D1=1

SKIP IF D6a=0, DK OR R

If [BL D22=1 AND BL D24 = 1 AND D6 = 1] OR [OR [BL D22=0,D,R AND BL D16=1 AND D6=1], fill [FATHER NAME] with [BL PARTNER]

IF [BL D22=1 AND BL D24 = 2, D, OR R] OR D6=0 OR [BL D22=0,d,r and BL D16 NE 1 AND BL D18=d,r or missing], FILL [FATHER NAME] from D6a

If BL D22=0,D,R AND BL D16=2 then fill [FATHER NAME] with [CHILD 1 PARENT]

IF BL D22=1 Fill [CHILD NAME] from D3

IF BL D22=0,D,R Fill [CHILD NAME] from BL D8

FaMLE

D7. Does [FATHER NAME] live in the same household with [CHILD NAME] …

All of the time, 1

Most of the time, 2

Some of the time, or 3

None of the time? 4

DON’T KNOW d

REFUSED r

SKIP IF D6a=0, DK OR R

If [BL D22=1 AND BL D24 = 1 AND D6 = 1] OR [OR [BL D22=0,D,R AND BL D16=1 AND D6=1], fill [FATHER NAME] with [BL PARTNER]

IF BL D22=1 AND [BL D24 = 2, D, OR R] OR D6=0 OR [BL D22=0,d,r and BL D16 NE 1 AND BL D18=d,r or missing], FILL [FATHER NAME] from D6a

If BL D22=0,D,R AND BL D16=2 then fill [FATHER NAME] with [CHILD 1 PARENT]

IF BL D22=1 Fill [CHILD NAME] from D3

IF BL D22=0,D,R Fill [CHILD NAME] from BL D8

BSF FU CO2

D8. In the past month, how often has [FATHER NAME] spent one or more hours a day with [CHILD]? Was it…

Every day or almost every day, 1

A few times a week, 2

A few times in the past month, 3

Once or twice, or 4

Never? 5

DON’T KNOW d

REFUSED r

SKIP IF D6a=0, DK OR R

If [BL D22=1 AND BL D24 = 1 AND D6 = 1] OR [OR [BL D22=0,D,R AND BL D16=1 AND D6=1], fill [FATHER NAME] with [BL PARTNER]

IF BL D22=1 AND [BL D24 = 2, D, OR R] OR D6=0 OR [BL D22=0,d,r and BL D16 NE 1 AND BL D18=d,r or missing], FILL [FATHER NAME] from D6a

IF BL D22=0,D,R AND BL D16=2 then fill [FATHER NAME] with [CHILD 1 PARENT]

If D4 = 1, fill his

If D4 = 2, fill her

IF BL D22=1 and D4 = 1, fill his

IF BL D22=1 and D4 = 2, fill her

IF BL D22=0,d,r and BL D10 = 1, fill his

IF BL D22=0,d,r and BL D10 = 1, fill his

IF BL D22=1 Fill [CHILD NAME] from D3

IF BL D22=0,D,R Fill [CHILD NAME] from BL D8

BSF FU PA12

D9. Now I’d like you to think about all the expenses associated with raising [CHILD NAME] such as [his/her] food, clothing, medical expenses, diapers, and any other costs of raising [him/her]. How much of the cost of raising [CHILD NAME] does [FATHER NAME] cover? Would you say its…

All or almost all, 1

More than half, 2

About half, 3

Less than half, or 4

Little or none? 5

DON’T KNOW d

REFUSED r

SKIP IF D6a=0, DK OR R

if BL INTRO = 1 (denver) AND IF [BL D22=1 AND BL D24 = 1 AND D6 = 1] OR [OR [BL D22=0,D,R AND BL D16=1 AND D6=1], fill [FATHER NAME] with [BL PARTNER]

if BL INTRO = 1 (denver) AND IF BL D22=1 AND [BL D24 = 2, D, OR R] OR D6=0 OR [BL D22=0,d,r and BL D16 NE 1 AND BL D18=d,r or missing], FILL [FATHER NAME] from D6a

if BL INTRO = 1 (denver) AND IF BL D22=0,D,R AND BL D16=2 then fill [FATHER NAME] with [CHILD 1 PARENT]

IF BL INTRO = 3 (PARENTING CENTER): BL C5=NAME GIVEN AND d16=1 ASK ABOUT PARTNER THEY ENTERED THE STUDY WITH, [BL PARTNER]

IF BL INTRO = 3 (PARENTING CENTER): fill Now I have some questions about parenting.

PAM

D10. [Now I have some questions about parenting.] The following statements are about [BL PARTNER/FATHER NAME]’s and your involvement in the care of your child/children. For each statement, please answer if overall you strongly agree, agree, disagree, or strongly disagree. In your answers, you should include all children that you have in common.

**NOTE: The specific wording of items D10a-j is not shown on this copy of the survey because the items are adapted and reproduced by special permission of the Publisher, Psychological Assessment Resources, Inc., 16204 North Florida Avenue, Lutz, Florida 33549, from the Parenting Alliance Measure by Richard Abidin, EdD and Timothy R Konold, PhD, Copyright 1999 by PAR, Inc. Further reproduction is prohibited without permission by PAR, Inc.

	STRONGLY AGREE	AGREE	DISAGREE	STRONGLY DISAGREE	DK	R
a. PAM 13 **SEE NOTE ABOVE **	1	2	3	4	d	r
b. PAM 4	1	2	3	4	d	r
c. PAM 18	1	2	3	4	d	r
d. PAM 14	1	2	3	4	d	r
e. PAM 11	1	2	3	4	d	r
f. PAM 10	1	2	3	4	d	r
g. PAM 3	1	2	3	4	d	r
h. PAM 5	1	2	3	4	d	r
i. PAM 6	1	2	3	4	d	r
j. PAM 7	1	2	3	4	d	r

ALL

FOR INTRO1=1 AND BL D22=1 THEN FILL CHILD NAME FROM D3

FOR INTRO1=1 AND BL D22=0,D,R THEN FILL CHILD NAME FROM BL D8

If BL D22=0,d,r, fill After

If D1 NE 6, DK or R, fill again

FOR INTRO 2 OR 3

If BL A1c=2 , fill been

If BL A1c=1, fill gotten someone

PPA

D11. [BL INTRO 1=1(DENVER)] Now I have some questions about other pregnancies. [Besides/After] your pregnancy with [CHILD NAME], to the best of your knowledge, since [RA DATE], have you been pregnant [again], even if no child was born?

[BL INTRO1=2 OR 3 (FWCA OR PARENTING CENTER)] Now I have some questions about pregnancies. To the best of your knowledge, since [RA DATE], have you [been/gotten someone] pregnant, even if no child was born?

YES 1

NO 0 GO TO E1

DON’T KNOW d

REFUSED r

D11=1

If BL A1c=2 , fill been

If BL A1c=1, fill gotten someone

D12. Since [RA DATE], how many times have you [been/gotten someone] pregnant?

PPA

INTERVIEWER INSTRUCTION: COUNT THE BASELINE PREGNANCY

| | | TIMES

(1-99)

DON’T KNOW d

REFUSED r

D11=1

IF D12 > 1, fill Let’s talk about the most recent pregnancy.

PACT

D13. [Let’s talk about the most recent pregnancy.] Right before the pregnancy, did you want to have a baby? Would you say…

Definitely yes, 1

Probably yes, 2

Probably no, or 3

Definitely no? 4 GO TO E1

DON’T KNOW d

REFUSED r

d11=1 AND D13 NE 4

PACT

D14. Would you say this pregnancy came sooner than you wanted, at about the right time, or later than you wanted?

SOONER 1

ABOUT RIGHT TIME 2

LATER 3

DIDN’T CARE 4

DIDN’T WANT TO HAVE A(NOTHER) BABY 5

DON’T KNOW d

REFUSED r

all

FaMLE

E1. The next questions are about sources of income and other support that you and other members of your household may have received in the past month.

In the past month, have you or anyone in your household received any income from [fill statements a-j]?

	CODE ONE RESPONSE PER ROW
	YES	NO	DK	REF
a. Temporary Assistance for Needy Families, or TANF	1	0	d	r
b. Supplemental Security Income, or SSI	1	0	d	r
c. Social Security Disability Insurance, or SSDI	1	0	d	r
d. food stamps or SNAP	1	0	d	r
e. Women, Infants, and Children, or WIC	1	0	d	r
f. Unemployment Insurance	1	0	d	r
g. housing choice vouchers, sometimes called Section 8	1	0	d	r

Now I would like to ask some questions about your work.

ALL

CSPED

E2. Are you currently working for pay?

Working for pay can include regular paid jobs, odd jobs, temporary jobs, work done in your own business, “under the table” work, “informal” work, or any other types of work you have done for pay.

YES 1 GO TO E3

NO 0 GO TO E2a

DON’T KNOW d GO TO E2a

REFUSED r GO TO E2a

E2 NE 1

CSPED

E2a. Have you worked for pay at any time since [RA MONTH YEAR]?

YES 1 GO TO E4b_1

NO 0 GO TO E11

DON’T KNOW d GO TO E11

REFUSED r GO TO E11

CSPED

NOTE: SPACE FOR UNLIMITED JOBS WILL BE IN CATI PROGRAM.

	JOB 1			JOB 2
E2=1 (CURRENTLY EMPLOYED) E3. First I am going to ask about your current job or jobs. Do you currently have your own business? This includes work you do for multiple people providing a service, such as lawn care or child care.	YES 1 GO TO E4 NO 0 GO TO E3a DON’T KNOW d GO TO E3a REFUSED r GO TO E3a			YES 1 GO TO E4 NO 0 GO TO E3a DON’T KNOW d GO TO E3a REFUSED r GO TO E3a
E3≠1 E3a. What is the name of the company or organization you currently work for? If you currently work for more than one company, please start with the job where you usually work the most hours.	COMPANY NAME (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r PROGRAMMER: IF E3a = D, R, make [Company Name] be “Job 1” for Job 1, “Job 2” for Job 2, etc. INTERVIEWER: IF E3a=D, R, THEN SAY: That’s okay, we’ll just refer to this job as “Job 1” in the next few questions.			COMPANY NAME (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r
E2=1 (CURRENTLY EMPLOYED) E4. Including all types of jobs, do you currently have any other paid jobs?	YES 1 GO TO E4a, JOB 2 NO 0 GO TO E4c DON’T KNOW d GO TO E4c REFUSED r GO TO E4c			YES 1 GO TO E4a, JOB 3 NO 0 GO TO E4c DON’T KNOW d GO TO E4c REFUSED r GO TO E4c
E2=1 (CURRENTLY EMPLOYED) E4a. Please tell me who you work for on that job?				COMPANY NAME (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r PROGRAMMER: IF E4a = D, R, make [Company Name] be “Job 1” for Job 1, “Job 2” for Job 2, etc. INTERVIEWER: IF E4a=D, R, THEN SAY: That’s okay, we’ll just refer to this job as “Job 2” in the next few questions. IF E2=1 LOOP E4 AND E4a JOBS UNTIL E4=(0,d, r). WHEN E4= 0,d,or r GO TO E4c.
E2a=1 (NOT CURRENTLY EMPLOYED) E4b_1. Since [RA DATE], have you worked in your own business? This includes working for multiple people in your own business providing a service, such as lawn care or child care.	YES 1 GO TO E4c NO 0 GO TO E4b_2 DON’T KNOW d GO TO E4b_2 REFUSED r GO TO E4b_2			YES 1 GO TO E4c NO 0 GO TO E4b_2 DON’T KNOW d GO TO E4b_2 REFUSED r GO TO E4b_2
E4b_1≠1 E4b_2. Since [RA DATE], please tell me who you worked for? If you worked for more than one company, please start with the job you had most recently. INTERVIEWER INSTRUCTION: ASK RESPONDENT FOR A DIFFERENT NAME THAN GIVEN AT E3a & E4a.	COMPANY NAME (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r			COMPANY NAME (SPECIFY) 99 (STRING 50) DON’T KNOW d REFUSED r
If E4=(0, d, r) [TOLD INTERVIEWER THAT NO MORE CURRENT JOBS] or E2a=1 [NOT CURRENTLY EMPLOYED BUT EMPLOYED SINCE RA DATE] E4c. Have you had any other paid jobs since [RA MONTH YEAR] that you haven’t told me about?	YES 1 GO TO E4b, JOB 2 NO 0 GO TO E5 DON’T KNOW d GO TO E5 REFUSED r GO TO E5 IF E4c=1 LOOP E4b AND E4c UNTIL E4C=0,d, or r . WHEN E4C=0, d, or r GO TO E5.			YES 1 GO TO F4b, JOB 3 NO 0 GO TO E5 DON’T KNOW d GO TO E5 REFUSED r GO TO E5 IF E4c=1 LOOP E4b AND E4c UNTIL E4C=0,d, or r. WHEN E4C=0, d, or r GO TO E5.
E2=1 OR E2a=1 IF E3 or E4b_1 = 1, FILL “YOURSELF;” ELSE FILL “NOW THINKING OF THE JOB YOU [DO/DID] AT [JOB NAME 1].” IF E2=1, FILL “DO” IF E2A=1, FILL “DID” E5. [Now thinking of the job you [do/did] at JOB NAME 1.] When did you start working for [JOB NAME 1/yourself]? INTERVIEWER: RECORD MONTH AND YEAR. NOTE: ALLOW SKIP ON MONTH.	| | | / | | | | | MONTH YEAR (1-12) (1990-2017) DON’T KNOW d REFUSED r			| | | / | | | | | MONTH YEAR (1-12) (1990-2017) DON’T KNOW d REFUSED r
E2=1 OR E2a=1 E6. Are you still working for [COMPANY NAME/yourself]?	YES 1 GO TO E7 NO 0 GO TO E6a DON’T KNOW d REFUSED r			YES 1 GO TO E7 NO 0 GO TO E6a DON’T KNOW d REFUSED r
E2=0 E6a. When did you stop working at this job? INTERVIEWER: RECORD MONTH AND YEAR.	| | | / | | | | | MONTH YEAR (1-12) (2013-2020) STILL AT JOB 98 DON’T KNOW d REFUSED r			| | | / | | | | | MONTH YEAR (1-12) (2013-2020) STILL AT JOB 98 DON’T KNOW d REFUSED r
E2=1 OR E2a=1 SKIP IF E3 or E4b _1= 1 FILL “ARE” IF E6=98, ELSE FILL “WERE” E7. Which of the following best describes your work at [JOB NAME]? [Are/Were] you working . . .	CODE ONE ONLY as a regular full-time employee, 1 as a regular part-time employee, 2 for a temporary help agency, 3 self-employed, 4 as a seasonal job, temporary job, or day laborer, 5 or something else (PLEASE specify)? 99 (STRING (100)) DON’T KNOW d REFUSED r			CODE ONE ONLY as a regular full-time employee 1 as a regular part-time employee, 2 for a temporary help agency, 3 self-employed, 4 as a seasonal job, temporary job, or day laborer, 5 or something else (PLEASE specify)? 99 (STRING (100)) DON’T KNOW d REFUSED r
E2=1 OR E2a=1 IF E2=1 FILL DO; IF E2a=1, FILL DID E7a. [Do/Did] you have taxes taken out of your paycheck for the work you [do/did] at this job?	YES 1 NO 0 R VOLUNTEERS: WAS PAID IN CASH 9 DON’T KNOW d REFUSED r			YES 1 NO 0 R VOLUNTEERS: WAS PAID IN CASH 9 DON’T KNOW d REFUSED r
E2=1 OR E2a=1 IF E6=98 FILL “DO”, ELSE FILL “DID” E8. How many hours [do/did] you usually work in a week on this job? Your best estimate is fine.	| | | HOURS PER WEEK (0-98) 99 OR MORE HOURS PER WEEK 99 DON’T KNOW d IF E4=1 OR E4c=1 GO TO E5 [JOB 2-6] WHEN (E4 NE 1 AND E4c NE 1) GO TO E10 REFUSED r			| | | HOURS PER WEEK (0-98) 99 OR MORE HOURS PER WEEK 99 DON’T KNOW d IF E4=1 OR E4c=1 GO TO E5 [JOB 2-6] WHEN E4 NE 1 AND E4c NE 1 GO TO E10 REFUSED r
E2=1 OR E2a=1 FILL “IS”, “CURRENT”, and “VARIES” IF E6=98, ELSE FILL “WAS”, “MOST RECENT”, AND “VARIED” E9. What [was/is] your [most recent/current] rate of pay, before taxes and deductions, at that job? PROBE: If your pay [varies/varied], please provide an average amount. ACCEPT MOST CONVENIENT PAY PERIOD. SOFT CHECK: IF ANSWER IS GREATER THAN $50 PER HOUR, $2000 PER WEEK, $4000 ONCE EVERY 2 WEEKS, $4000 TWICE A MONTH, $100,000 PER YEAR, $400 DAY/DAILY, OR $8000 MONTH, SAY: “I RECORDED [E9 AND E9_AMOUNT ANSWER]. IS THAT CORRECT?”	$ | | | |,| | | |.| | | AVERAGE (0-999,999.99) AMOUNT PER HOUR 1 PER WEEK 2 MONTH 3 ONCE EVERY TWO WEEKS 4 TWICE A MONTH 5 PER YEAR 6 DAY/DAILY 7 OTHER (SPECIFY) 99 (STRING (100)) DON’T KNOW d REFUSED r	$ | | | |,| | | |.| | | AVERAGE (0-999,999.99) AMOUNT PER HOUR 1 PER WEEK 2 MONTH 3 ONCE EVERY TWO WEEKS 4 TWICE A MONTH 5 PER YEAR 6 DAY/DAILY 7 OTHER (SPECIFY) 99 (STRING (100)) DON’T KNOW d REFUSED r
E2=1 OR E2a=1 FILL PAY PER PERIOD WITH AMOUNT AND PERIOD FROM E9 AND E9_AMOUNT. E9a. Did you always earn [PAY PER PERIOD] at this job? that job?	YES 1 GO TO E10 NO 0 GO TO E9b DON’T KNOW d REFUSED r	YES 1 GO TO E10 NO 0 GO TO E9b DON’T KNOW d REFUSED r
E9A=0 E9b. How much did you earn when you started? PROBE: If your pay varied, please provide an average amount. ACCEPT MOST CONVENIENT PAY PERIOD. SOFT CHECK: IF ANSWER IS GREATER THAN $50 PER HOUR, $2000 PER WEEK, $4000 ONCE EVERY 2 WEEKS, $4000 TWICE A MONTH, $100,000 PER YEAR, $400 DAY/DAILY, OR $8000 MONTH, SAY: “I RECORDED [E9b AND E9b_AMOUNT ANSWER]. IS THAT CORRECT?”	$ | | | |,| | | |.| | | AVERAGE (0-999,999.99) AMOUNT PER HOUR 1 PER WEEK 2 MONTH 3 ONCE EVERY TWO WEEKS 4 TWICE A MONTH 5 PER YEAR 6 DAY/DAILY 7 OTHER (SPECIFY) 99 (STRING (100)) DON’T KNOW d REFUSED r		$ | | | |,| | | |.| | | AVERAGE (0-999,999.99) AMOUNT PER HOUR 1 PER WEEK 2 MONTH 3 ONCE EVERY TWO WEEKS 4 TWICE A MONTH 5 PER YEAR 6 DAY/DAILY 7 OTHER (SPECIFY) 99 (STRING (100)) DON’T KNOW d REFUSED r
E2=1 SKIP IF E3 or E4b = 2 OR E7=5 E10. Which of the following benefits are available to you on your job (READ EACH ITEM) . . . SELECT IF AVAILABLE, BUT NOT USED.	CODE ALL THAT APPLY Paid leave for holidays, vacation or illness? 1 Health insurance or membership in an HMO or PPO plan? 2 DON’T KNOW d REFUSED r		CODE ALL THAT APPLY Paid leave for holidays, vacation or illness? 1 Health insurance or membership in an HMO or PPO plan? 2 DON’T KNOW d REFUSED r

all

PACT

E11. Since [RA MONTH YEAR], was there anything else you did for pay, such as odd jobs or any other type of work, that we haven’t already talked about?

YES 1

NO 0 GO TO E13

DON’T KNOW d GO TO E13

REFUSED r GO TO E13

E11=1

PACT

E12. What is your best guess of how much money you received from these activities in a typical month since [RA MONTH YEAR]? Please do not include money you made from jobs we talked about earlier.

PROBE: Your best guess is fine.

$| | | , | | | |

(0-99,999)

DON’T KNOW d GO TO E12a

REFUSED r

E12= DON’T KNOW

E12a. I just need to know a range. Can you tell me if it was . . .

$0 - $200, 1

$201 - $500, 2

$501 to $700, 3

$701 to $900, 4

$901 to $1000, 5

$1000 to $2,000, or 6

more than $2,000? 7

DON’T KNOW d

REFUSED r

E2 = 1

If number of CURRENT jobs rostered equals 1 fill “job”

If number of CURRENT jobs rostered greater than 1 fill “jobs”

PACT

E13. How satisfied are you with your current [job/jobs]? Would you say very satisfied, somewhat satisfied, or not satisfied?

VERY SATISFIED 1

SOMEWHAT SATISFIED 2

NOT SATISFIED 3

DON’T KNOW d

REFUSED r

ALL

NEW

E14. Since [RA DATE], have you done any of the following?

	CODE ONE RESPONSE PER ROW
	YES	NO	DK	REF
a. Create or update your resume?	1	0	d	r
b. Look for a job?	1	0	d	r
c. Submit a job application?	1	0	d	r
d. Go on a job interview?	1	0	d	r

ALL

Hong et al 2012

E15. Now I am going to read you some statements about employment. On a scale from 0 to 10, where 0 is strongly disagree and 10 is strongly agree, please tell me how strongly you agree with each statement. You can choose any number from 0 to 10.

[FILL STATEMENT A-E]… On a scale from 0 to 10, how strongly do you agree with this statement?

	Scale	DK	REF
a. I am worthy of working in a good job	[0-10] NUM	d	r
b. I am capable of working in a good job	[0-10] NUM	d	r
c. I am aware of the skills and resources I have to be employed in a good job	[0-10] NUM	d	r
d. I know how to use my skills and resources to move toward my career goals	[0-10] NUM	d	r
e. My current path will take me to where I need to be in my career	[0-10] NUM	d	r

ALL

CSPED

E16. The next question asks about bank accounts you might have, such as savings accounts or checking accounts with a bank or credit union. Do you currently have a checking or savings account?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

Moore 2003

E17. Are you currently saving or putting money aside for a long-term goal such as education, a car, a house, or a vacation?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

Moore 2003

E18. Do you regularly keep track of your money and how much you are spending?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

Moore 2003

E19. Do you currently have a written budget or spending plan you use to manage your expenses?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

STREAMS

E20. In the past 3 months, have you had to pay a late fee on a bill or loan?

YES 1

NO 0

DON’T KNOW d

REFUSED r

All

PACT

E21. Are you better off financially than you were a year ago?

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

CSPED

E22. Since [RA MONTH YEAR], did you do any of the following because you didn’t have enough money?

CODE ONE RESPONSE PER ROW

	YES	NO	D	R
a. Cut the size of your meals or skip meals because you couldn’t afford enough food?	1	0	d	r
b. Move in with other people, even for a little while, because of financial problems?	1	0	d	r
c. Ask to borrow money from friends or family?	1	0	d	r
d. Go without a phone because you could not afford to pay the bill or buy extra cell phone minutes?	1	0	d	r
e. Sold or pawned your belongings, or taken a payday loan or auto-title loan?	1	0	d	r
f. Thought about going to the doctor, dentist or hospital, but decided not to because of the cost?	1	0	d	r

ALL

FaMLE, CSPED

E23. Now I am going to read you a list of things that can make it hard to find or keep a good job.

Please tell me if the following has made it not at all hard, a little hard, somewhat hard, very hard, or extremely hard for you to find or keep a good job in the past year.

[FILL a-j]. Would you say that made it not at all hard, a little hard, somewhat hard, very hard, or extremely hard for you to find or keep a good job in the past year?

INTERVIEWER INSTRUCTION: IF NEEDED READ RESPONSE CATEGORIES FOR B-J

CODE ONE RESPONSE PER ROW

	NOT AT ALL	A LITTLE	SOMEWHAT	VERY HARD	EXTREMELY		DK	REF
a. Not having reliable transportation	0	1	2	3	4		d	r
b. Not having the right clothes for work	0	1	2	3	4		d	r
c. Not having the required documentation for employment, such as a birth certificate	0	1	2	3	4		d	r
d. Not having good enough childcare or family help	0	1	2	3		4	d		r
e. Having a criminal record	0	1	2	3	4		d	r
f. Not having the right skills or education	0	1	2	3	4		d	r
g. Having substance use or mental health problems	0	1	2	3	4		d	r
h. Trouble getting along with other people or controlling your anger	0	1	2	3	4		d	r
i. Your physical health	0	1	2	3	4		d	r
j. A lack of jobs available in your area	0	1	2	3	4		d	R

These next questions are about how you are doing.

ALL

F1. In general, how would you describe your health? Would you say it is…

FaMLE

excellent, 1

very good, 2

good, 3

fair, or 4

poor? 5

DON’T KNOW d

REFUSED r

all

PHQ-8

F2. Over the last two weeks, how often have you been bothered by any of the following problems?

[PROGRAMMER: FILL a-h]

Would you say that the problem happened not at all, several days, more than half the days, or nearly every day in the last two weeks?

INTERVIEWER INSTRUCTION: IF NEEDED READ RESPONSE CATEGORIES FOR B-H

	CODE ONE RESPONSE PER ROW
	NOT AT ALL	SEVERAL DAYS	MORE THAN HALF THE DAYS	NEARLY EVERY DAY	DK	REF
a. Little interest or pleasure in doing things.	0	1	2	3	d	r
b. Feeling down, depressed, or hopeless.	0	1	2	3	d	r
c. Trouble falling or staying asleep, or sleeping too much.	0	1	2	3	d	r
d. Feeling tired or having little energy.	0	1	2	3	d	r
e. Poor appetite or overeating.	0	1	2	3	d	r
f. Feeling bad about yourself—or that you are a failure or have let yourself or your family down.	0	1	2	3	d	r
g. Trouble concentrating on things, such as reading or watching television.	0	1	2	3	d	r
h. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual.	0	1	2	3	d	r

Now I would like to ask you a few questions about your experience with the criminal justice system.

ALL

PACT

F3. Have you been arrested since [RA DATE]?

YES 1

NO 0 GO TO F6

DON’T KNOW d GO TO F6

REFUSED r GO TO F6

F3= 1

PACT

F4. How many times have you been arrested since [RA DATE]?

INTERVIEWER: CODE 0 IF NEVER ARRESTED

| | | TIMES GO TO F6

(1-99)

NEVER ARRESTED 0 GO TO F6

DON’T KNOW d

REFUSED r

F4=d or r

PACT

F5. Would you say . . .

Once or twice, 1

3 to 5 times, or 2

6 or more? 3

DON’T KNOW d

REFUSED r

ALL

BSF

F6. Have you ever been convicted of a crime?

YES 1

NO 0 GO TO G1

DON’T KNOW d GO TO G1

REFUSED r GO TO G1

F6=1

BSF

F7. Have you been convicted of a crime since [RA DATE]?

YES 1 GO TO F8

NO 0 GO TO G1

DON’T KNOW d

REFUSED r

F7=1

CSPED

F8. Since [RA DATE], were you ever in an adult correctional institution like a county, state, or federal jail or prison?

YES 1

NO 0

DON’T KNOW d

REFUSED r

F7=1 AND F8 NE DK OR R

BSF

F9. Are you currently on parole or probation?

YES 1

NO 0

DON’T KNOW d

REFUSED r

Now, I would like to ask you about some of the services you may have received since [RA DATE].

ALL

PACT

G1. Since [RA DATE], did you participate in any group activities to help with your romantic relationships? These could be called workshops or classes.

YES 1

NO 0 GO TO G4

DON’T KNOW d GO TO G4

REFUSED r GO TO G4

G1=1

PACT

G2. Since [RA DATE], about how many hours in total did you spend in these group activities?

PROBE: Your best estimate of the number of hours is fine.

| | | HOURS GO TO G4

(0-999)

DON’T KNOW d

REFUSED r

G2 = d OR r

G3. I just need to know a range. Can you tell me if it was…?

PACT

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

ALL

PACT

G4. Since [RA DATE], did you participate in any group activities to help with parenting? These could be called workshops or classes.

YES 1

NO 0 GO TO G7

DON’T KNOW d GO TO G7

REFUSED r GO TO G7

G4 = 1

PACT

G5. Since [RA DATE], about how many hours in total did you spend in these group activities?

PROBE: Your best estimate of the number of hours is fine.

| | | HOURS GO TO G7

(0-999)

DON’T KNOW d

REFUSED r

G5 = d OR r

G6. I just need to know a range. Can you tell me if it was…?

PACT

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

ALL

STREAMS

G7. Since [RA DATE], did you participate in any group or one-on-one activities that helped you with money management or financial literacy? For example, they may have helped you develop a budget or spending plan, set financial goals, or open a checking or savings account.

YES 1

NO 0 GO TO G10

DON’T KNOW d GO TO G10

REFUSED r GO TO G10

G7 = 1

STREAMS

G8. Since [RA DATE], about how many hours in total did you spend in these group or one-on-one activities?

PROBE: Your best estimate of the number of hours is fine.

| | | HOURS GO TO G10

(0-999)

DON’T KNOW d

REFUSED r

G8 = d or r

STREAMS

G9. I just need to know a range. Can you tell me if it was… ?

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

ALL

PACT

G10. Since [RA DATE], did you participate in a training program for a specific job, trade, or occupation?

YES 1

NO 0 GO TO G13

DON’T KNOW d GO TO G13

REFUSED r GO TO G13

G10 = 1

G11. Are you participating in the program now?

PACT

YES 1 GO TO G13

NO 0

DON’T KNOW d

REFUSED r

G11= 0, d, r

G12. Did you complete the program?

PACT

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

PACT

G13. Since [RA DATE], did you participate in any group activities that helped you get a job in other ways? For example, they may have helped you create a resume, practice interviewing, or talk to you about how to look for a job.

YES 1

NO 0 GO TO G16

DON’T KNOW d GO TO G16

REFUSED r GO TO G16

G13 = 1

PACT

G14. Thinking about since [RA DATE], about how many hours in total did you attend these group activities?

PROBE: Your best estimate of the number of hours is fine.

| | | HOURS GO TO G16

(0-999)

DON’T KNOW d

REFUSED r

G14 = d OR r

G15. I just need to know a range. Can you tell me if it was…?

PACT

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

ALL

PACT

G16. Since [RA DATE], did you receive any one-on-one assistance in getting a job?

YES 1

NO 0 GO TO END1

DON’T KNOW d GO TO END1

REFUSED r GO TO END1

G16 = 1

PACT

G17. Since [RA DATE], about how many hours in total did you spend getting one-on-one assistance for help in getting a job?

PROBE: Your best estimate of the number of hours is fine.

| | | HOURS GO TO END1

(0-999)

DON’T KNOW d

REFUSED r

G17 = d OR r

G18. I just need to know a range. Can you tell me if it was…?

PACT

1 - 5 hours, 1

6 - 10 hours, 2

11 - 15 hours, 3

16 - 20 hours, 4

21 - 30 hours, or 5

More than 30 hours? 6

DON’T KNOW d

REFUSED r

H. Contact Information

We are almost finished. I just have a few more questions in case we need to contact you again.

ALL

YB 30 Mth J1-mod

H1. What is your street address?

(STRING 200)

Street Address 1

(STRING 200)

Street Address 2 or Apt

(STRING 200)

City

(STRING 200)

State/Territory

(STRING 10)

Zip

DON’T KNOW d

REFUSED r

ALL

YB 30 Mth J1a

H2. Is your mailing address the same as your street address?

YES 1 GO TO H4

NO 0 GO TO H3

DON’T KNOW d GO TO H4

REFUSED r GO TO H4

H2 = 0

YB 30 Mth J1b

H3. What is your mailing address?

(STRING 200)

Street /PO BOX Address 1

(STRING 200)

Street/ PO BOX Address 2 or Apt

(STRING 200)

City

(STRING 200)

State/Territory

(STRING 10)

Zip

DON’T KNOW d

REFUSED r

ALL

YB 30 Mth J2

H4. What is your cell phone number?

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO CELL PHONE 1 GO TO H6

DON’T KNOW d GO TO H6

REFUSED r GO TO H6

H4 HAS COMPLETE PHONE NUMBER ENTERED

YB 30 Mth J3

H5. May we send you text messages? Message and data rates may apply.

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

YB 30 Mth J4

H6. What is your home phone number?

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO HOME PHONE 1 GO TO H9

DON’T KNOW d GO TO H9

REFUSED r GO TO H9

H6 HAS COMPLETE PHONE NUMBER ENTERED

YB 30 Mth J4_cell

H7. Is this number, [FILL H6], for a cell phone?

YES 1

NO 0

DON’T KNOW d

REFUSED r

H6 HAS COMPLETE PHONE NUMBER ENTERED

YB 30 Mth J5

H8. Whose name is that number listed under?

(STRING 20)

First name

(STRING 20)

Middle name

(STRING 20)

Last name

DON’T KNOW d

REFUSED r

PROGRAMMER BOX H8a.1

IF H7 = 1, CONTINUE TO H8b;

ELSE, SKIP TO H9.

H7 = 1

YB 30 Mth J5b

H8b. May we send you text messages at this number: ([FILL H6])? Message and data rates may apply.

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

YB 30 Mth J6

H9. What is another phone number where you can be reached?

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO OTHER NUMBER 1 GO TO H12

DON’T KNOW d GO TO H12

REFUSED r GO TO H12

H9 HAS COMPLETE PHONE NUMBER ENTERED

YB 30 Mth J6_cell

H10. Is this number, [H9], for a cell phone?

YES 1

NO 0

DON’T KNOW d

REFUSED r

H9 HAS COMPLETE PHONE NUMBER ENTERED

YB 30 Mth J7

H11. Whose name is that number listed under?

(STRING 20)

First name

(STRING 20)

Middle name

(STRING 20)

Last name

DON’T KNOW d

REFUSED r

PROGRAMMER BOX H11a.1

IF H10 = 1, CONTINUE TO H11b;

ELSE, SKIP TO H12.

H10 = 1

YB 30 Mth J7b

H11b. May we send you text messages at this number: ([FILL H6_phone])? Message and data rates may apply.

YES 1

NO 0

DON’T KNOW d

REFUSED r

ALL

YB 30 Mth J8a

H12. Are you planning on moving in the next 12 months?

YES 1 GO TO H12a

NO 0 GO TO H13

DON’T KNOW d GO TO H13

REFUSED r GO TO H13

H12 = 1

YB 30 Mth J8b

H12a. Where will you be moving to?

PROBE: Please provide as much information as you know at this time. Do you know the city and state?

(STRING 200)

Street Address 1

(STRING 200)

Street Address 2 or Apt

(STRING 200)

City

(STRING 200)

State/Territory

(STRING 10)

Zip

DON’T KNOW d

REFUSED r

PROGRAMMER: THIS DOES NOT HAVE TO BE A COMPLETE ADDRESS

ALL

PACT

H13. In case we have trouble reaching you, we would like to have the names of three people who would most likely know where you are or who you keep in close contact with, such as a grandmother or grandfather, other relative, or friend. We will not contact these people for any other reason.

What is the full name of the first person we should contact?

(STRING 50)

FIRST NAME

(STRING 50)

MIDDLE INITIAL/NAME

(STRING 50)

LAST NAME

DON’T KNOW d GO TO END

REFUSED r GO TO END

H13 NE D AND R

H14. What is (his/her) address?

PACT

PROBE: Is there an apartment number?

(STRING 200)

Street Address 1

(STRING 200)

Street Address 2 or Apt

(STRING 200)

City

(STRING 200)

State/Territory

(STRING 10)

Zip

DON’T KNOW d

REFUSED r

H13 NE D AND R

H15. What is (his/her) relationship to you?

PACT

SPOUSE/PARTNER 1

MOTHER 2

FATHER 3

SISTER/BROTHER 4

GRANDMOTHER/GRANDFATHER 5

FRIEND 6

OTHER (SPECIFY) 99

(STRING 50)

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): ENTER OTHER RELATIONSHIP TYPE

H13 NE D AND R

PACT

H16. What is (his/her) home telephone number?

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO LANDLINE 0

DON’T KNOW d

REFUSED r

H13 NE D AND R

H17. Does (he/she) have a cell phone?

PACT

YES 1 GO TO H21a

NO 0 GO TO H22

DON’T KNOW d GO TO H22

REFUSED r GO TO H22

H17=1

H17a. Can I have that number?

PACT

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

DON’T KNOW d

REFUSED r

H13 NE D AND R

H18. What is (his/her) work telephone number?

PACT

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO WORK NUMBER 0

DON’T KNOW d

REFUSED r

H13 NE D AND R

H19. What is (his/her) email address?

PACT

INTERVIEWER: ENTER E-MAIL ON NEXT SCREEN

(STRING 50)

EMAIL ADDRESS

DOESN’T HAVE ONE 0 GO TO H25

DON’T KNOW d GO TO H25

REFUSED r GO TO H25

H13 NE D AND R

H20. Does (he/she) have another email address?

PACT

INTERVIEWER: ENTER E-MAIL ON NEXT SCREEN

(STRING 50)

EMAIL ADDRESS

DOESN’T HAVE ONE 0 GO TO H25

DON’T KNOW d

REFUSED r

SECOND CONTACT

ALL

H21. What is the full name of the second person we should contact?

PACT

(STRING 50)

FIRST NAME

(STRING 50)

MIDDLE INITIAL/NAME

(STRING 50)

LAST NAME

DON’T KNOW d GO TO END

REFUSED r GO TO END

H21 NE D AND R

H22. What is (his/her) address?

PACT

PROBE: Is there an apartment number?

STREET 1

STREET 2

APT. #

CITY

STATE

ZIP

DON’T KNOW d

REFUSED r

H21 NE D AND R

H23. What is (his/her) relationship to you?

PACT

SPOUSE/PARTNER 1

MOTHER 2

FATHER 3

SISTER/BROTHER 4

GRANDMOTHER/GRANDFATHER 5

FRIEND 6

OTHER (SPECIFY) 99

(STRING 50)

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): ENTER OTHER RELATIONSHIP TYPE

H21 NE D AND R

H24. What is (his/her) home telephone number?

PACT

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO LANDLINE 0

DON’T KNOW d

REFUSED r

H21 NE D AND R

H25. Does (he/she) have a cell phone?

PACT

YES 1 GO TO H29a

NO 0 GO TO H30

DON’T KNOW d GO TO H30

REFUSED r GO TO H30

H25=1

H25a. Can I have that number?

PACT

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

DON’T KNOW d

REFUSED r

H21 NE D AND R

H26. What is (his/her) work telephone number?

PACT

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO WORK NUMBER 0

DON’T KNOW d

REFUSED r

H21 NE D AND R

H27. What is (his/her) email address?

PACT

(STRING 50)

EMAIL ADDRESS

DOESN’T HAVE ONE 0 GO TO H33

DON’T KNOW d GO TO H33

REFUSED r GO TO H33

H21 NE D AND R

H28. Does (he/she) have another email address?

PACT

(STRING 50)

EMAIL ADDRESS

DOESN’T HAVE ONE 0 GO TO H33

DON’T KNOW d

REFUSED r

THIRD CONTACT

(H13 NE D AND R) AND (H21 NE D AND R)

H29. What is the full name of the third person we should contact?

PACT

(STRING 50)

FIRST NAME

(STRING 50)

MIDDLE INITIAL/NAME

(STRING 50)

LAST NAME

DON’T KNOW d GO TO END

REFUSED r GO TO END

H29 NE D AND R

H30. What is (his/her) address?

PACT

PROBE: Is there an apartment number?

STREET 1

STREET 2

APT. #

CITY

STATE

ZIP

DON’T KNOW d

REFUSED r

H29 NE D AND R

H31. What is (his/her) relationship to you?

PACT

SPOUSE/PARTNER 1

MOTHER 2

FATHER 3

SISTER/BROTHER 4

GRANDMOTHER/GRANDFATHER 5

FRIEND 6

OTHER (SPECIFY) 99

(STRING 50)

DON’T KNOW d

REFUSED r

IF OTHER SPECIFY (99): ENTER OTHER RELATIONSHIP TYPE

H29 NE D AND R

H32. What is (his/her) home telephone number?

PACT

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO LANDLINE 0

DON’T KNOW d

REFUSED r

H29 NE D AND R

H33. Does (he/she) have a cell phone?

PACT

YES 1

NO 0 GO TO H38

DON’T KNOW d GO TO H38

REFUSED r GO TO H38

H33=1

H33a. Can I have that number?

PACT

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

DON’T KNOW d

REFUSED r

H29 NE D AND R

H34. What is (his/her) work telephone number?

PACT

| | | | - | | | | -| | | | | TELEPHONE

(201-989) (200-999) (0000-9999)

NO WORK NUMBER 0

DON’T KNOW d

REFUSED r

H29 NE D AND R

H35. What is (his/her) email address?

PACT

INTERVIEWER: ENTER E-MAIL ON NEXT SCREEN

(STRING 50)

EMAIL ADDRESS

DOESN’T HAVE ONE 0 GO TO END

DON’T KNOW d GO TO END

REFUSED r GO TO END

H29 NE D AND R

H36. Does (he/she) have another email address?

PACT

INTERVIEWER: ENTER E-MAIL ON NEXT SCREEN

(STRING 50)

EMAIL ADDRESS

DOESN’T HAVE ONE 0 GO TO END

DON’T KNOW d

REFUSED r

END OF CALL

interview completed

PACT

END1. Thank you very much for your time. Those are all the questions I have right now. You will receive a $25 gift card as a token of our appreciation. Thank you for your participation in the STREAMS study.

i1=0

END2. I am sorry to hear that, our condolences for your loss. Thank you for your time.

PACT

INTERVIEWER: BRING THIS CASE TO LOCATING FOR CONFIRMATION OF DEATH.

If MakeDialphone=5

END3. Please hand the phone back to our field locator.

PACT

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	STREAMS CATI BILINGUAL
Subject	CATI
Author	MATHEMATICA STAFF
File Modified	0000-00-00
File Created	2021-01-14