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pdfOMB CONTROL NUMBER: 0704-0604
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0604, is estimated to average 15 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number.
2021 Survey of Active Duty Spouses
7.
BACKGROUND INFORMATION
1.
What is your marital status?
Married
Separated
[Ask if Q6 = "Yes"] How many children under
the age of 18 do you or your spouse have,
living at home either part-time or full-time, in
each age group? Please select the number of
children you have in each age group. To
indicate none, select “0”. To indicate more
than nine, select “9”.
Less than 1 year old
Divorced
Widowed
1 year to less than 2 years old
2.
Is your spouse currently serving on active duty
(not a member of the National Guard or
Reserve)?
2 to 5 years old
Yes
No
3.
How many years have you been married? To
indicate less than 1 year, enter “0”.
Years
4.
6 to 13 years old
14 to less than 18 years old
Are you Spanish/Hispanic/Latino?
No, not Spanish/Hispanic/Latino
Yes, Mexican, Mexican-American, Chicano,
Puerto Rican, Cuban, or other Spanish/
Hispanic/Latino
5.
What is your race? Mark one or more races to
indicate what you consider yourself to be.
White
Black or African American
American Indian or Alaska Native
Asian (e.g., Asian Indian, Chinese, Filipino,
Japanese, Korean, or Vietnamese)
Native Hawaiian or other Pacific Islander (e.g.,
Samoan, Guamanian, or Chamorro)
YOUR FAMILY
6.
Do you or your spouse have any children under
the age of 18 living at home either part-time or
full-time?
Yes
No
OPA
1
Error! Reference source not found.
8.
[Ask if Q6 = "Yes"] At any time during the
2020–2021 school year, how many children in
this household were enrolled in kindergarten
through 12th grade or grade equivalent?
Please select the number of children in each
type of school. To indicate none, select “0”.
To indicate more than nine, select “9”.
The following items will help us understand a bit about your
child care arrangements for children in the household.
10. [Ask if Q6 = "Yes"] During the work day, do you
routinely use the following sources of child
care? Mark “Yes” or “No” for each item.
No
Number enrolled in a public school
Yes
a.
b.
Number enrolled in a private school
c.
Number attending a Department of Defense-run
school (DoDEA Americas, DoDEA Europe or
DoDEA Pacific)
Number homeschooled, that is not enrolled in public
or private school
d.
Military child care center ............................
Military (or military-affiliated) family child
care home..................................................
Civilian child care—receiving military child
care fee assistance....................................
Civilian child care—not receiving military
child care fee assistance ...........................
11. [Ask if Q6 = "Yes"] How many of your child(ren)
in each age group routinely use child care
arrangements? Mark one answer in each row.
To indicate none, select “0”. To indicate more
than nine, select “9”.
Less than 1 year old
Not enrolled in any type of school
1 year to less than 2 years old
9.
[Ask if Q6 = "Yes" AND (Q8 a > "0" OR Q8 b >
"0" OR Q8 c > "0" OR Q8 d > "0")] During the
2020–2021 school year, how did the children in
this household receive their education? Mark
all that apply.
2 to 5 years old
6 to 13 years old
Children received live instruction from a teacher
in person at their school
Children received live instruction from a teacher
on-line/virtually
14 to less than 18 years old
Children learned on their own using on-line
materials provided by their school
Children learned on their own using paper
materials provided by their school
Children learned on their own using materials
that were NOT provided by their school
Children did not participate in any learning
activities because their school was closed
Children were sick and could not participate in
education
Other
12. [Ask if Q6 = "Yes" AND (Q11 a > "0" OR Q11 b >
"0" OR Q11 c > "0" OR Q11 d > "0" OR Q11 e >
"0")] At any time in the last year, were any
children in the household unable to attend day
care or another child care arrangement
because of the coronavirus pandemic? Please
include before school care, after school care,
and all other forms of childcare that were
unavailable.
Yes
[Ask if Q6 = "Yes" AND (Q8 a > "0" OR Q8 b >
"0" OR Q8 c > "0" OR Q8 d > "0") AND Q9 h =
"Marked"] During the 2020–2021 school year,
what other way did the children in this
household receive their education? Do not
provide any personally identifiable information.
2
No
OPA
OMB CONTROL NUMBER: 0704-0604
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0604, is estimated to average 15 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number.
2021 Survey of Active Duty Spouses
13. [Ask if Q6 = "Yes" AND (Q11 a > "0" OR Q11 b >
"0" OR Q11 c > "0" OR Q11 d > "0" OR Q11 e >
"0") AND Q12 = "Yes"] Which if any of the
following occurred as a result of child care
being closed or unavailable? Mark all that
apply.
You (or another adult) took unpaid leave to care
for your children
COVID-19
15. Have you received a COVID-19 vaccine?
Yes
No
16. [Ask if Q15 = "Yes"] Did you receive (or do you
plan to receive) all required doses?
You (or another adult) used vacation or sick
days in order to care for your children
Yes
You (or another adult) cut your hours in order to
care for your children
No
You (or another adult) left a job in order to care
for your children
17. [Ask if Q15 = "No"] Once a vaccine to prevent
COVID-19 is available to you, would you…
You (or another adult) lost a job because of time
away to care for your children
Definitely get a vaccine
You (or another adult) did not look for a job in
order to care for your children
Probably get a vaccine
Be unsure about getting a vaccine
You (or another adult) supervised one or more
children while working
Probably NOT get a vaccine
None of the above
Definitely NOT get a vaccine
Other
[Ask if Q6 = "Yes" AND (Q11 a > "0" OR Q11 b >
"0" OR Q11 c > "0" OR Q11 d > "0" OR Q11 e >
"0") AND Q12 = "Yes" AND Q13 i = "Marked"]
Please specify any other outcomes of child
care being closed or unavailable. Do not
provide any personally identifiable information.
14. [Ask if Q6 = "Yes" AND (Q10 a = "No" AND Q10
b = "No") AND (Q11 a > "0" OR Q11 b > "0" OR
Q11 c > "0" OR Q11 d > "0" OR Q11 e > "0")]
Which of the following are reasons why you do
not use military child care? Mark “Yes” or
“No” for each item.
No
Yes
OPA
a.
Availability of child care .............................
b.
Quality of child care ...................................
c.
Affordability of child care ...........................
d.
Inconvenient location .................................
e.
Operating hours .........................................
3
Error! Reference source not found.
18. [Ask if (Q15 = "Yes" AND Q16 = "No") OR (Q15
= "No" AND (Q17 = "Probably get a vaccine"
OR Q17 = "Be unsure about getting a vaccine"
OR Q17 = "Probably NOT get a vaccine" OR
Q17 = "Definitely NOT get a vaccine"))] Which
of the following, if any, are reasons that you
[have not gotten all required doses of] [only
probably would get] [are unsure about getting]
[probably would not get] [definitely would not
get] a COVID-19 vaccine? Mark all that apply.
I am concerned about possible side effects of a
COVID-19 vaccine
I don't know if a COVID-19 vaccine will work
I don't believe I need a COVID-19 vaccine
I don't like vaccines
19. [Ask if ((Q15 = "Yes" AND Q16 = "No") OR (Q15
= "No" AND (Q17 = "Probably get a vaccine"
OR Q17 = "Be unsure about getting a vaccine"
OR Q17 = "Probably NOT get a vaccine" OR
Q17 = "Definitely NOT get a vaccine")) AND
Q18 = "I don't believe I need a COVID-19
vaccine")] Why do you believe that you don't
need a COVID-19 vaccine? Mark all that apply.
I already had COVID-19
I am not a member of a high-risk group
I plan to use masks or other precautions instead
I don't believe COVID-19 is a serious illness
I don't think vaccines are beneficial
Other
My doctor has not recommended it
I plan to wait and see if it is safe and may get it
later
I think other people need it more than I do right
now
I am concerned about the cost of a COVID-19
vaccine
20. Has a doctor or other health care provider ever
told you that you have COVID-19?
Yes
No
Not sure
I don't trust COVID-19 vaccines
I don't trust the government
Other
[Ask if (Q15 = "Yes" AND Q16 = "No") OR (Q15
= "No" AND (Q17 = "Probably get a vaccine"
OR Q17 = "Be unsure about getting a vaccine"
OR Q17 = "Probably NOT get a vaccine" OR
Q17 = "Definitely NOT get a vaccine")) AND
Q18 k = "Marked"] What are some other
reasons that you [have not gotten all required
doses of] [only probably would get] [are unsure
about getting] [probably would not get]
[definitely would not get] a COVID-19 vaccine?
Do not provide any personally identifiable
information.
SERVICE, EDUCATION, AND EMPLOYMENT
21. Have you previously served in an active duty
Service (e.g., Army, Navy, Marine Corps, Air
Force, Coast Guard) or National Guard/
Reserve? Mark one.
No
Yes, I served in an active duty Service or
National Guard/Reserve, but did NOT retire
Yes, I served in an active duty Service or
National Guard/Reserve and retired
22. Are you currently serving in the military?
Yes, on active duty (not a member of the
National Guard/Reserve)
Yes, as a member of the National Guard or
Reserve in a full-time active duty program
(AGR/FTS/AR)
Yes, as a traditional National Guard/Reserve
member (e.g., drilling unit, IMA, IRR)
No
23. [Ask if Q22 = "No" or Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" or Q22 = .] Last
week, did you do any work for pay or profit?
Mark “Yes” even if you worked only one hour,
or helped without pay in a family business or
farm for 15 hours or more.
Yes
No
4
OPA
OMB CONTROL NUMBER: 0704-0604
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0604, is estimated to average 15 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number.
2021 Survey of Active Duty Spouses
24. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
Q23 = "No"] Last week, were you temporarily
absent from a job or business?
Yes, on vacation, temporary illness, labor
dispute, etc.
I am/was sick (not coronavirus related) or
disabled
No
I am retired
25. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
Q23 = "No" AND Q24 = "No"] Have you been
looking for work during the last four weeks?
Yes
I am/was caring for children not in school or
daycare
I was preparing for/recovering from a
Permanent Change of Station (PCS) move
I was unable to work while my spouse was
deployed
I do/did not have transportation to work
No
I did not want to be employed at this time
26. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
Q23 = "No" AND Q24 = "No" AND Q25 = "Yes"]
Last week, could you have started a job if one
had been offered?
Yes
I am/was caring for someone or sick myself with
coronavirus symptoms
I was concerned about getting or spreading the
coronavirus
I am/was laid off or furloughed due to
coronavirus pandemic
My employer closed temporarily due to the
coronavirus pandemic
No
27. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
Q23 = "No" AND Q24 = "No" AND Q25 = "Yes"]
How many weeks have you been looking for
work? If you have been looking for work for
less than one week, enter “0”. If you have been
looking for work for more than one year, enter
“52”.
Weeks
OPA
28. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
Q23 = "No"] What is your main reason for not
working for pay or profit? Mark one.
My employer went out of business due to the
coronavirus pandemic
Other
[Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
Q23 = "No" AND Q28 = "Other"] Please specify
any other reasons you have not worked for pay
or profit. Do not provide any personally
identifiable information.
5
Error! Reference source not found.
29. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
(Q23 = "Yes" OR (Q23 = "No" AND Q24 = "Yes,
on vacation, temporary illness, labor dispute,
etc."))] Are you employed by government, by a
private company, a nonprofit organization, or
are you self-employed or working in a family
business? Mark one.
32. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
(Q23 = "Yes" OR (Q23 = "No" AND Q24 = "Yes,
on vacation, temporary illness, labor dispute,
etc."))] Are you currently employed within the
area of your education or training?
Yes
No
Government
Private company
Non-profit organization including tax exempt
and charitable organizations
Self-employed
Working in a family business
30. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
(Q23 = "Yes" OR (Q23 = "No" AND Q24 = "Yes,
on vacation, temporary illness, labor dispute,
etc."))] On average, how many hours a week do
you spend working for pay (including hours
worked for a family business or farm)?
Hours
31. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
(Q23 = "Yes" OR (Q23 = "No" AND Q24 = "Yes,
on vacation, temporary illness, labor dispute,
etc."))] Please indicate how much you agree or
disagree with the following statements. Mark
one answer for each item.
Strongly disagree
Disagree
33. [Ask if (Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
(Q23 = "Yes" OR (Q23 = "No" AND Q24 = "Yes,
on vacation, temporary illness, labor dispute,
etc."))] Does your employer offer the
following... Mark “Yes” or “No” for each item.
No
Yes
a.
Flexible scheduling? ..................................
b.
Remote work? ...........................................
34. What is the highest degree or level of school
that you have completed? Mark the one
answer that describes the highest grade or
degree that you have completed.
12 years or less of school (no diploma)
High school graduate—high school diploma or
equivalent (e.g., GED)
Some college credit, no degree
Vocational or technical diploma
Associate's degree
Bachelor's degree
Advanced degree (e.g., MA/MS/PhD/MD/JD)
Neither agree nor disagree
Agree
Strongly agree
a.
b.
c.
d.
e.
f.
6
I am paid less than those
with similar credentials .....
Given my credentials, I
should have a higher
position at work ................
I need to find a job that
allows me to work more
hours ................................
I work in temporary
positions, but I would
prefer not to ......................
I had to take a job outside
of my field .........................
My pay is not enough to
live on ...............................
OPA
OMB CONTROL NUMBER: 0704-0604
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0604, is estimated to average 15 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number.
2021 Survey of Active Duty Spouses
35. In what career field is your current or most
recent employment? Mark one.
Not applicable, I have never been employed
36. What barriers have you faced in entering your
most recent or current career field? Mark all
that apply.
Pay does not cover cost of child care
Administrative services (e.g., administrative
assistant, secretary)
Lack vocational training
Child care and child development (e.g., attend
to children at schools, businesses, private
households, and childcare institutions)
Lack required 2-year degree
Lack required 4-year degree
Communications and marketing (e.g., writer/
editor, call center, film/TV, social media, web
development)
Lack required certification
Lack transferability of certifications/licensure
Community and social services (e.g., mental
health counselor, social worker, probation
officers and correctional treatment specialists,
school bus monitor)
Lack experience
Lack available/flexible child care
Frequent moves
Education (e.g., teacher, teacher's assistant)
Lack of jobs in my field in my current location
Financial services (e.g., claim adjuster, credit
analyst, accountant, financial counselor, banker,
insurance agent)
Medical or health limitations
Caregiver (non child) requirements
Health care practitioners and technical
occupations (e.g., nurse, dental hygienist,
pharmacist, medical records specialist, dentist,
doctor, paramedic, optician, veterinarian)
Health care support (e.g., home health aide,
nursing assistant, occupational or physical
therapy aid)
Information technology (e.g., network analyst,
database administrator)
Lack of part-time options
Lack of flexible hours/flexible schedule
Not applicable
37. Regardless of your current employment status,
does your occupation or career field require...
Mark “Yes” or “No” for each item.
Legal (e.g., lawyer, paralegal, legal assistant,
mediator, magistrate)
Protective services (e.g., correctional officer,
firefighter, police officer, animal control worker,
security guard)
Recreation and hospitality (e.g., restaurant,
hotel business/management, personal trainer,
ticket agent)
No
Yes
a.
A certification provided by an organization
that sets standards for your occupation? ...
b.
A state issued license? ..............................
Retail and customer service (e.g., cashier, sales
person, customer service representative,
manager)
Skilled trades (e.g., electrician, cosmetology,
plumber, construction, welder)
Software development (e.g., coding)
Transportation and material moving occupations
(e.g., aircraft service attendant; parking
attendant; bus, taxi or truck driver)
Other occupations which require a state license
Other occupations which do NOT require a
state license
OPA
7
Error! Reference source not found.
38. [Ask if Q37 a = "Yes" OR Q37 b = "Yes"] What
kind of professional license/certification/
credential does your career field require? Mark
one.
41. [Ask if Q40 = "No, but I am aware of this
resource"] What is the main reason you did not
use a MyCAA Scholarship? Mark one.
I am not eligible because of my husband/wife's
rank.
Accounting
I will not be eligible long enough to use MyCAA
(e.g., my spouse will soon be promoted or leave
the military).
Architecture
Counseling (e.g., professional counselor,
marriage and family therapist)
Dentistry/Dental hygiene
I need education, training, or testing not
covered by MyCAA.
Law (e.g., attorney)
I have limited time for additional education/
training because of family/personal obligations.
Massage therapy
I am not interested in additional education/
training.
Medicine
I do not feel that additional education/training
are important for my career.
Nursing
Occupational therapy
Pharmacy/Pharmacy technician
Physical therapy
Professional engineer
Skilled trade (e.g., master electrician, plumber,
heating, air conditioning, ventilation and
refrigeration)
Social work
Teaching (elementary and secondary)
Other
FOOD SECURITY
These next questions are about the food eaten in your
household in the last 12 months, since %%currentmonth%%
of last year, and whether you were able to afford the food you
need.
42. The following are statements that people have
made about their food situation. How often
were each of the following statements true for
you and your household in the past 12
months—that is, since the last
%%currentmonth%%? Mark one answer for
each item.
39. Are you working toward or did you receive a
new credential(s) or certification, in the last 12
months? Mark all that apply.
Don't know
Often true
High school graduate—high school diploma or
equivalent (e.g., GED)
Sometimes true
Vocational or technical diploma
Associate's degree
Never true
a.
Bachelor's degree
Master's, doctoral, or professional school
degree
Professional license
Professional certificate
None/Not applicable
40. Have you used a Military Spouse Career
Advancement Accounts (MyCAA) Scholarship?
Mark one.
Yes, in the past 12 months
b.
The food that I/we bought just
didn't last, and I/we didn't have
money to get more....................
I/We couldn't afford to eat
balanced meals. .......................
43. In the past 12 months, since last
%%currentmonth%%, did you or other adults in
your household ever cut the size of your meals
or skip meals because there was not enough
money for food?
Yes
No
Don't know
Yes, but not in the past 12 months
No, and I was not aware of this resource
No, but I am aware of this resource
8
OPA
OMB CONTROL NUMBER: 0704-0604
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0604, is estimated to average 15 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number.
2021 Survey of Active Duty Spouses
44. [Ask if Q43 = "Yes"] In the past 12 months, how
often did you or other adults in your household
cut the size of your meals or skip meals
because there was not enough money for
food?
Almost every month
Some months but not every month
Only 1 or 2 months
Don't know
49. [Ask if Q47 = "No"] Which of the following best
describes where your spouse currently lives?
Military housing, on base
Military housing, off base
Civilian housing
50. [Ask if Q48 = "Military housing, off base" OR
Q48 = "Civilian housing"] How close do you
live to a military base/installation?
Less than 30 minutes
45. In the past 12 months, did you ever eat less
than you felt you should because there was not
enough money for food?
Yes
30 minutes to less than 1 hour
1 to 2 hours
More than 2 hours
No
Don't know
46. In the past 12 months, were you ever hungry
but did not eat because there was not enough
money for food?
LIFE IN THE MILITARY
51. Overall, how satisfied are you with the military
way of life?
Very satisfied
Yes
Satisfied
No
Neither satisfied nor dissatisfied
Don't know
Dissatisfied
Very dissatisfied
RESIDENCE/WHERE YOU LIVE
47. Do you and your spouse currently reside
together in the same home (except for during
deployments)?
52. Do you think your spouse should stay on or
leave active duty?
I strongly favor staying
Yes
I somewhat favor staying
No
I have no opinion one way or the other
I somewhat favor leaving
48. Which of the following best describes where
you currently live?
I strongly favor leaving
Military housing, on base
Military housing, off base
Civilian housing
PERMANENT CHANGE OF STATION (PCS)
53. During your spouse's active duty career, have
you ever experienced a PCS move?
Yes
No
OPA
9
Error! Reference source not found.
54. [Ask if Q53 = "Yes"] In what month and year
was your last PCS move?
Does not apply
Not a problem
Month
Small extent
Moderate extent
Year
Large extent
Very large extent
55. [Ask if Q53 = "Yes"] For your most recent PCS
move, to what extent were the following a
problem for you? Mark one answer for each
item.
j.
Does not apply
Not a problem
Small extent
Moderate extent
k.
Large extent
Very large extent
a.
b.
c.
d.
e.
f.
g.
h.
i.
10
Loss or
decrease of
your income ......
Finding
employment ......
Changing
schools for your
education ..........
Obtaining
licenses/
certifications
necessary for
employment ......
Availability of
special medical
and/or
educational
services for
yourself .............
Coordinating
move with
moving
company ...........
Timeliness of
receiving
household
goods................
Waiting for
permanent
housing to
become
available ...........
Settling claims
for damaged or
missing
household
goods................
Un-reimbursable
moving costs
(e.g., housing
deposits, costs
of setting up
new residency,
temporary
lodging costs,
transportation
costs) ................
Access to
relocation
information,
services, or
support .............
56. [Ask if Q53 = "Yes" AND Q6 = "Yes"] For your
most recent PCS move, to what extent were the
following a problem for your child(ren)? Mark
one answer for each item.
Does not apply
Not a problem
Small extent
Moderate extent
Large extent
Very large extent
a.
b.
c.
d.
My child(ren)
changing
schools .............
Availability of
child care ..........
Availability of
special medical
and/or
educational
services for my
child ..................
Missed
deadlines for
participating in
extracurricular
activities/sports .
OPA
OMB CONTROL NUMBER: 0704-0604
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0604, is estimated to average 15 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number.
2021 Survey of Active Duty Spouses
Does not apply
Not a problem
60. [Ask if Q53 = "Yes" AND Q59 > "0"] What are
some reasons you chose to remain in place
and not PCS with your spouse? Do not provide
any personally identifiable information.
Small extent
Moderate extent
Large extent
DEPLOYMENT
Very large extent
e.
Missed
deadlines for
placement
lotteries in
magnet schools/
charter schools/
special
programs ..........
61. During your spouse's active duty career, has
he/she been deployed for more than 30
consecutive days?
Yes, in the past 36 months
Yes, but not in the past 36 months
No
57. [Ask if Q53 = "Yes"] How long did it take you to
find employment after your last PCS move?
Mark one.
Less than 1 month
1 month to less than 4 months
4 months to less than 7 months
62. [Ask if Q61 = "Yes, in the past 36 months" OR
Q61 = "Yes, but not in the past 36 months"]
During your spouse's most recent deployment,
to what extent were each of the following a
problem for you? Mark one answer for each
item.
Very large extent
7 months to less than 10 months
Large extent
10 months or more
Moderate extent
Sought but could not find employment after last
PCS move
Small extent
Did not seek employment after last PCS move
Not at all
58. [Ask if Q53 = "Yes"] After your last PCS move,
did you have to acquire a new professional or
occupational license or credential in order to
work at the new duty location?
a.
b.
Yes
c.
No
d.
Does not apply
e.
59. [Ask if Q53 = "Yes"] During your spouse's
active duty career, how many times have you
chosen to remain in place/not PCS with your
spouse? To indicate “never,” enter “0”.
Times
f.
g.
h.
OPA
My job and/or educational
demands ...........................
Managing expenses and
bills ...................................
Home/car repairs/
maintenance or yard work
Safety of my family in our
community ........................
Health problems in the
family, including emotional
problems ...........................
Technical difficulties
communicating with my
spouse ..............................
Marital problems, difficulty
maintaining emotional
connection with spouse ....
Loneliness, dealing with
issues/decisions alone ......
11
Error! Reference source not found.
Very large extent
Large extent
Moderate extent
Small extent
Not at all
i.
j.
k.
l.
Parenting alone,
managing child care/child
schedules, school/
education, etc ...................
No time for recreation,
fitness, or entertainment
activities............................
A lack of and/or problems
with military offered
support for myself/my
family ................................
65. [Ask if (Q61 = "Yes, in the past 36 months" OR
Q61 = "Yes, but not in the past 36 months")
AND (Q64 = "Yes, but my spouse has since
redeployed" OR Q64 = "Yes, and my spouse
has not redeployed")] After your spouse most
recently returned home from a deployment, to
what extent did your spouse seem to... Mark
one answer for each item.
Very large extent
Large extent
Moderate extent
Small extent
Not at all
a.
Other ................................
63. [Ask if Q61 = "Yes, in the past 36 months" OR
Q61 = "Yes, but not in the past 36 months"]
Was your spouse's most recent deployment to
a combat zone (e.g., an area where he/she drew
imminent danger pay or hostile fire pay)? Mark
one.
b.
c.
No
Yes, deployed to Iraq/Afghanistan
Yes, deployed to a combat zone other than Iraq/
Afghanistan
64. [Ask if Q61 = "Yes, in the past 36 months" OR
Q61 = "Yes, but not in the past 36 months"]
Has your spouse returned home from a
deployment? Mark one.
Yes, but my spouse has since redeployed
Yes, and my spouse has not redeployed
No
Be more emotionally
distant (e.g., less talkative,
less affectionate, less
interested in social life)? ...
Show negative personality
changes (e.g., more
critical, indifferent to
family/life)? .......................
Show positive personality
changes (e.g., more
attentive, more
agreeable)? ......................
d.
Appreciate life more?........
e.
f.
Get angry faster? ..............
Appreciate family and
friends more?....................
Have mental health
concerns (e.g., anxiety,
being “on guard”)? ............
g.
h.
Drink more alcohol?..........
i.
j.
Have more confidence? ....
Take more risks with his/
her safety? ........................
Have difficulty adjusting
(e.g., to family
responsibilities, to civilian
life)?..................................
k.
l. Have trouble sleeping? .....
m. Have difficulty with day-today activities (e.g., driving,
eating, hygiene)? ..............
n. Be different in another
way? .................................
12
OPA
OMB CONTROL NUMBER: 0704-0604
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0604, is estimated to average 15 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number.
2021 Survey of Active Duty Spouses
[Ask if (Q61 = "Yes, in the past 36 months" OR
Q61 = "Yes, but not in the past 36 months")
AND (Q64 = "Yes, but my spouse has since
redeployed" OR Q64 = "Yes, and my spouse
has not redeployed") AND (Q65 n = "Very large
extent" or Q65 n = "Large extent" or Q65 n =
"Moderate extent" or Q65 n = "Small extent")]
In what other way(s) did your spouse change
after returning home from his/her most recent
deployment? Do not provide any personally
identifiable information.
68. Have you seen a counselor... Mark “Yes” or
“No” for each item.
No
Yes
a.
During your spouse's active duty career? ..
b.
In the past six months? ..............................
FINANCIAL CONDITION
69. In 2020, what was your total household income
before taxes?
Less than $25,000
YOUR PERSONAL LIFE AND SUPPORT
66. Taking things altogether, how satisfied are you
with your marriage right now?
$25,000–$34,999
$35,000–$49,999
$50,000–$74,999
Very satisfied
$75,000–$99,999
Satisfied
$100,000–$149,999
Neither satisfied nor dissatisfied
$150,000–$199,999
Dissatisfied
$200,000 and above
Very dissatisfied
67. Over the last 7 days, how often have you been
bothered by any of the following problems?
Mark one answer for each item.
Nearly every day
More than half the days
Several days
Not at all
a.
b.
c.
d.
OPA
Little interest or pleasure in
doing things ..............................
Feeling down, depressed, or
hopeless ...................................
Feeling nervous, anxious, or on
edge .........................................
Not being able to stop or
control worrying ........................
70. [Ask if ((Q22 = "No" OR Q22 = "Yes, as a
traditional National Guard/Reserve member
(e.g., drilling unit, IMA, IRR)" OR Q22 = .) AND
(Q23 = "Yes" OR (Q23 = "No" AND Q24 = "Yes,
on vacation, temporary illness, labor dispute,
etc."))) OR (Q22 = "Yes, on active duty (not a
member of the National Guard/Reserve)" OR
Q22 = "Yes, as a member of the National Guard
or Reserve in a full-time active duty program
(AGR/FTS/AR)")] How much does your income
contribute toward your total household
income?
Less than 50%
50%
More than 50%
13
Error! Reference source not found.
71. Thinking about your experiences over the last
year, which of the following did you or your
household members use to meet your
spending needs? Mark all that apply.
Regular income sources like those received
before the pandemic
COMMENTS
74. Please share what the military could do to
improve support for you and your family. Do
not provide any personally identifiable
information.
Credit cards or loans
Money from savings or selling assets (including
withdrawals from retirement accounts)
Borrowing from friends or family
Unemployment insurance (UI) benefit payments
75. Please describe the top issue(s) impacting the
quality of life for you and your family. Do not
provide any personally identifiable information.
Stimulus (economic impact) payment
Money saved from deferred or forgiven
payments (to meet your spending needs)
Supplemental Nutrition Assistance Program
(SNAP)
72. How well does each statement describe you or
your situation? Mark one answer for each item.
Completely
Very well
Somewhat
Very little
Not at all
a.
b.
c.
76. [Ask if Q1 = "Widowed" OR Q1 = "Divorced"
OR Q2 = "No"] Based on your answers to
previous questions, you are ineligible to take
this survey. If you feel you have encountered
this message in error, click the back arrow
button and check your answers.
If you have any additional comments or concerns,
please enter them below.
To submit your answers click Submit. For further
help, please call our Survey Processing Center
toll-free at 1-800-881-5307 or e-mail ADSSurvey@mail.mil.
Do not provide any personally identifiable
information.
Because of my money
situation, I feel like I will
never have the things I
want in life ........................
I am just getting by
financially..........................
I am concerned that the
money I have or will save
won't last ..........................
73. How often does each statement apply to you?
Mark one answer for each item.
Always
Often
Sometimes
Rarely
Never
14
a.
I have money left over at
the end of the month ........
b.
My finances control my life
OPA
File Type | application/pdf |
File Modified | 2021-08-04 |
File Created | 2021-08-04 |