Attachment Q: Intermeditate Follow-up Survey Sources

S upporting Statement for OMB Clearance Request

Attachment Q: Intermediate Follow-up Survey Sources

National and Tribal Evaluation of the 2^nd Generation of the Health Profession Opportunity Grants (HPOG)

0970-0462

April 2019

Revised June 2020

Submitted by:

Office of Planning,
Research & Evaluation

Administration for Children & Families

U.S. Department of Health
and Human Services

Federal Project Officers:

Nicole Constance, Hilary Bruck, and Amelia Popham

#	Domain/Topic	Sources
Training and Employment History
A1	Status of employment or school enrollment at time of last interview	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 72-month Follow-up Survey (OMB No. 0970-0397)/HPOG 1.0 72-month Follow-up Survey (OMB No. 0970-0394). Modified
A2-A5	Job or school status at LASTINTERVIEW	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). Minor modifications.
A3	Other activities at LASTINTERVIEW	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A4	Any job or school spells since LASTINTERVIEW	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A5	If respondent had any job or school spell since LASTINTERVIEW, which did they do first	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A6	OMITTED
A7a and A7b	Number of preschool aged children in household	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
“Main” Activity Spell Details
A8 and A8a A8_1	Employer name and self-employment/School name School address (street, cross-street, and city)	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
A9-A9b	Spell start date	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). Modified to capture year and season if date unknown.
A10-A10c	Spell end date	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). Modified to capture year and season if date unknown; captures total time spent in that activity if season and year are unknown.
A11	Hours worked (job spells) Hours of attendance (school spells)	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). Modified for school spells under HPOG 2.0 to capture hours of attendance as opposed to full or part time enrollment.
A12a and A12b	Hours of child care respondent had to arrange in order to work or attend classes	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
A13-A14	Next activity after current spell ended	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A15	Did respondent ever work or go to school again?	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A16	Did respondent work or go to school first?	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A17	Identification of overlapping job spell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A18	Identification of overlapping school spell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A19	Main activity during gap period (4+ months between work and/or school spells)	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A20	Current employment status	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A21	Employed since last job spell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
“Subspell” Activity Details
A22	Employer or School name	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
A23 -A23b	Start date for this subspell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). Previously modified under HPOG 2.0 to capture year and season if date unknown.
A24-A24b	End date for this subspell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). Previously modified under HPOG 2.0 to capture year and season if date unknown; captures total time spent in that activity if year and season are unknown.
A24c	Hours worked (job subspells) Hours of attendance (school subspells)	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). Modified for subspells.
A24d	Hours of child care respondent had to arrange in order to work or attend classes for this subspell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)-revised for subspells.
A25	Working in same field as course of study	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
A26	Additional jobs worked or schools attended during this subspell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
	Additional schools attended during this subspell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
School Experiences
B1	Gaps in training for 4 weeks or more	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397). Minor modifications.
B1a	Number of 4 week gaps during this school spell	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B1b	Date stopped classes	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B1c	Date resumed classes	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B2	Participation in basic education classes	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-month Follow-Up Survey (OMB No. 0970-0397). Minor modifications to capture for each spell.
B2a	Completion of basic education classes	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-month Follow-Up Survey (OMB No. 0970-0397). Minor modifications to capture multiple spells.
B2b	Did classes help prepare for enrollment in regular college?	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
B3-B3a	Receipt of college credits	HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B3b-c	Verification of college credits earned	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/
B4	Completion status of for each spell	HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B5	Cost of training program	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/Workforce Incentives Act (WIA) Gold Standard Evaluation 15-month Follow up Survey (OMB No. 1205-0504). Minor modifications.
B6a-k	Financial support sources for school expenses	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-Month Follow-up Survey (OMB No. 0970-0397)/ HPOG 1.0 15- and 36-Month Follow-Up Surveys 0970-0394).
B7	Amount respondent paid to take classes	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
B8	Amount paid by respondent’s parents/family members	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/
B9	Student Loan Respondent Debt	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B9a	Student Loan Respondent Debt	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B10	Student Loan Family Debt	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B10a	Student Loan Family Debt	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
B11a-j	Financial support from school attended	B11a-e: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-month Follow-Up Survey (OMB No. 0970-0397). B11f-j: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-month Follow-Up Survey (OMB No. 0970-0397). Modified to capture costs incurred by others.
B12	OMITTED
B13	Services received from school	PACE 15-month Follow-Up Survey (OMB No. 0970-0397).
B14 B14a	Time spent in one-on-one service receipt	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
B15 B15a	Time spent in group service sessions	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
B16a-f	Participation in occupation related activities	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-month Follow-Up Survey (OMB No. 0970-0397).
Credentials
C1-C1b	Were courses taken to prepare for work in particular occupation? Was that occupation healthcare related?	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
C1c-C1d	OMITTED
C2-C2f	Academic degrees or diplomas receipt	C2, 2a, 2c-f: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/ PACE 15- and 36- and 72-Month Follow-Up Surveys (OMB No. 0970-0397). Original sources: based on the Green Jobs 15-Month Follow-Up Survey (OMB No. 1205-0481NOA), the 2005 National Household Education Survey (OMB No. 1850-0768), and the National Community College Survey of Student Engagement (CCSSE). C2b: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/Adult Training and Education Survey, Part of the 2016 National Household Education Survey (OMB No. 1850-0768).
C3 – C3i	Academic certificate receipt	C3-a-c: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15- and 36-Month Follow-Up Surveys (OMB No. 0970-0397). Modified to follow the format of the Adult Training and Education Survey, Part of the 2016 National Household Education Survey (OMB No. 1850-0768). C3d, 3g: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-and 36-Month Follow-Up Surveys (OMB No. 0970-0397). Original sources: based on the Green Jobs 15-Month Follow-Up Survey (OMB No. 1205-0481NOA), the 2005 National Household Education Survey (OMB No. 1850-0768), and the National Community College Survey of Student Engagement (CCSSE). C3e, C3i: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15- 36-, and 72-Month Follow-Up Surveys (OMB No. 0970-0397). C3h: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/Adult Training and Education Survey, Part of the 2016 National Household Education Survey (OMB No. 1850-0768). C3f: NEW
C4-C4f	Professional certification or state/industry license receipt C4e and C4f: OMITTED	C4: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15- and 36-Month Follow-Up Surveys (OMB No. 0970-0397). Modified to include introductory text to follow format of the Adult Training and Education Survey , Part of the 2016 National Household Education Survey (OMB No. 1850-0768) C4a, C4i: HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (OMB No. 0970-0397). C4b, C4d, and C4h: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15- and 36-Month Follow-Up Surveys (OMB No. 0970-0397). Original sources: based on the Green Jobs 15-Month Follow-Up Survey (OMB No. 1205-0481NOA), the 2005 National Household Education Survey (OMB No. 1850-0768), and the National Community College Survey of Student Engagement (CCSSE). C4c: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/Adult Training and Education Survey, Part of the 2016 National Household Education Survey (OMB No. 1850-0768). C4e, C4f: OMITTED C4g: NEW
C5	Work-based training	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (0970-0397). Original source Adult Training and Education Survey, Part of the 2016 National Household Education Survey (OMB No. 1850-0768). Modified to capture any work-based training, not most recent one.
C6	OMITTED
C7	OMITTED
C8a	Progress toward long-range education goals	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15- and 36-Month Follow-Up Surveys (OMB No. 0970-0397). Original sources: based on the Green Jobs 15-Month Follow-Up Survey (OMB No. 1205-0481NOA) and the 2005 National Household Education Survey (OMB No. 1850-0768).
C8b-c	Self-perception of career track progress	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE and HPOG 1.0 15-and 36-Month Follow-Up Surveys (OMB No. 0970-0397; OMB No. 0970-0394).
C9	Knowledge of additional training needs to advance in career	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
C10	Plans to pursue training for next level of occupation	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
Current / Most Recent Job
D1-2a	Industry	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (0970-0397). Original source American Community Survey (OMB No. 0607-0810 and OMB No. 0607-0936).
D3	Occupation	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (0970-0397). Original source the American Community Survey (OMB No. 0607-0810 and OMB No. 0607-0936).
D4	Job activities	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15- and 36-Month Follow-Up Surveys (OMB No. 0970-0397). Original source the American Community Survey (OMB No. 0607-0810 and OMB No. 0607-0936).
D5	Job title	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15- and 36-Month Follow-Up Surveys (OMB No. 0970-0397). Original source the American Community Survey (OMB No. 0607-0810 and OMB No. 0607-0936).
D6 D6a	Occupation related to healthcare and type of healthcare setting	D6: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394). D6a: NEW
D7- D7c	Job pay (hourly earnings/weekly pay for self-employed)	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36 and 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Survey (0970-0397).
D8- D8c	Requirement for shift work	8 and 8a: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE and HPOG 1.0 15- 36- and 72-Month Follow-Up Surveys (OMB No. 0970-0397; OMB No. 0970-0394).Originally taken n from Green Jobs 15-Month Follow-Up Survey (OMB No. 1205-0481NOA). 8b: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE and HPOG 1.0 72-Month Follow-Up Surveys (OMB No. 0970-0397/0970-0394). 8c: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
D9a-c	Job flexibility (hours and schedules)	9a: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-month Follow-Up Surveys (OMB No. 0970-0394). Originally modified question from the Education Longitudinal Study (OMB No. 1850-0652). Modified to change scale from numeric ranking to level of agreement. 9b-c: HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-and 72-month Follow-Up Surveys (OMB No. 0970-0394).
D10	Available benefits	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-month Follow-Up Survey (OMB No. 0970-0394). Originally a modified question from Green Jobs 15-Month Follow-Up Survey (OMB No. 1205-0481NOA). Modified to eliminate follow-up sub-items. Added item to capture personal time off, also referred to as earned time or paid time off.
D11	Quality of work life	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 72-month Follow-Up Survey (OMB No. 0970-0397).
D12-D13 D14	Self-perception of opportunities for career advancement D14-OMITTED	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397).). Original source: Project Quest 6-Year Follow-Up Survey (the evaluation of Project Quest is being conducted by the Economic Mobility Corporation with a grant from the Charles Stuart Mott Foundation).
D15a-d	Employer provided financial support for education and training (D15b, c, and d OMITTED)	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (0970-0397).
D16a-d	Employer provided non-financial support for education and training (D16a, b, and d OMITTED)	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (0970-0397).
Household Composition
E1	Household composition including marital status	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397). Original sources: Slight modification of American Community Survey (ACS) and the Supporting Healthy Marriages (SHM) baseline (OMB No. 0970-0299).
E2	How long respondent has been married or living with a romantic partner	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (0970-0397).
E2a	OMITTED
E2b	Ever been married or lived with a romantic partner during follow-up period	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (0970-0397).
E3	Number of adults in the household	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 72-Month Follow-up Survey (OMB No. 0970-0394)/PACE 72-Month Follow-up Survey (0970-0397).
E4	Number of children in the household	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 15-, 36-, and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 15-, 36-, and 72-Month Follow-up Surveys (0970-0397). Original source: based on the Supporting Healthy Marriages (SHM) baseline (OMB No. 0970-0299).
E5	Number of dependents in the household	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397). Original source: Employment, Retention, Advancement (ERA) Study (OMB No. 0970-0285). Modified 36-month language to shift from legal guardian to primary caregiver.
E6	Current fertility	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-, 36-, and 72-Month Follow-up Surveys (0970-0397). Modified wording for male respondents.
E7	Recent fertility	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PACE 15-, 36-, and 72-Month Follow-up Surveys (0970-0397). Modified wording for male respondents.
E8 and E9	OMITTED
Income and Adult Well Being
F1	Receipt of public benefits (F1d, j, k and l OMITTED)	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397). Original source: Supporting Healthy Marriages (SHM) baseline (OMB No. 0970-0299). Modified to ask for respondent and other household members in same question rather than separately and to revise child support question.
F2	Total personal income in prior month	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 15-, 36-, and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 15-, 36-, and 72-Month Follow-up Surveys (0970-0397). Original sources: based on the PACE Baseline intake form (BIF) (OMB No. 0970–0343).
F3	Total household income in prior month	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 15-, 36-, and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 15-, 36-, and 72-Month Follow-up Surveys (0970-0397). Original sources: based on the PACE BIF (OMB No. 0970–0343).
F4	EITC	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397).
F5	Types of student loans	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/2015 National Finance Capability Study State by State Survey (No OMB control number as it was privately funded.)
F6	Started loan repayment yet?	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
F7	OMITTED
F8	Material hardship	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397). Original source was modified question from Assets for Independence (AFI) Experiment: 12-Month Follow-Up Survey (OMB No. 0970-0414).
F9	Hunger, food insecurity	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397). Original source was exact question from Assets for Independence (AFI) Experiment 12-Month Follow-Up Survey (OMB No. 0970-0414).
F10	Making ends meet	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397) Original source was from PACE 15-Month Follow-Up Survey (OMB No. 0970-0397) and based on the PACE Self-administered questionnaire (SAQ (OMB No. 0970–0343).
F11	Ability to meet emergency expenses	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/Survey on Household Economics and Decision-Making (OMB No. 7100-0359).
F12-13	Health Insurance through employer or non-employer	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397). Modified to first capture whether those employed have insurance through employer and whether those unemployed have insurance through another source.
F14	Current housing	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/HPOG 1.0 36- and 72-Month Follow-up Surveys (OMB No. 0970-0394)/PACE 36- and 72-Month Follow-up Surveys (0970-0397). Original source Moving to Opportunity (MTO) Adult Survey (OMB No. 2528-0218).
F15-F15a	Whether respondent was doubled-up or living with friends or relatives and if so, for how long	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/Family Options Study 36-Month Follow-Up Survey (OMB No. 2528-0259).
F16	Physical health	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/National Health and Nutrition Examination Survey (OMB No. 0920-0237).
21st Century Skills/Cognitive Skills
G1	Computer skills utilization in everyday life	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/PIAAC Background Questionnaire (OMB Control No. 1850-0870). Modified to include only a subset of items.
G2	OMITTED
G3	OMITTED
G4	Self-directed learning	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)
G5	OMITTED	HPOG 2.0 Short-Term Follow-up Survey (OMB No. 0970-0462)/
COVID-19 Module
H1	Desire to work in healthcare post-COVID-19	NEW
H2	Desire to continue healthcare training post-COVID-19	NEW
H3	COVID-19 Effect on education and training	NEW
H4	COVID-19 employment changes	NEW
H5	Provision of direct care and setting	Epidemic Pandemic Impact Inventory- (EPII) Modified
H6	Provision of supportive care and setting	EPII-Modified
H7	Effect of COVID-19 on quality of life	H7a, b, c, and g: NEW H7d, e, g, and h: EPII-Modified
H8	Post-COVID financial resiliency	HPOG 2.0 Short-term Follow-up Survey-Modified
H9a-b	Concerns about COVID-19 and family well-being	H9a: Kaiser Family Foundation Poll: February 2020 Kaiser Health Tracking Poll H9b: COVID-19 measures associated with the study: Telling our stories in the age of COVID-19-Modified
Contact Information
I1 – I12	Respondent and Secondary Contact Information	HPOG 36-month Follow-Up Survey (OMB No. 0970-0394)/PACE 36-month Follow-Up Survey (OMB No. 0970-0397).
21st Century Literacy and Numeracy Skills Assessment
J1-J22	Multiple choice questions to assess literacy and numeracy skills	J1, J2,: Questions about numeracy skills found in the public domain-modified J3-J5, J7-J22: Newly developed Items developed by the Abt team for this instrument. Informed by items and scales from: the Health and Psychosocial Instruments (HAPI) and Health Literacy Toolshed databases, an intensive literature search; and other sources. J6: : HL: Questions about health literacy found in the public domain-modified