ATTACHMENT
S
YOUTH SECOND follow-up SURVEY
Question BY Question JUSTIFICATION
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This document lists each question on the STREAMS second follow-up survey for youth, along with its source(s). The overall structure of the survey matches the previously approved first follow-up survey, and both surveys include several of the same questions. New questions added for the second follow-up are indicated in the table and justified under the “Additional Information” column.
Q # |
Question text |
From first follow-up survey |
Added to second follow-up survey |
Additional information |
Section A |
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A1 |
Are you male or female? |
x |
|
Question A1 from STREAMS first follow-up survey. Original source: Required item A1 from FaMLE Cross-Site ACS. |
A2 |
What is your date of birth? |
X |
|
Question A2 from STREAMS first follow-up survey. Original Source: Required item A2 from FaMLE Cross-Site ACS. |
A3 |
What is your current grade? |
x |
|
Question A10 from STREAMS first follow-up survey. Original Source: Required item B4 from FaMLE Cross-Site ACS. |
A3a |
What is the highest level of education you have completed? |
|
X |
Source: Item B5 from FaMLE Cross-Site ACS. Added as a measure of educational background for students who may no longer be in school. |
A4 |
What kind of grades do you usually get in school? |
x |
|
Question A11 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
A5 |
How many times have you ever been suspended or expelled from school? |
x |
|
Question A12 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
A5a |
On a scale of 1-5, where 1 is low and 5 is high, how likely is it that you will graduate high school? |
|
X |
Developed for STREAMS. Added to the follow-up survey as a measure of expectations to complete high school. |
A6 |
On a scale of 1-5, where 1 is low and 5 is high, how much do you want to go to college? |
x |
|
Question A13 from STREAMS first follow-up survey. Original Source: The National Longitudinal Study of Adolescent to Adult Health (Add Health). |
A7 |
On a scale of 1-5, where 1 is low and 5 is high, how likely is it that you will go to college? |
x |
|
Question A14 from STREAMS first follow-up survey. Original Source: The National Longitudinal Study of Adolescent to Adult Health (Add Health). |
A8 |
What is your current employment status? |
|
X |
Source: Item B6a from FaMLE Cross-Site ACS. Added as a measure of employment status. |
A9 |
How much do you agree or disagree with the following statement? I have specific goals for my future career. |
x |
|
Question A16 from STREAMS first follow-up survey. Original Source: Adapted from the Career Commitment Measure (CCM) (Carson, K. and A.G. Bedeian. 1994; Diemer and Blustein 2007). |
A10 |
How much do you agree or disagree with the following statement? I have a plan for reaching my future career goals. |
x |
|
Question A17 from STREAMS first follow-up survey. Original Source: Adapted from the Career Commitment Measure (CCM) (Carson, K. and A.G. Bedeian. 1994; Diemer and Blustein 2007). |
A11 |
How much do you agree or disagree with the following statement? Planning a career is not worth the effort. |
x |
|
Question A18 from STREAMS first follow-up survey. Original Source: Adapted from the Career Commitment Measure (CCM) (Carson, K. and A.G. Bedeian. 1994; Diemer and Blustein 2007). |
A12 |
How much do you agree or disagree with the following statement? I haven’t thought much about my future career. |
x |
|
Question A19 from STREAMS first follow-up survey. Original Source: Adapted from the Career Commitment Measure (CCM) (Carson, K. and A.G. Bedeian. 1994; Diemer and Blustein 2007). |
A13 |
How much do you agree or disagree with the following statement? If I have a career, I won’t be able to enjoy other things in life. |
x |
|
Question A20 from STREAMS first follow-up survey. Original Source: Adapted from the Career Commitment Measure (CCM) (Carson, K. and A.G. Bedeian. 1994; Diemer and Blustein 2007). |
A14 |
How much do you agree or disagree with the following statement? Going to college is important for getting a good job. |
x |
|
Question A21 from STREAMS first follow-up survey. Original Source: Adapted from the Career Commitment Measure (CCM) (Carson, K. and A.G. Bedeian. 1994; Diemer and Blustein 2007). |
A15 |
In general, how would you describe your health? |
X |
|
Question A23 from STREAMS first follow-up survey. Original Source: Required item D1 from FaMLE Cross-Site ACS. |
|
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B1 |
The next few questions ask about your biological parents. Do you live with your biological mother? |
x |
|
Question B1 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
B2 |
Do you live with your biological father? |
x |
|
Question B2 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
B3 |
Which of the following best describes the relationship between your biological mother and biological father? |
x |
|
Question B3 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
B4 |
In the past month, how often did you feel like you could count on at least one of your parents to be there when you needed them? |
x |
|
Question B6 from STREAMS first follow-up survey. Original Source: Parent-adolescent relationship scale (Lippman et al. 2014). |
B5 |
In the past month, how often did you feel like you could talk with your parent(s) about things that really matter? |
x |
|
Question B7 from STREAMS first follow-up survey. Original Source: Parent-adolescent relationship scale (Lippman et al. 2014). |
B6 |
In the past month, how often did you feel like you could share your thoughts and feelings with your parent(s)? |
x |
|
Question B8 from STREAMS first follow-up survey. Original Source: Parent-adolescent relationship scale (Lippman et al. 2014). |
B7 |
In the past month, how often did you feel like you could count on your friends to be there when you needed them? |
x |
|
Question B9 from STREAMS first follow-up survey. Original Source: Parent-adolescent relationship scale (Lippman et al. 2014). |
B8 |
In the past month, how often did you feel like you could talk with your friends about things that really matter? |
x |
|
Question B10 from STREAMS first follow-up survey. Original Source: Parent-adolescent relationship scale (Lippman et al. 2014). |
B9 |
In the past month, how often did you feel like you could share your thoughts and feelings with your friends? |
x |
|
Question B11 from STREAMS first follow-up survey. Original Source: Parent-adolescent relationship scale (Lippman et al. 2014). |
|
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C1 |
In the past 12 months, did you have any classes on romantic relationships or dating? |
x |
|
Question C1 from STREAMS first follow-up survey. Original Source: Adapted from Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
C2 |
In the past 12 months, did you have any classes on dating violence? |
x |
|
Question C2 from STREAMS first follow-up survey. Original Source: Adapted from Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
C3 |
In the past 12 months, did you have any classes on teen pregnancy or sexually transmitted infections? |
x |
|
Question C3 from STREAMS first follow-up survey. Original Source: Adapted from Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
C4 |
In the past 12 months, did you have any classes on marriage? |
x |
|
Question C4 from STREAMS first follow-up survey. Original Source: Adapted from Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
C5 |
In the past 12 months, did you have any classes on career planning or job readiness? |
x |
|
Question C4a from STREAMS first follow-up survey. Original Source: Adapted from Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
C6 |
How much do you agree or disagree with the following statement? Marriages are happy or unhappy and there is not much you can do to change it. |
X |
|
Question C9 from STREAMS first follow-up survey. Original Source: Required item A1a from FaMLE Cross-Site PPS. |
C7 |
How much do you agree or disagree with the following statement? If you are happily married, you don’t need to work on your relationship. |
X |
|
Question C10 from STREAMS first follow-up survey. Original Source: Required item A1b from FaMLE Cross-Site PPS. |
C8 |
How much do you agree or disagree with the following statement? There is only one true love out there who is right for me to marry. |
x |
|
Question C11 from STREAMS first follow-up survey. Original Source: Faulty relationship beliefs scale (Kerpelman et al. 2009; Cobb, Larson, and Watson 2003). |
C9 |
How much do you agree or disagree with the following statement? In the end, feelings of love should be enough to sustain a happy marriage. |
x |
|
Question C12from STREAMS first follow-up survey. Original Source: Faulty relationship beliefs scale (Kerpelman et al. 2009; Cobb, Larson, and Watson 2003). |
C10 |
How much do you agree or disagree with the following statement? Living together before marriage will improve a couple’s chances of remaining happily married. |
x |
|
Question C13 from STREAMS first follow-up survey. Original Source: Faulty relationship beliefs scale (Kerpelman et al. 2009; Cobb, Larson, and Watson 2003). |
C11 |
How much do you agree or disagree with the following statement? A boy angry enough to hit his girlfriend must love her very much. |
x |
|
Question C14 from STREAMS first follow-up survey. Original Source: Acceptance of male on female violence scale (Foshee et al. 1992). |
C12 |
How much do you agree or disagree with the following statement? Girls sometimes deserve to be hit by the boys they date. |
x |
|
Question C15 from STREAMS first follow-up survey. Original Source: Acceptance of male on female violence scale (Foshee et al. 1992). |
C13 |
How much do you agree or disagree with the following statement? A girl who makes her boyfriend jealous on purpose deserves to be hit. |
x |
|
Question C16 from STREAMS first follow-up survey. Original Source: Acceptance of male on female violence scale (Foshee et al. 1992). |
C14 |
How much do you agree or disagree with the following statement? Boys sometimes deserve to be hit by the girls they date. |
x |
|
Question C17 from STREAMS first follow-up survey. Original Source: Acceptance of male on female violence scale (Foshee et al. 1992). |
C15 |
How much do you agree or disagree with the following statement? A girl angry enough to hit her boyfriend must love him very much. |
x |
|
Question C18 from STREAMS first follow-up survey. Original Source: Acceptance of male on female violence scale (Foshee et al. 1992). |
C16 |
How much do you agree or disagree with the following statement? A boy who makes his girlfriend jealous on purpose deserves to be hit. |
x |
|
Question C19 from STREAMS first follow-up survey. Original Source: Acceptance of male on female violence scale (Foshee et al. 1992). |
C17 |
How much do you agree or disagree with the following statement? Violence between dating partners can improve the relationship. |
x |
|
Question C20 from STREAMS first follow-up survey. Original Source: Acceptance of general dating violence scale (Foshee et al. 1992). |
C18 |
How much do you agree or disagree with the following statement? There are times when violence between dating partners is ok. |
x |
|
Question C21 from STREAMS first follow-up survey. Original Source: Acceptance of general dating violence scale (Foshee et al. 1992). |
C19 |
How much do you agree or disagree with the following statement? It’s okay to stay in a relationship even if you’re afraid of your dating partner. |
X |
|
Question C21a from STREAMS first follow-up survey. Original Source: Required item A5d from FaMLE Cross-Site PPS. |
C20 |
How much do you agree or disagree with the following statement? Sometimes violence is the only way to express your feelings. |
x |
|
Question C22 from STREAMS first follow-up survey. Original Source: Acceptance of general dating violence scale (Foshee et al. 1992). |
C21 |
How much do you agree or disagree with the following statement? Some couples must use violence to solve their problems. |
x |
|
Question C23 from STREAMS first follow-up survey. Original Source: Acceptance of general dating violence scale (Foshee et al. 1992). |
C22 |
How much do you agree or disagree with the following statement? Violence between dating partners is a personal matter and people should not interfere. |
x |
|
Question C24 from STREAMS first follow-up survey. Original Source: Acceptance of general dating violence scale (Foshee et al. 1992). |
C23 |
How much do you agree or disagree with the following statement? Two people who are in love do not need to use condoms/birth control. |
X |
|
Question C25 from STREAMS first follow-up survey. Original Source: Required item B1a from FaMLE Cross-Site PPS. |
C24 |
How much do you agree or disagree with the following statement? At my age right now, it is okay to have sexual intercourse if I use protection, like a condom, the pill, etc. |
X |
|
Question C26 from STREAMS first follow-up survey. Original Source: Required item B1g from FaMLE Cross-Site PPS. |
C25 |
How much do you agree or disagree with the following statement? If my dating partner wanted to have sex, but I didn’t, I would find it pretty hard to say “no”. |
X |
|
Question C26a from STREAMS first follow-up survey. Original Source: Required item B2a from FaMLE Cross-Site PPS. |
C26 |
How much do you agree or disagree with the following statement? Getting pregnant/getting a girl pregnant in the next year or two would hurt my chances of being successful in life. |
x |
|
Question C26b from STREAMS first follow-up survey. Original Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Smith et al. 2016). |
C26a |
If I got pregnant/got a girl pregnant in the next year or two, I would have to become a responsible adult before I wanted to. |
x |
|
Question C26c from STREAMS first follow-up survey. Original Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Smith et al. 2016). |
C26b |
If I got pregnant/got a girl pregnant in the next year or two, my life would become a lot better |
x |
|
Question C26d from STREAMS first follow-up survey. Original Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Smith et al. 2016). |
C26c |
It is important to finish school before having a child. |
|
X |
Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Goesling et al. 2015). Added to follow-up survey as a measure of the success sequence for poverty prevention. |
C26d |
It is important to have a job and stable income before having a child. |
|
X |
Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Goesling et al. 2015). Added to follow-up survey as a measure of the success sequence for poverty prevention. |
C26e |
Do you think the following statement is true or false? All sexually transmitted infections (STIs) can be cured. |
x |
|
Question C26e from STREAMS first follow-up survey. Original Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Goesling et al. 2015). |
C26f |
Do you think the following statement is true or false? A sexually active girl can become pregnant if she forgets to take her birth control pills for several days in a row. |
x |
|
Question C26f from STREAMS first follow-up survey. Original Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Goesling et al. 2015). |
C26g |
Do you think the following statement is true or false? Using a condom can help prevent HIV. |
x |
|
Question C26g from STREAMS first follow-up survey. Original Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Goesling et al. 2015). |
C26h |
Do you think the following statement is true or false? You cannot tell if a person has HIV by looking at them. |
x |
|
Question C26h from STREAMS first follow-up survey. Original Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Goesling et al. 2015). |
C26i |
Do you think the following statement is true or false? Latex condoms are 100% effective in preventing pregnancy and STIs (including HIV). |
x |
|
Question C26i from STREAMS first follow-up survey. Original Source: Evaluation of Adolescent Pregnancy Prevention Approaches (Goesling et al. 2015). |
C27 |
When you think of your future, what do you think are the chances that you will get married? |
x |
|
Question C27 from STREAMS first follow-up survey. Original Source: Adapted from FaMLE Cross-Site PPS. Added as a potential outcome of relationship education programming. |
C28 |
How likely is it that you will get married in the next 2 years? |
|
X |
Developed for STREAMS. Added to the follow-up survey as a measure of future plans for marriage. |
C28a |
When you think of your future, what do you think are the chances that you will be married to one person for life? |
X |
|
Question C28 from STREAMS first follow-up survey. Original Source: Required item A2a from FaMLE Cross-Site PPS. |
C29 |
When you think of your future, what do you think are the chances that you will live with a partner without being married? |
X |
|
Question C29 from STREAMS first follow-up survey. Original Source: Required item A2b from FaMLE Cross-Site PPS. |
C30 |
When you think of your future, what do you think are the chances that you will have children? |
x |
|
Question C30 from STREAMS first follow-up survey. Original Source: Adapted from FaMLE Cross-Site PPS. |
C31 |
When you think of your future, what do you think are the chances that you will have a child without being married? |
X |
|
Question C31 from STREAMS first follow-up survey. Original Source: Required item A2c from FaMLE Cross-Site PPS. |
C32 |
How likely is it that you will get pregnant/get a girl pregnant in the next 2 years? |
|
X |
Developed for STREAMS. Added to the follow-up survey as a measure of future plans for pregnancy. |
|
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D1 |
How much do you agree or disagree with the following statement? I believe I will be able to effectively deal with conflicts that arise in my relationships. |
x |
|
Question D1 from STREAMS first follow-up survey. Original Source: Relationship Confidence Subscale, Relationship Deciding Scale (Vennum and Fincham 2011). |
D2 |
How much do you agree or disagree with the following statement? I feel good about my ability to make a romantic relationship last. |
x |
|
Question D2 from STREAMS first follow-up survey. Original Source: Relationship Confidence Subscale, Relationship Deciding Scale (Vennum and Fincham 2011). |
D3 |
How much do you agree or disagree with the following statement? I am very confident when I think of having a stable, long term relationship. |
x |
|
Question D3 from STREAMS first follow-up survey. Original Source: Relationship Confidence Subscale, Relationship Deciding Scale (Vennum and Fincham 2011). |
D4 |
How much do you agree or disagree with the following statement? I have the skills needed for a lasting stable romantic relationship. |
x |
|
Question D4 from STREAMS first follow-up survey. Original Source: Relationship Confidence Subscale, Relationship Deciding Scale (Vennum and Fincham 2011). |
D4a |
How much do you agree or disagree with the following statement? I am able to recognize early on the warning signs in a bad relationship. |
x |
|
Question D4a from STREAMS first follow-up survey. Original Source: Warning Signs Subscale, Relationship Deciding Scale (Vennum and Fincham 2011). |
D4b |
How much do you agree or disagree with the following statement? I know what to do when I recognize the warning signs in a bad relationship. |
x |
|
Question D4b from STREAMS first follow-up survey. Original Source: Warning Signs Subscale, Relationship Deciding Scale (Vennum and Fincham 2011). |
D5 |
How good are you at admitting that you might be wrong during an argument? |
x |
|
Question D5 from STREAMS first follow-up survey. Original Source: Conflict Management Subscale, Interpersonal Competence Questionnaire (Buhrmester et al. 1988). |
D6 |
How good are you at avoiding saying things that could turn an argument into a big fight? |
x |
|
Question D6 from STREAMS first follow-up survey. Original Source: Conflict Management Subscale, Interpersonal Competence Questionnaire (Buhrmester et al. 1988). |
D7 |
How good are you accepting another person’s point of view even if you don’t agree with it? |
x |
|
Question D7 from STREAMS first follow-up survey. Original Source: Conflict Management Subscale, Interpersonal Competence Questionnaire (Buhrmester et al. 1988). |
D8 |
How good are you at listening to another person’s opinion during an argument? |
x |
|
Question D8 from STREAMS first follow-up survey. Original Source: Conflict Management Subscale, Interpersonal Competence Questionnaire (Buhrmester et al. 1988). |
D9 |
How good are you at working through problems without arguing? |
x |
|
Question D9 from STREAMS first follow-up survey. Original Source: Conflict Management Subscale, Interpersonal Competence Questionnaire (Buhrmester et al. 1988). |
D10 |
How often do you show respect for teachers and neighbors? |
x |
|
Question D10 from STREAMS first follow-up survey. Original Source: National Survey of Children's Health. |
D11 |
How often do you get along well with other people your age? |
x |
|
Question D11 from STREAMS first follow-up survey. Original Source: National Survey of Children's Health. |
D12 |
How often do you try to understand other people’s feelings? |
x |
|
Question D12 from STREAMS first follow-up survey. Original Source: National Survey of Children's Health. |
D13 |
How often do you try to see things from another person’s point of view? |
x |
|
Question D13 from STREAMS first follow-up survey. Original Source: Child Trends Supporting Healthy Marriage (SHM) Project. |
D14 |
How often do you work hard to listen to what other people have to say? |
x |
|
Question D14 from STREAMS first follow-up survey. Original Source: Child Trends 3M Project. |
D15 |
How often do you say thank you when someone does something nice? |
x |
|
Question D15 from STREAMS first follow-up survey. Original Source: Child Trends 3M Project. |
D16 |
How often do you apologize when you’re wrong? |
x |
|
Question D16 from STREAMS first follow-up survey. Original Source: Child Trends 3M Project. |
|
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E1 |
Have you ever been in a romantic relationship or dated anyone? |
|
X |
Developed for STREAMS. Added to follow-up survey as a measure of romantic relationship experiences. |
E2 |
What is the length of your longest relationship? |
|
X |
Developed for STREAMS. Added to follow-up survey as a measure of romantic relationship experiences. |
E3 |
Are you still in this relationship? |
|
X |
Developed for STREAMS. Added to follow-up survey as a measure of romantic relationship experiences. |
E4 |
Which of the following reasons best describe why this relationship ended? |
|
X |
Question C5 from STREAMS Adult first follow-up survey. Original source: BSF Evaluation. Added to follow-up survey as a measure of romantic relationship experiences. |
E5 |
Do you think it is a good thing for you that you broke up? |
|
X |
Question C6 from STREAMS Adult first follow-up survey. Original source: Parents and Children Together (PACT) Evaluation. Added to follow-up survey as a measure of romantic relationship experiences. |
E6 |
How would you define the status of this relationship?/How would you define your current relationship status? |
x |
|
Question E1 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
E7 |
The following questions are about your current relationship. On a scale of 0-10, where 0 is not at all happy and 10 is completely happy, how happy would you say your current relationship is? |
x |
|
Question E2 from STREAMS first follow-up survey. Original Source: Adapted from Building Strong Families (BSF) 15 Month Follow-up. |
E8 |
How much do you agree or disagree with the following statement? I am very satisfied with how my partner and I talk to each other. |
x |
|
Question E3 from STREAMS first follow-up survey. Original Source: Relationship satisfaction scale (Kerpelman 2009). |
E9 |
How much do you agree or disagree with the following statement? I am very satisfied with how my partner and I treat each other. |
x |
|
Question E4 from STREAMS first follow-up survey. Original Source: Relationship satisfaction scale (Kerpelman 2009). |
E10 |
How much do you agree or disagree with the following statement? I can turn to my partner for advice about problems. |
x |
|
Question E5 from STREAMS first follow-up survey. Original Source: Relationship satisfaction scale (Kerpelman 2009). |
E11 |
Has your partner ever tried to keep you from seeing or talking with your friends? |
x |
|
Question E5a from STREAMS first follow-up survey. Original Source: Supporting Healthy Marriages (SHM) Evaluation. |
E12 |
Has your partner ever made you feel stupid? |
x |
|
Question E5b from STREAMS first follow-up survey. Original Source: Supporting Healthy Marriages (SHM) Evaluation. |
E13 |
Has your partner ever made you feel afraid that they might hurt you? |
x |
|
Question E5c from STREAMS first follow-up survey. Original Source: Supporting Healthy Marriages (SHM) Evaluation. |
E14 |
How often does your partner criticize your ideas? |
X |
|
Question E6 from STREAMS first follow-up survey. Original Source: Required item C2f from FaMLE Cross-Site PPS. |
E15 |
When you have a serious disagreement with your partner, how often do you end up throwing things or hitting something? |
X |
|
Question E9 from STREAMS first follow-up survey. Original ource: Source: Required item C3c from FaMLE Cross-Site PPS. |
E16 |
Do you consider yourself to be… (Sexual Preferences) |
x |
|
Question E12 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
E17 |
Have you ever had sexual intercourse? |
x |
|
Question E13 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
E18 |
In the past 3 months, have you ever had sexual intercourse? |
x |
|
Question E14 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
E19 |
In the past 3 months, have you ever had sexual intercourse without using a condom? |
x |
|
Question E15 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
E20 |
The next question is about your use of the following methods of birth control (condoms, birth control pills, the shot (Depo-provera), the patch, the ring (NuvaRing), IUD (Mirena, Paragard, or Skyla), implant (Implanon or Nexplanon). In the past 3 months, have you had sexual intercourse without using any of these methods of birth control? |
x |
|
Question E16 from STREAMS first follow-up survey. Original Source: Personal Responsibility Education Program (PREP) Multi-Component Evaluation. |
E21 |
Are you currently pregnant? |
X |
|
Question E17 from STREAMS first follow-up survey. Original Source: Required item C4a from FaMLE Cross-Site ACS. |
E22 |
Is anyone currently pregnant with your child? |
X |
|
Question E18 from STREAMS first follow-up survey. Original Source: Required item C4b from FaMLE Cross-Site ACS. |
E23 |
How many children do you have? (Do not include current pregnancies) |
|
X |
Source: Required item C5a from FaMLE Cross-Site ACS. |
|
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F1 |
The next questions are about how to contact you in the future for your next survey. What is your address? |
x |
|
Question F1 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F1a |
Before we hang up, can you please provide me with your full name and mailing address so we can mail your gift card? You should receive your card within two weeks. |
x |
|
Question F1a from STREAMS first follow-up survey. Original Source: Developed for STREAMS. |
F2 |
What is your cell phone number? |
x |
|
Question F2 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F2a |
Check here if you don’t have a cell phone |
x |
|
Question F2a from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F3 |
May we send you text messages? Message and data rates may apply. |
x |
|
Question F3 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F4 |
What is another phone number where you can be reached? |
x |
|
Question F4 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F4a |
Check here if you don’t have another phone number |
x |
|
Question F4a from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F5 |
Is this number, [F4], for a cell phone? |
x |
|
Question F5 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F6 |
Whose name is that number listed under? |
x |
|
Question F6 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F6a |
Check here if you don’t know |
x |
|
Question F6a from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F6b |
May we send you text messages at this number: ([FILL F4_phone])? Message and data rates may apply. |
x |
|
Question F6b from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F7 |
What is the best email address to reach you at? |
x |
|
Question F7 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F7a |
Check here if you don’t have an email address |
x |
|
Question F7a from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F8 |
If you have another email address, what is it? |
x |
|
Question F8 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F8a |
Check here if you don’t have another email address |
x |
|
Question F8a from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F9/F13 |
FIRST PERSON: As part of the study, we may contact you again in the future. In case you move, we would like the name, address and telephone number of up to two relatives (such as your parents or grandparents) or other adults who would know where you are. We will only contact them if we have trouble getting in touch with you directly. What is the name of the first person who will know where you are? SECOND PERSON: What is the name of another relative or adult who will know how to contact you a year from now? |
x |
|
Question F13 and F17 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F9a/F13a |
Check here is there is no one [else] who will know how to contact you |
x |
|
Question F13a and F17afrom STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F10/F14 |
What is [FILL NAME]’s relationship to you? |
x |
|
Question F14 and F18 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F11/F15 |
What is [FILL NAME]’s telephone number? |
x |
|
Question F15 and F19 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F11a/F15a |
Check here if you can’t find the number |
x |
|
Question 15a and F19a from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F12/F16 |
What is [FILL NAME]’s address? |
x |
|
Question F16 and F20 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
F17 |
How would you like to be contacted in the future? |
x |
|
Question F21 from STREAMS first follow-up survey. Original Source: Evaluation of the Impact of the Youth Build Program 30-Month Followup Modification. |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | BCollette |
File Modified | 0000-00-00 |
File Created | 2021-01-14 |