Third follow-up survey

OPRE Evaluation: Evaluation of Employment Coaching for TANF and Other Related Populations [Experimental impact study and an Implementation study]

Attachment Q Third follow-up survey_public_v2_clean

Third follow-up survey

OMB: 0970-0506

Document [docx]
Download: docx | pdf

Shape1





Evaluation of Employment Coaching for TANF and Related Populations

Third Follow-up Survey

February 2022

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0970-0506. The time required to complete this information collection is estimated to average 45 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.



PUBLIC VERSION


CONTENTS

Section Page

i INTRODUCTION 3

CV Consent and verification 13

A. economic stability 19

B. employment Challenges and skills 33

C. sERVICE RECEIPT 41

D. Demographics 45

E. contact information 49



Shape2

PROGRAMMER:

PRELOAD program NAMES.



PROGRAMMER BOX IN0.

IF DIAL OUT, GO TO IN1;

IF FIELD CALL IN, GO TO IN2;

IF RESPONDENT CALL IN, GO TO IN3.



CALL OUT

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

SPEAKING TO [NAME] 1 GO TO IN13

[NAME] COMES TO PHONE 2 GO TO IN13

PERSON ASKS WHAT CALL IS ABOUT 3 GO TO IN4

[NAME] IS NOT AVAILABLE 4 GO TO IN6

[NAME] IS INCARCERATED 5 GO TO IN8

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

NEVER HEARD OF [NAME] / WRONG NUMBER 7 IN22, STATUS 1530

[NAME] IS DECEASED 8 GO TO IN12

[NAME] DOES NOT SPEAK ENGLISH 9 IN22, STATUS 1401

HUNG UP 10 STATUS 1240

REFUSED r STATUS 1220

FIELD CALL IN

IN2. May I have your first name?

(STRING 20)

FIELD INTERVIEWER FIRST NAME



IN2 = ANSWERED (FIELD CALL IN)

IN2a. And your last name?

(STRING 30)

FIELD INTERVIEWER LAST NAME




IN2a = ANSWERED (FIELD CALL IN)

IN2b. May I have your field interviewer ID number?

| | | | | |

(0000 - 99999)



IN2b = ANSWERED (FIELD CALL IN)

IN2c. CODE PURPOSE OF FIELD CALL IN

CALLED TO COMPLETE INTERVIEW 1 GO TO IN13

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

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



RESPONDENT CALL IN

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

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

SOMEONE ELSE CALLED TO COMPLETE INTERVIEW 2 GO TO IN5

CALLED TO ASK WHY WE CALLED 3 GO TO IN4

CALLED TO SET APPOINTMENT 4 GO TO IN6

CALLED TO REFUSE 5 GO TO IN22

STATUS 1240

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

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

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

CALLED TO SAY NEVER HEARD OF [NAME] / WRONG NUMBER 9 GO TO IN22

STATUS 1530

HUNG UP 10 STATUS 1240







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

IF BL A1C=1 FILL HE/HIM

IF BL A1C=2 FILL SHE/HER

FILL RESPONDENT NAME

IN4. I would like to speak with [NAME] about a research study [he/she] joined about [FILL MONTHS] months ago. I want to ask [NAME] some questions about how [he/she] has been doing since then. [NAME] will be given a $65 gift card for [his/her] time.

May I please speak with [NAME]?

SPEAKING TO [NAME] 1 GO TO IN13

[NAME] COMES TO PHONE 2 GO TO IN13

[NAME] IS NOT AVAILABLE 3 GO TO IN6

[NAME] IS INCARCERATED 4 GO TO IN8

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

NEVER HEARD OF [NAME] / WRONG NUMBER 6 GO TO IN22

STATUS 1530

[NAME] IS DECEASED 7 GO TO IN12

[NAME] DOES NOT SPEAK ENGLISH 8 GO TO IN22

STATUS 1401

HUNG UP 9 STATUS 1240

REFUSED r STATUS 1220



PROGRAMMER SKIP BOX IN4 =6 or in4=8

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

If in4=6 STATUS CASE 1530

if in4=8 status case 1401







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

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

[NAME] COMES TO PHONE 1 GO TO IN13

[NAME] IS NOT AVAILABLE 2 GO TO IN6

[NAME] IS INCARCERATED 3 GO TO IN8

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

NEVER HEARD OF [NAME] / WRONG NUMBER 5 GO TO IN22

STATUS 1530

[NAME] IS DECEASED 6 GO TO IN12

[NAME] DOES NOT SPEAK ENGLISH 7 GO TO IN22

STATUS 1401

HUNG UP 8 STATUS 1240

REFUSED r STATUS 1220



PROGRAMMER SKIP BOX IN5 =5 or in5=7

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

If in5=5 STATUS CASE 1530

if in5=7 status case 1401



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

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

[NAME] COMES TO PHONE 1 GO TO IN13

SET APPOINTMENT 2 GO TO IN7



IN6 = 2 (SET APPOINTMENT)

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

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

INSTRUCTION: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK.

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

(STRING 20)





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

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

(STRING 200)

NAME OF PRISON

DON’T KNOW d

REFUSED r GO TO BOX IN8d.1



IN8 = ANSWERED, d

IN8a. In what city or town is that located?

(STRING 50)

NAME OF CITY/TOWN

DON’T KNOW d

REFUSED r



IN8 = ANSWERED, d

IN8b. In what state is that located?

(STRING 20)

NAME OF STATE

DON’T KNOW d

REFUSED r



IN8 = ANSWERED, d

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

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

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

programmer:

ENTER DATE ON NEXT SCREEN 1

SERVING A LIFE SENTENCE 2 GO TO IN8d


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

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

| | | / | | | | |

(1-12) (2018- 2099)

DON’T KNOW d

REFUSED r



IN8 = ANSWERED, d

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

INTERVIEWER: ENTER NUMBER OR CODE DON’T KNOW

(STRING 20)

INMATE NUMBER

DON’T KNOW d

REFUSED r



PROGRAMMER Box

IF IN5=3 OR IN3=8 OR IN4=4 GO TO IN22 & STATUS CASE 1541 (PRISON).

Else go to in9 or in13



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

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

YES 1 GO TO IN10

NO 0 STATUS 1530



if in9=0

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



IN9 = 1

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

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

ENTER NUMBER 1

DON’T KNOW d GO TO IN11

REFUSED r GO TO IN11




IN10 = 1

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

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



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

SOFT CHECK: USE STANDARD PHONE NUMBER CHECKS.



IN9 = 1 AND IN10=DK OR R

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

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

ENTER ADDRESS 1

DON’T KNOW d GO TO IN22

REFUSED r GO TO IN22



IN11 = 1

IN11_address. What is [NAME]’s address?

STREET 1

STREET 2

STREET 3

CITY

STATE

ZIP



if in11=1 GO TO IN22.

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







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

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

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

Thank you. Please accept my condolences. Goodbye.

programmer:

ENTER DATE ON NEXT SCREEN 1

DON’T KNOW d

REFUSED r



IN12_month & IN12_day & IN12_year

Thank you. Please accept my condolences. Goodbye.

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

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

DON’T KNOW d

REFUSED r

STATUS CASE 1440 (DECEASED).





IF IN1= 1 Or 2; IN3=1; IN4=1 OR 2; IN5=1; IN6=1

IF BL INTRO1 = 1, fill PROGRAM NAME

IF BL INTRO1 = 2, fill PROGRAM NAME

IF BL INTRO1 = 3, fill PROGRAM NAME

IF IN4 = 1 OR 2; IF IN5=1; IF IN6 =1, fill “Hello, my name is [FILL INTERVIEWER NAME] and I’m calling from Mathematica Policy Research, a research company in Princeton, New Jersey.”

IF IN2c=1, fill “Today, we are going to talk”

IF IN1 =1 OR 2; IN4 = 1 OR 2; IF IN5=1; IF IN6 =1, fill “I’m calling you”

IN13. [Hello, my name is [FILL INTERVIEWER NAME] and I’m calling from Mathematica Policy Research, a research company in Princeton, New Jersey. [I’m calling you/Today, we are going to talk] about a study you joined when you applied to [PROGRAM NAME] about [FILL MONTHS] months ago. Before we get started I would like to make sure we have your name recorded correctly.

Can you verify your first name?

PROBE: Can you spell that for me please?

INTERVIEWER: IF THE NAME DOES NOT MATCH THEN TELL YOUR SUPERVISOR AND IF NECESSARY DISCONTINUE THE INTERVIEW

(STRING 20)

FIRST NAME



ALL

IN14. And your middle name please?

PROBE: Can you spell that for me please?

INTERVIEWER: IF THE NAME DOES NOT MATCH THEN TELL YOUR SUPERVISOR AND IF NECESSARY DISCONTINUE THE INTERVIEW



(STRING 20)

MIDDLE NAME



ALL

IN15. And your last name please?

PROBE: Can you spell that for me please?

INTERVIEWER: IF THE NAME DOES NOT MATCH THEN TELL YOUR SUPERVISOR AND IF NECESSARY DISCONTINUE THE INTERVIEW



(STRING 20)

LAST NAME




ALL

Fill [RESP FIRST name] from IN15.

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

INSTRUCTION: IF SAME JUST HIT ENTER.

PROBE: Can you spell that for me please?

(STRING 20)

FIRST NAME



Shape10



CATI



IF Mygoals, fill ‘the Evaluation of Employment Coaching for TANF and Related Populations survey, which is working with the MyGoals study’

else fill ‘our study’

CV1. You may have received a letter recently to let you know that we would be calling you for a follow-up interview for [our study/the Evaluation of Employment Coaching for TANF and Related Populations survey, which is working with the MyGoals study]. I’d like to interview you today.

The interview will take about 45 minutes and you will receive a $65 gift card for completing the interview. Your participation in the interview is voluntary. You do not have to answer any questions that make you uncomfortable. All your responses will be kept strictly private and will only be used for research purposes, except if you say something that suggests you are very likely to harm yourself, that you are planning to hurt another person or child, or that someone is likely to harm you. Nobody will ever publish your name in connection with the information you provide. Instead, information about you will be combined with information about other people in the study.

Is now a good time to start?

YES 1 GO TO CV3

NO 0 GO TO CV2



CATI

CV1=0

CV2. When would be a good time to do the interview?

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

INSTRUCTION: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK.

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

(STRING 20)



CATI: CV1=1

CAWI

Computer-assisted telephone interview (CATI): First we are going to ask you some questions to check that we are speaking with the correct person.



Computer-assisted web interview (CAWI): The survey will take about 45 minutes and you will receive a $65 gift card as a token of our appreciation for completing the survey. Your participation in the survey is voluntary. You do not have to answer any questions that make you uncomfortable. All your responses will be kept strictly private and will only be used for research purposes. Nobody will ever publish your name in connection with the information you provide. Instead, information about you will be combined with information about other people in the study.

First we are going to ask you some questions to check that we are surveying the correct person.







CATI: CV1=1

CAWI

IF CAWI DO NOT SHOW DK OR REF

IF PROGRAM = LIFT OR FADSS OR UTAH



CV3. When you enrolled in the program in [RA MONTH YEAR], what was the highest level of education you had completed?

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

Select one only

DID NOT COMPLETE HIGH SCHOOL OR GED 11

HIGH SCHOOL: DIPLOMA (NOT GENERAL EDUCATION DEVELOPMENT OR GED) 1 2

GENERAL EDUCATION DEVELOPMENT OR GED 13

SOME COLLEGE BUT NO DEGREE 14

2-YEAR OR 3-YEAR COLLEGE DEGREE (ASSOCIATE’S DEGREE) 15

4-YEAR COLLEGE DEGREE (BACHELOR’S DEGREE) 16

GRADUATE OR PROFESSIONAL DEGREE (e.g., MA, MBA, Ph.D., JD, MD) 17

NEVER ATTENDED SCHOOL 18

DON’T KNOW d

REFUSED r



CATI/CAWI HARD CHECK: AN ANSWER MUST BE PROVIDED FOR THIS QUESTION.

















CATI: CV1=1

CAWI

IF CAWI DO NOT SHOW DK OR REF

IF PROGRAM = MYGOALS



CV3a. When you enrolled in the program in [RA MONTH YEAR], what was the highest level of education you had completed?

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

Select one only

GRADE 9 OR LESS 1

GRADE 10 OR 11 2

COMPLETED GRADE 12 WITHOUT A DIPLOMA OR GED 3

GED 4

HIGH SCHOOL DIPLOMA 5

SOME COLLEGE 6

ASSOCIATE OR TWO YEAR DEGREE 7

FOUR YEAR COLLEGE DEGREE OR HIGHER 8

DON’T KNOW d

REFUSED r



CATI/CAWI HARD CHECK: AN ANSWER MUST BE PROVIDED FOR THIS QUESTION.









CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

CV4. And what are the last 4-digits of your Social Security number?

| | | | | LAST FOUR

(0000-9999)

DON’T KNOW d GO TO CV5

REFUSED r GO TO CV5





CATI HARD CHECK: AN ANSWER MUST BE PROVIDED FOR THIS QUESTION.

CAWi hard check: an anSwer must be provided to go to the next question. this is to protect your privacy to make sure no one accesses the information provided in the survey.















PROGRAM BOX



IF FADSS OR LIFT OR UTAH AND IF CV3 = BL B4 AND CV4 = SSN THEN GO TO A1. OTHERWISE GO TO CV5.

IF MYGOALS AND IF CV3.a = EDUCATION AND CV4 = SSN THEN GO TO A1 OTHERWISE GO TO CV5

IF CV3 OR CV4 = Refused OR Don’t know GO TO CV5 (EVEN IF REFUSED OR DON’T KNOW MATCH ON BASELINE INFO)

IF CV3a OR CV4 = Refused OR Don’t know GO TO CV5 (EVEN IF REFUSED OR DON’T KNOW MATCH ON BASELINE INFO)

IF BL DATA IS MISSING THEN THE QUESTION WILL BE AN AUTOMATIC FAIL

CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF



CV5. What is your date of birth?

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

MONTH DAY YEAR

(1-12) (1-31) (1918-2001)

DON’T KNOW d

REFUSED r



CATI HARD CHECK: AN ANSWER MUST BE PROVIDED FOR THIS QUESTION.

CAWi hard check: an anSwer must be provided to go to the next question. this is to protect your privacy to make sure no one accesses the information provided in the survey.















PROGRAM BOX



IF LIFT OR FADSS OR UTAH AND [BL B4 = CV3] AND [SSN != CV5] GO TO CV6

IF LIFT OR FADSS OR UTAH AND [BL B4 != CV3] AND [DOB EQUALS CV5] GO TO CV6

IF MYGOALS AND [EDUCATION = CV3a] AND [DOB != CV5] GO TO CV6

IF MYGOALS AND [EDUCATION NE CV3.a] AND [DOB = CV5] GO TO CV6

[SSN = CV4] AND [DOB != CV5] GO TO CV6

[SSN NE CV4] AND [DOB EQUALS CV5] GO TO CV6

OTHERWISE GO TO A1





CV6. CATI: Thank you for your response. I need to check our records before continuing the interview. Please hold on a moment while I get my supervisor.

CON’T 1 GO TO CV7



CATI HARD CHECK: SUPERVISOR PLEASE ENTER YOUR ID TO CONTINUE

| | | | |



(2112-9117)







CAWI: Thank you for your time. We need to check our records before continuing the interview. Please contact the Mathematica Survey Operations Center at 1-833-371-3617 and ask for Casey Thomas, a survey representative at Mathematica, to complete the survey.

STATUS 1380 FOR SUP REVIEW




























DISPLAY STREET ADDRESS AND APARTMENT NUMBER FOR VERIFICATION



CV7. CATI ONLY: Can you tell me the name of the street that you lived on when you first enrolled in the program on [RA DATE]?

(STRING 20)

INSTRUCTION: Record address given by respondent

DON’T KNOW d GO TO CV8

REFUSED r GO TO CV8



CATI HARD CHECK: AN ANSWER MUST BE PROVIDED FOR THIS QUESTION.







PROGRAM BOX



IF CV7 = BL Resp_physaddress_street1 THEN GO TO A1

OTHERWISE, GO TO CV8







CV8. CATI ONLY: I’m sorry. I need to check my records before I can interview you. Is this the best time to reach you in the future?



YES 1

NO, CALL BACK INFO 0

(STRING 20)

INSTRUCTION: RECORD DATE AND TIME FOR CALL BACK.

STATUS CASE 1380 FOR SUP





















Shape11




CATI/CAWI

all

IF CAWI DO NOT SHOW DK OR REF

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

A1. In the past month, have you or anyone in your household received any support [fill statements a-i]?

[PROGRAMMER: CATI - Gray question text but continue to bold [FILL] from A1b-i.]


CODE ONE RESPONSE PER ROW


YES

NO

DK

REF

a. From Temporary Assistance for Needy Families, or TANF (this is also known as welfare)?

1

0

d

r

b. From Supplemental Security Income, or SSI?

1

0

d

r

c. From Social Security Disability Insurance, or SSDI?

1

0

d

r

d. From Food stamps or SNAP?

1

0

d

r

e. From Women, Infants, and Children, or WIC?

1

0

d

r

f. From Unemployment Insurance?

1

0

d

r

g. From Housing choice vouchers, Section 8, project-based rental assistance, public housing, housing where an agency helps you pay the rent, or other housing assistance?

1

0

d

r

h. For heating and cooling your home?

1

0

d

r

i. For free or reduced price school meals?

1

0

d

r





A1a = 1

A1j. How much money have you or anyone in your household received from TANF in the past month? If both you and someone else in your household received money from TANF, please add those amounts together.

PROBE: Your best guess is fine.

$| | | , | | | |

(0-99,999)

DON’T KNOW d

REFUSED r















CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

CATI: Now I would like to ask some questions about work.

CAWI: The next questions are about work.



A2. Are you currently working for pay?

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



YES 1 GO TO A3

NO 0 GO TO A2a

DON’T KNOW d GO TO A2a

REFUSED r GO TO A2a


CATI/CAWI

A2 != 1

IF CAWI DO NOT SHOW DK OR REF

A2a. Have you worked for pay at any time in the past 12 months?

YES 1 GO TO A4b

NO 0 GO TO A15

DON’T KNOW d GO TO A15

REFUSED r GO TO A15




PROGRAMMER: CREATE SLOTS FOR 20 JOBS. SET LIMIT OF 10 CURRENT JOBS (i.e., A3-A4a loop) AND 10 FORMER JOBS (i.e., A4b-A4c loop; TOTAL OF 20 JOBS)


























JOB 1

JOB 2

A2 =1

IF CAWI DO NOT SHOW DK OR REF

CATI: FILL “NOW I AM GOING TO ASK ABOUT YOUR CURRENT JOB OR JOBS” FOR JOB 1 ONLY.

CAWI: FILL “THE NEXT QUESTIONS ARE ABOUT YOUR CURRENT JOB OR JOBS.” FOR JOB 1 ONLY.

A3. CATI: [First I am going to ask about your current job or jobs.] Please tell me who you work for.

CAWI: [The next questions are about your current job or jobs.] Please tell us who you work for.

CATI/CAWI: This could be the name of a job, organization, person, or you could work for yourself or have your own business. If you currently work at more than one job, please start with the job where you usually work the most hours.

JOB NAME (SPECIFY) 1

(STRING 50)

SELF EMPLOYED 2

DON’T KNOW d

REFUSED r

PROGRAMMER: IF A3 = d, r, make [JOB NAME] be “Job 1” for Job 1, “Job 2” for Job 2, etc.

INTERVIEWER: IF A3=d, r, THEN SAY: That’s okay, we’ll just refer to this job as “Job 1” in the next few questions.








JOB NAME (SPECIFY) 1

(STRING 50)

SELF EMPLOYED 2

DON’T KNOW d

REFUSED r




IF A2=1

CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

A4. Including all types of jobs, do you currently have any other paid jobs?

YES 1 GO TO A3, JOB 2

NO 0 GO TO A4c

DON’T KNOW d GO TO A4c

REFUSED r GO TO A4c



IF A2=1 LOOP A4 JOBS UNTIL A4=(0,d, r). WHEN A4= 0,d,or r GO TO A4c JOB 1.

YES 1 GO TO A3, JOB 3

NO 0 GO TO A4c

DON’T KNOW d GO TO A4c

REFUSED r GO TO A4c



IF A2=1 LOOP A4 JOBS UNTIL A4=(0,d, r). WHEN A4= 0,d,or r GO TO A4c JOB 1.

A2a=1 (NOT CURRENTLY EMPLOYED BUT EMPLOYED IN PAST YEAR)

IF CAWI DO NOT SHOW DK OR REF

A4b. CATI: Please tell me who you worked for in the past 12 months.

CAWI: Please indicate who you worked for in the past 12 months.

CATI/CAWI: This could be the name of a company, organization, person, or you could work for yourself or have your own business. If you had more than one job, please start with the job where you worked the most hours.

JOB NAME (SPECIFY) 1

(STRING 50)

SELF EMPLOYED 2

DON’T KNOW d

REFUSED r


JOB NAME (SPECIFY) 1

(STRING 50)

SELF EMPLOYED 2

DON’T KNOW d

REFUSED r


If A4=(0, d, r) [TOLD INTERVIEWER THAT NO MORE CURRENT JOBS] or A2=1 OR A2a=1 [NOT CURRENTLY EMPLOYED BUT EMPLOYED IN PAST YEAR]



IF CAWI DO NOT SHOW DK OR REF



A4c. CATI: Have you had any other paid jobs in the past 12 months that you haven’t told me about?

CAWI: Have you had any other paid jobs in the past 12 months?


YES 1 GO TO A4b, JOB 2

NO 0 GO TO A5

DON’T KNOW d GO TO A5

REFUSED r GO TO A5



IF A4c=1 LOOP A4b AND A4c UNTIL A4c=0,d, or r . WHEN A4c=0, d, or r GO TO A5.




YES 1 GO TO A4b, JOB 3

NO 0 GO TO A5

DON’T KNOW d GO TO A5

REFUSED r GO TO A5





IF A4c=1 LOOP A4b AND A4c UNTIL A4c=0,d, or r. WHEN A4c=0, d, or r GO TO A5.





JOB 1

JOB 2

CATI/CAWI

A2=1 OR A2a=1

IF CAWI DO NOT SHOW DK OR REF

IF A3=2 or A4b=2 FILL “being self-employed”, “to become self-employed” ELSE FILL “the job you [do/did]…”, “to help get this job”



IF MORE THAN ONE JOB REPORTED, FILL “NOW THINKING OF [BEING SELF-EMPLOYED/THE JOB YOU [DO/DID] AT [JOB NAME]].”

IF A3=1 FILL DO; ELSE, FILL DID



A5. [Now thinking of [being self-employed/the job you [do/did] at [JOB NAME].]] Did you receive assistance from an organization or an agency [to help get this job/to become self-employed]? Please do not include temp agencies.


ORGANIZATION 1

AGENCY 2

DID NOT RECEIVE ANY ASSISTANCE 3

DON’T KNOW d

REFUSED r

ORGANIZATION 1

AGENCY 2

DID NOT RECEIVE ANY ASSISTANCE 3

DON’T KNOW d

REFUSED r

CATI/CAWI

A2=1 OR A2a=1

IF CAWI DO NOT SHOW DK OR REF



IF A3=2 or A4b=2 (self-employed) FILL “YOURSELF;” ELSE FILL “[JOB NAME]”

A6. When did you start working for [JOB NAME]/[yourself]]?

INTERVIEWER: RECORD MONTH AND YEAR.

NOTE: ALLOW SKIP ON MONTH.


| | | / | | | | |

MONTH YEAR

(1-12) (1990-current year)

DON’T KNOW d

REFUSED r

| | | / | | | | |

MONTH YEAR

(1-12) (1990-current year)

DON’T KNOW d

REFUSED r

CATI/CAWI

A2=1 OR A2a=1

IF CAWI DO NOT SHOW DK OR REF



IF A3=2 or A4b=2 (self-employed) FILL “YOURSELF,” ELSE FILL JOB NAME

A7. Are you still working for [[JOB NAME]/yourself]?

YES 1 GO TO A8

NO 0 GO TO A7a

DON’T KNOW d

REFUSED r

YES 1 GO TO A8

NO 0 GO TO A7a

DON’T KNOW d

REFUSED r

CATI/CAWI

A7 =0

IF CAWI DO NOT SHOW DK OR REF



A7a. When did you stop working at this job?

INTERVIEWER: RECORD MONTH AND YEAR.


| | | / | | | | |

MONTH YEAR

(1-12) (2013-current year)

STILL AT JOB 98

DON’T KNOW d

REFUSED r

| | | / | | | | |

MONTH YEAR

(1-12) (2013-current year)

STILL AT JOB 98

DON’T KNOW d

REFUSED r

CATI/CAWI



A2 = 1 OR A2a=1

IF CAWI DO NOT SHOW DK OR REF



FILL “ARE” IF A7=1, ELSE FILL “WERE”

SKIP IF A3 = 2 or A4b = 2 (if self-employed)

A8. Which of the following best describes your employment at that job? [Were/Are] you working . . .

CATI: PROBE: A temporary help agency supplies workers to other companies on an as needed basis.

PROBE: Some companies provide employees or their services to others under contract. A few examples of services that can be contracted out include security, landscaping, or computer programming.

PROBE: Independent contractors, independent consultants, and free-lance workers obtain customers on their own to provide a product or service and can have other employees working for them.

PROBE: Day laborers are people who work as needed. For example, day laborers may get work by waiting at a place where employers pick up people to work for a day or by posting paper or electronic job wanted ads and responding on a day-by-day basis.

PROBE: On-call workers are in a pool of workers who are ONLY called to work as needed, although they can be scheduled to work for several days or weeks in a row, for example, substitute teachers, and construction workers supplied by a union hiring hall.

CODE ONE ONLY

as a regular full-time employee? 1

as a regular part-time employee? 2

for a temporary help agency? 3

for a company that contracts out you or your services? 4

as an independent contractor, independent consultant, or freelance worker? 5

as a day laborer? 6

as an on-call employee? 7

for friends, family, or other people doing part-time tasks or odd jobs? 8

or something else (PLEASE specify)? 99

(STRING (100))

DON’T KNOW d

REFUSED r

CODE ONE ONLY

as a regular full-time employee? 1

as a regular part-time employee? 2

for a temporary help agency? 3

for a company that contracts out you or your services? 4

as an independent contractor, independent consultant, or freelance worker? 5

as a day laborer? 6

as an on-call employee? 7

for friends, family, or other people doing part-time tasks or odd jobs? 8

or something else (PLEASE specify)? 99

(STRING (100))

DON’T KNOW d

REFUSED r





JOB 1

JOB 2

CATI/CAWI

A2=1 OR A2a=1

IF CAWI DO NOT SHOW 9, DK OR REF



IF A7=1 FILL DO; ELSE, FILL DID

A8a. [Do/Did] you have taxes taken out of your paycheck for the work you [do/did] at this job?

YES 1

NO 0

R VOLUNTEERS: WAS PAID IN CASH 9

DON’T KNOW d

REFUSED r

YES 1

NO 0

R VOLUNTEERS: WAS PAID IN CASH 9

DON’T KNOW d

REFUSED r

CATI/CAWI

A2=1 OR A2a=1

IF CAWI DO NOT SHOW DK OR REF



IF A7=1 FILL DO; ELSE FILL DID

A9. How many hours [do/did] you usually work in a week at this job? Your best estimate is fine.

| | | HOURS PER WEEK

(0-98)

99 OR MORE HOURS PER WEEK 99

DON’T KNOW d

REFUSED r






| | | HOURS PER WEEK

(0-98)

99 OR MORE HOURS PER WEEK 99

DON’T KNOW d

REFUSED r




CATI/CAWI

A2=1 OR A2a=1

IF CAWI DO NOT SHOW DK OR REF



IF A3=2 or A4b=2 FILL “being self-employed” ELSE FILL “your job at [job name]”





FILL ”DO” IF A7=1, ELSE FILL ”DID”

FILL “VARIES” / “ARE” / “MAKE” IF A7=1. ELSE FILL “VARIED” / “WERE” / “MADE”

A10. Now thinking about [being self-employed/your job at [JOB NAME]], how much [do/did] you get paid before taxes and deductions, at this job? Please include tips, commissions, and regular overtime.



CATI: PROBE: If your pay [varies/varied], please provide an average amount. If you [are/were] paid per day of work, per job or for completing a particular task, please tell us the total amount you usually [make/made] per week or month while doing this type of work.



CAWI: SOFTCHECK: If your pay [varies/varied], please provide an average amount. If you [are/were] paid per day of work, per job or for completing a particular task, please tell us the total amount you usually [make/made] per week or month while doing this type of work.



IF THE RESPONDENT DOES NOT PROVIDE A PAY PERIOD THEN PROBE: And, is that per hour, per week, per month, once every two weeks, twice a month, per year, or something else?

ACCEPT MOST CONVENIENT PAY PERIOD.

SOFT CHECK: IF ANSWER IS GREATER THAN $50 PER HOUR, $2000 PER WEEK, $4000 ONCE EVERY 2 WEEKS, $4000 TWICE A MONTH, $100,000 PER YEAR, OR $8000 MONTH, SAY: “I recorded [A10 and A10 amount answer]. Is that correct?”

$ | | | |,| | | |.| | | AVERAGE

(0-999,999.99) AMOUNT

PER HOUR 1

PER WEEK 2

MONTH 3

ONCE EVERY TWO WEEKS 4

TWICE A MONTH 5

PER YEAR 6

OTHER (SPECIFY) 99

(STRING (100))

DON’T KNOW d

REFUSED r












$ | | | |,| | | |.| | | AVERAGE

(0-999,999.99) AMOUNT

PER HOUR 1

PER WEEK 2

MONTH 3

ONCE EVERY TWO WEEKS 4

TWICE A MONTH 5

PER YEAR 6

OTHER (SPECIFY) 99

(STRING (100))

DON’T KNOW d

REFUSED r


CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

FILL WAGE AND HOUR/UNIT FROM A10.

IF A10 = 99, D, R, or M, FILL “YOUR CURRENT WAGE”

A11. Did you always earn [[A10 WAGE] per [HOUR/UNIT FROM A12]/your current wage] at this job?

YES 1

NO 0

DON’T KNOW d

REFUSED r

YES 1

NO 0

DON’T KNOW d

REFUSED r

CATI/CAWI

If A11= 0

IF CAWI DO NOT SHOW DK OR REF

FILL “VARIES” IF A7=1. ELSE FILL “VARIED”.



A11a. How much were you paid when you started working at this job before taxes and deductions? If your pay [varies/varied], please provide an average amount.



ACCEPT MOST CONVENIENT PAY PERIOD.

SOFT CHECK: IF ANSWER IS GREATER THAN $50 PER HOUR, $2000 PER WEEK, $4000 ONCE EVERY 2 WEEKS, $4000 TWICE A MONTH, $100,000 PER YEAR, OR $8000 MONTH, SAY: “I recorded [A11a and A11a amount answer]. Is that correct?”


$ | | | |,| | | |.| | | AVERAGE

(0-999,999.99) AMOUNT

PER HOUR 1

PER WEEK 2

PER MONTH 3

ONCE EVERY TWO WEEKS 4

TWICE A MONTH 5

PER YEAR 6

OTHER (SPECIFY) 99

(STRING (100))

DON’T KNOW d

REFUSED r

$ | | | |,| | | |.| | | AVERAGE

(0-999,999.99) AMOUNT

PER HOUR 1

PER WEEK 2

PER MONTH 3

ONCE EVERY TWO WEEKS 4

TWICE A MONTH 5

PER YEAR 6

OTHER (SPECIFY) 99

(STRING (100))

DON’T KNOW d

REFUSED r

CATI/CAWI

SKIP IF A3=2 OR A4b=2 (self-employed)

IF CAWI DO NOT SHOW DK OR REF

FILL “ARE” IF A7=1 ELSE FILL “WERE”

A12. Which of the following benefits [are/were] available to you at your job? (READ EACH ITEM) . . .


CODE ALL THAT APPLY

Paid leave for holidays, vacation or illness? 1

Health insurance or membership in an HMO or PPO plan? 2

Retirement benefits? 3

None of the above 0

DON’T KNOW d

REFUSED r

CODE ALL THAT APPLY

Paid leave for holidays, vacation or illness? 1

Health insurance or membership in an HMO or PPO plan? 2

Retirement benefits? 3

None of the above 0

DON’T KNOW d

REFUSED r

CATI/CAWI

SKIP IF A3=2 OR A4b=2 (self-employed)

IF CAWI DO NOT SHOW DK OR REF

FILL “Have” IF A7=1 ELSE FILL “Had”

A13. [Have/Had] you been promoted to a higher position with greater responsibility while working at this job?

YES 1

NO 0

DON’T KNOW d

REFUSED r

YES 1

NO 0

DON’T KNOW d

REFUSED r

CATI/CAWI

A7=1

SKIP IF A3=2 OR A4b=2 (self-employed)

IF CAWI DO NOT SHOW DK OR REF

A14. How likely do you think it is that you will be promoted by [Job Name] in the next 12 months?

Very likely, 1

somewhat likely, 2

not very likely, or 3

not likely at all? 4

DON'T KNOW d

REFUSED r


IF A4=1 OR A4c=1 GO TO A5 [JOB 2-20]

WHEN (A4 NE 1 AND A4c NE 1) GO TO A15


very likely, 1

somewhat likely, 2

not very likely, or 3

not likely at all? 4

DON'T KNOW d

REFUSED r


IF A4=1 OR A4c=1 GO TO A5 [JOB 3-20]

WHEN (A4 NE 1 AND A4c NE 1) GO TO A15





all

IF CAWI DO NOT SHOW DK OR REF

A15. CATI: In the past 12 months, was there anything else you did for pay, such as odd jobs, “under the table” jobs, or any other type of work, that we haven’t already talked about?

CAWI: In the past 12 months, was there anything else you did for pay, such as odd jobs, “under the table” jobs, or any other type of work that you haven’t reported here?

YES 1

NO 0 GO TO A17

DON’T KNOW d GO TO A17

REFUSED r GO TO A17




A15=1

IF CAWI DO NOT SHOW DK OR REF

A16. CATI: What is your best guess of how much money you received from these activities in a typical month in the past 12 months? Please do not include money you made from jobs we talked about earlier. We just need your best guess for how much money you’ve received from these activities.

CAWI: What is your best guess of how much money you received from these activities in a typical month in the past 12 months? Please do not include money you made from jobs you reported earlier. Just make your best guess for how much money you’ve received from these activities.



$| | | , | | | |

(0-99,999)

DON’T KNOW d

REFUSED r


CATI/CAWI

A2 = 1

IF CAWI DO NOT SHOW DK OR REF

If number of CURRENT JOBS equals 1 fill “job”

If number of CURRENT JOBS IS greater than 1 fill “jobs”

A17. How satisfied are you with your current [job/jobs]? Would you say very satisfied, somewhat satisfied, or not satisfied?

VERY SATISFIED 1

SOMEWHAT SATISFIED 2

NOT SATISFIED 3

DON’T KNOW d

REFUSED r





CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

A18. Are you currently looking for a job?

YES 1

NO 0

DON’T KNOW d

REFUSED r



CATI/CAWI

A18=0, d, r AND A2 !=1

IF CAWI DO NOT SHOW DK OR REF

A18a. How would you describe your current status? Are you . . .

CODE ALL THAT APPLY

Temporarily laid off? 1

Retired? 2

In school or training? 3

Unable to work because of caring for another family member? 4

Unable to work because of pregnancy? 5

Sick or disabled? 6

Gave up looking for work? 7

Something else? (SPECIFY) 99

(STRING (NUM))

DON’T KNOW d

REFUSED r




CATI: Now, we are going to talk about changes in your work situation because of the COVID-19 pandemic.

CAWI: The next set of questions ask about changes in your work situation because of the COVID-19 pandemic.


CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

A18b. Since the start of the pandemic in March 2020, have any of the following changes happened to you at work because of COVID-19?

Select one per row


NO

YES

I did not have a job during this time period

DK

REF

a. Were you temporarily laid off or furloughed?

0 m

1 m

2 m

d m

r m

b. Did you lose your job?

0 m

1 m

2 m

d m

r m

c. Did you quit your job because of the risk of exposure to COVID-19?

0 m

1 m

2 m

d m

r m

d. Did you get a vaccine for COVID-19 because your job required it?

0 m

1 m

2 m

d m

r m

e. Did you quit your job because your job required a vaccine for COVID-19?

0 m

1 m

2 m

d m

r m














CATI: Now we are going to talk about some of the things you might have done because there wasn’t enough money.

CAWI: The next set of questions ask about some of the things you might have done because there wasn’t enough money.

CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

A19. In the past 12 months, did you do any of the following because there wasn’t enough money?

[PROGRAMMER: CATI – Gray question text from A19b-k.]


CODE ONE RESPONSE PER ROW


YES

NO

DON’T KNOW

REFUSED

a. Cut the size of your meals or skip meals because you couldn’t afford enough food?

1

0

d

r

b. Move in with other people, even for a little while, because of financial problems?

1

0

d

r

c. Ask to borrow money from friends or family?

1

0

d

r

d. Go without a phone because you could not afford to pay the bill or buy extra cell phone minutes?

1

0

d

r

e. Took a payday loan or auto-title loan, or sold or pawned your belongings?

1

0

d

r

f. Thought about going to the doctor, dentist or hospital, but decided not to because of the cost?

1

0

d

r

g. Go without prescription medicine?

1

0

d

r

h. Go without paying utility bills?

1

0

d

r

i. Did not pay the full amount of the rent or mortgage because you could not afford it?

1

0

d

r

j. Were evicted from your home or apartment for not paying the rent or mortgage?

1

0

d

r

k. Filed in court for bankruptcy?

1

0

d

r



















CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

A20. CATI: Now, I’m going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for you in the last 30 days.

CAWI: The next set of questions ask about your household’s food situation.

[PROGRAMMER: Gray question text from A20b-c.]

CODE ONE RESPONSE PER ROW


OFTEN TRUE

SOMETIMES TRUE

NEVER TRUE

DK

REF

a. I worried whether my food would run out before I got money to buy more.

1

2

3

d

r

b. The food that I bought just didn’t last, and I didn’t have money to get more.

1

2

3

d

r

c. I couldn’t afford to eat balanced meals.

1

2

3

d

r



CATI/CAWI

all

IF CAWI DO NOT SHOW DK OR REF

The next question is about where you live.

A21. CATI: Do you currently own your home or apartment or have a mortgage, rent it, pay some amount toward rent, live rent free with a friend or relative, or do you have some other arrangement?

CAWI: Do you currently…

OWN OR HAVE MORTGAGE 1

RENT 2

PAY SOME OF THE RENT 3

LIVE RENT FREE (SOMEONE ELSE RENTS/OWNS HOUSE OR APARTMENT) 4

LIVE IN SHELTER 5

LIVE ON STREETS 6

LIVE IN ABANDONED BUILDING/CAR 7

OTHER (SPECIFY) 99 GO TO A21a

DON’T KNOW d

REFUSED r



CATI/CAWI

A21=99



A21a. What is your other living arrangement?


__________________________(STRING 250)



CATI/CAWI

all

IF CAWI DO NOT SHOW DK OR REF

The next questions are about your finances.

A22. Do you currently use a spending plan or budget to help you meet or keep track of your monthly expenses?

YES 1

NO 0

DON’T KNOW d

REFUSED r



CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF



A23. Do you currently have a checking or savings account of any kind at a bank or a credit union?

YES 1

NO 0

DON’T KNOW d

REFUSED r




CATI/CAWI

All

IF CAWI DO NOT SHOW DK OR REF



A24. Suppose you or anyone in your household had an emergency expense that costs $400.

CATI: Based on your current situation, how would you pay for this expense? Please choose the most likely method of payment, if any.

CAWI: Based on your current situation, how would you pay for this expense? Please choose the most likely method of payment, if any.


PUT IT ON YOUR CREDIT CARD 1

USE MONEY IN YOUR CHECKING OR SAVINGS ACCOUNT OR USE CASH ON HAND 2

BORROW FROM A FRIEND OR FAMILY MEMBER 3

USE A PAYDAY LOAN, DEPOSIT ADVANCE, OR OVERDRAFT 4

SELL SOMETHING 5

USE A PAYMENT PLAN WHERE YOU PAY “LITTLE BY LITTLE” 6

DON’T KNOW d

REFUSED r



CATI/CAWI

If A23 = 1

IF CAWI DO NOT SHOW DK OR REF



A25. How much do you have in savings? Savings includes but is not limited to savings accounts, and covers any money you set aside for the future. Your best estimate is fine.



$| | | | , | | | |

(0-999,999)

DON’T KNOW d

REFUSED r



CATI/CAWI

All

IF CAWI DO NOT SHOW DK OR REF



A26. How often does your household pay its bills on time?

CATI: Would you say you pay your bills on time most of the time (late 1 time or less per year), very often (late 2-3 times per year), sometimes (late every other month), rarely or never (late about every month).

CAWI: Would you say:

MOST OF THE TIME (LATE 1 TIME OR LESS PER YEAR) 1

VERY OFTEN (LATE 2-3 TIMES PER YEAR) 2

SOMETIMES (LATE EVERY OTHER MONTH) 3

RARELY OR NEVER (LATE ABOUT EVERY MONTH) 4

DON’T KNOW d

REFUSED r





CATI/CAWI

All

IF CAWI DO NOT SHOW DK OR REF



A27. In the past 12 months, have you seen your credit report from a credit-reporting agency?

YES 1

NO 0

DON’T KNOW d

REFUSED r


Shape16





ALL

IF CAWI DO NOT SHOW DK OR REF

B1. CATI: Now I am going to read you a list of things that some people find challenging in finding and keeping a good job.

Please tell me if the following has made it not at all hard, a little hard, somewhat hard, very hard, or extremely hard for you to find or keep a good job in the past 12 months.

Would you say that [FILL a-g] made it not at all hard, a little hard, somewhat hard, very hard, or extremely hard for you to find or keep a good job in the past 12 months?

PROGRAMMER: (CATI) Gray question text but black fill on sub-items b-g.

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

CAWI: The next set of questions are about things that some people find challenging in finding and keeping a good job.

Would you say that [FILL a-g] made it not at all hard, a little hard, somewhat hard, very hard, or extremely hard for you to find or keep a good job in the past 12 months?



PROGRAMMER: CODE ONE PER ROW

CODE ONE RESPONSE PER ROW


NOT AT ALL

A LITTLE

SOMEWHAT

VERY

EXTREMELY

DK

REF

a. Not having reliable transportation

1

2

3

4

5

d

r

b. Not having good enough child care or family help

1

2

3

4

5

d

r

c. Not having the right clothes or tools for work

1

2

3

4

5

d

r

d. Not having the right skills or education

1

2

3

4

5

d

r

e. Having a criminal record

1

2

3

4

5

d

r

f. A lack of good jobs available in your area

1

2

3

4

5

d

r

g. Not being able to do certain kinds or amounts of work, training, or school work because of your health

1

2

3

4

5

d

r

h. The risk that you or someone in your household or family will get sick from COVID-19

1

2

3

4

5

d

r















CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

B2a. Do you have a regular child care arrangement you can use so that you can go to a job, a job interview, school, or other appointment?

YES 1

NO 0 GO TO B3

DON’T NEED CHILD CARE 2 GO TO B3

DON’T KNOW d

REFUSED r



B2a=1

IF CAWI DO NOT SHOW DK OR REF

B2b. CATI: Now I would like to talk about backup child care arrangements.

CAWI: The next set of questions talk about backup child care arrangements.

CATI/CAWI: If your child care falls through, would you say that you always, very often, sometimes, rarely or never have a backup child care arrangement?

ALWAYS 1

VERY OFTEN 2

SOMETIMES 3

RARELY 4

NEVER 5 GO TO B3

DON’T KNOW d

REFUSED r



CATI/CAWI

B2b=1, 2, 3, or 4

IF CAWI DO NOT SHOW DK OR REF

B2c. How many backup child care arrangements do you have?

| | | NUMBER

(0-50)

DON’T KNOW d

REFUSED r









CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

B4. Do you currently have a valid driver’s license? By valid we mean that it has not expired, and has not been suspended or taken away.



YES 1

NO 0

DON’T KNOW d

REFUSED r

CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

B4a. In the past 12 months, have you ever not been able to apply to a job because you didn’t have a valid driver’s license?

YES 1

NO 0

DON’T KNOW d

REFUSED r



























IF A2=1 THEN DO NOT ASK B.

else, ALL.

IF CAWI DO NOT SHOW DK OR REF

B5. CATI, a-b: Please tell me if you strongly disagree, disagree, agree, or strongly agree with the following statements.

CATI, c-i: Please tell me if you strongly disagree, disagree, agree, or strongly agree with the following statements, or if you never had an employment goal.

CAWI, a-b: Please indicate if you strongly disagree, disagree, agree, or strongly agree with the following statements.

CAWI c-i: Please indicate if you strongly disagree, disagree, agree, or strongly agree with the following statements, or if you never had an employment goal.

CODE ONE RESPONSE PER ROW


STRONGLY DISAGREE

DISAGREE

AGREE

STRONGLY AGREE

NEVER HAD EMPLOYMENT GOAL

DK

REF

a. I know I need to get a job or a better job and really think I should work on finding one.

1

2

3

4

-

d

r

b. I guess being out of work is not good, but there is nothing I can do about it right now.

1

2

3

4

-

d

r

c. I set employment goals based on what is important to me or my family.

1

2

3

4

5

d

r

d. I set long-term employment goals that I hope to achieve (such as finding a job, finding a better job, getting promoted, or enrolling in further education).

1

2

3

4

5

d

r

e. I set specific short-term goals that will allow me to achieve my long-term employment goals.

1

2

3

4

5

d

r

f. Based on everything I know about myself, I believe I can achieve my employment goals.

1

2

3

4

5

d

r

g. When I set employment goals, I think about barriers that might get in my way and make specific plans for overcoming those barriers.

1

2

3

4

5

d

r

h. Even when I face challenges, I continue to pursue my employment goals.

1

2

3

4

5

d

r

i. I keep track of my overall progress toward my long-term employment goals and adjust my plans if needed.

1

2

3

4

5

d

r




CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

DISPLaY PUBLISHER LANGUAGE FOR B6a: Reproduced by special permission of the Publisher, Psychological Assessment Resources, Inc. (PAR), 16204 North Florida Avenue, Lutz, Florida 33549, from the Behavior Rating Inventory of Executive Function-Adult Version by Robert M. Roth, PhD, Peter K. Isquith, PhD and Gerard A. Gioia, PhD, Copyright 1996, 1998, 2001, 2003, 2004, 2005 by PAR. Further reproduction is prohibited without permission from PAR.

display copyright sign for all items after B6.1:

For Review Only, Do NOT Copy

B6.1. During the past month, how often has each of the following behaviors been a problem? Would you say that the following behaviors have been a problem never, sometimes, or often?

[PROGRAMMER: CATI – Gray question text from B6.1b-l).]

**NOTE: The specific wording of items B6.1a-l and B6.2a-h are not shown on this copy of the survey because the items are adapted and reproduced by special permission of the Publisher, Psychological Assessment Resources, Inc., 16204 North Florida Avenue, Lutz, Florida 33549. Further reproduction is prohibited without permission by PAR, Inc.



CODE ONE RESPONSE PER ROW

For Review Only, Do NOT Copy

NEVER

SOMETIMES

OFTEN

DK

REF


a. Item 25 **SEE NOTE ABOVE

0

1

2

d

r


b. Item 49

0

1

2

d

r


c. Item 52

0

1

2

d

r


d. Item 6

0

1

2

d

r


e. Item 71

0

1

2

d

r


f. Item 75

0

1

2

d

r


g. Item 24

0

1

2

d

r


h. Item 53

0

1

2

d

r


i. Item 9

0

1

2

d

r


j. Item 15 - edited

0

1

2

d

r


k. Item 63 - edited

0

1

2

d

r


l. Item 2

0

1

2

d

r

















CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

display copyright sign for all items :

For Review Only, Do NOT Copy



B6.2. During the past month, how often has each of the following behaviors been a problem? Would you say that the following behaviors have been a problem never, sometimes, or often?

[PROGRAMMER: CATI – Gray question text from B6.2b-h).]



CODE ONE RESPONSE PER ROW

For Review Only, Do NOT Copy

NEVER

SOMETIMES

OFTEN

DK

REF

a. Item 28

0

1

2

d

r

b. Item 69

0

1

2

d

r

c. Item 1

0

1

2

d

r

d. Item 72

0

1

2

d

r

e. Item 23.

0

1

2

d

r

f. Item 50

0

1

2

d

r

g. Item 64

0

1

2

d

r

h. Item 70 - edited

0

1

2

d

r




CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

B7. Since [RA MONTH YEAR/FUP COMP MONTH YEAR], how often have you [FILL A-F]?

CATI [PROGRAMMER: Gray from B7b-f]: Would you say a few times a week, a few times a month, about once a month, or hardly ever or never?



CODE ONE RESPONSE PER ROW


A FEW TIMES A WEEK

A FEW TIMES A MONTH

ABOUT ONCE A MONTH

HARDLY EVER OR NEVER

DK

REF

a. Lost your temper with someone other than friends or family.

1

2

3

4

d

r

b. Said something that you later regretted to someone other than friends or family.

1

2

3

4

d

r

c. Decided not to apply for a job because you didn’t think you would get an interview.

1

2

3

4

d

r

d. Overcome a barrier that could have prevented you from finding or keeping a job.

1

2

3

4

d

r

e. Been late for a job, interview, program meeting, class, or training session.

1

2

3

4

d

r

f. Missed an appointment related to work, looking for a job, a program, school, or training for a reason other than you were sick or ill.

1

2

3

4

d

r


CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

B8. CATI [PROGRAMMER: Gray from B8b-c]: Next, I’m going to read a list of opinions people have about themselves. After I read each one, I want you to tell me whether you strongly disagree, disagree, agree, or strongly agree.

CAWI: The next set of items are a list of opinions people have about themselves. Indicate whether you strongly disagree, disagree, agree, or strongly agree with each one.



CODE ONE RESPONSE PER ROW


STRONGLY DISAGREE

DISAGREE

AGREE

STRONGLY AGREE

DK

REF

a. I am able to do things as well as most people.

1

2

3

4

d

r

b. I certainly feel useless at times.

1

2

3

4

d

r

c. All in all, I tend to feel that I am a failure.

1

2

3

4

d

r



CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

B9. CATI [PROGRAMMER: Gray from B9b-h]: The next questions are about how you may have felt or behaved in the past 2 weeks. After I read each statement, please tell me how often have you been bothered by any of the following.

Would you say not at all, several days, more than half the days, or nearly every day over the last 2 weeks?

CAWI: Below is a list of ways you may have felt or behaved. Over the last 2 weeks, how often have you been bothered by any of the following?



CODE ONE RESPONSE PER ROW


Not at all

Several days

More than half the days

Nearly every day

DK

REF

a. Little interest or pleasure in doing things?….

1

2

3

4

d

r

b. Feeling down, depressed, or hopeless?.

1

2

3

4

d

r

c. Trouble falling or staying asleep, or sleeping too much?.

1

2

3

4

d

r

d. Feeling tired or having little energy?

1

2

3

4

d

r

e. Poor appetite or overeating?

1

2

3

4

d

r

f. Feeling bad about yourself—or that you are a failure or have let yourself or your family down?

1

2

3

4

d

r

g. Trouble concentrating on things, such as reading the newspaper or watching television?

1

2

3

4

d

r

h. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual?

1

2

3

4

d

r




Shape17




CATI: Now we are going to ask you about services you may have received to help you find a job or advance in your career.


CAWI: The next set of questions are about services you may have received to help you find a job or advance in your career.


CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

C1a. In the past 12 months, have you attended any workshops or classes that provided instruction on how to find a job? These may have provided help with things such as resume writing, interviewing, and networking.

YES 1

NO 0

DON’T KNOW d

REFUSED r


CATI/CAWI

ALL

IF CAWI DO NOT SHOW DK OR REF

C2. We are interested in learning if you met one-on-one with someone to receive assistance in finding a job or advancing your career. By one-on-one assistance, we mean meeting with someone whose job it is to help you find a job. This assistance may have been provided by a coach, case manager, counselor, or some other type of worker. It could have been in-person or by phone.

In the past 12 months have you met one-on-one with someone to receive job assistance?

YES 1

NO 0

DON’T KNOW d

REFUSED r


CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

ALL

C5. In the past 12 months, did any coach, case manager, counselor, or other type of worker provide you with names of employers who were interviewing, or set up interviews with employers for you?

YES 1

NO 0

DON’T KNOW d

REFUSED r




CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

ALL

C6. In the past 12 months, did you complete any career assessments to find out what types of jobs would be good for you? A career assessment may be used to help identify a career that is right for you based on your interests and skills.

YES 1

NO 0

DON’T KNOW d

REFUSED r



CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

ALL

The next questions ask you about your participation in education and training programs.



C7. Since [RA MONTH YEAR/FUP COMP MONTH YEAR], did you participate in any education programs? This includes adult basic education or GED courses, English as a Second Language classes, online courses, and college or other types of school. Do not include training programs to develop skills for a particular job or occupation or any other work experience in which all or part of your wages were paid for by a program.

YES 1

NO 0 GO TO C8

DON’T KNOW d GO TO C8

REFUSED r GO TO C8



CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

C7 = 1

C7a. Are you participating in the program now?

YES 1 GO TO C8

NO 0 GO TO C7B

DON’T KNOW d GO TO C7B

REFUSED r GO TO C7B









CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

C7=1 and C7A != 1

C7b. Did you complete the program?

YES 1 GO TO C7C

NO 0 GO TO C8

DON’T KNOW d GO TO C7C

REFUSED r GO TO C7C


CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

C7=1 AND C7A != 1 AND C7B != 0

C7c. Did you receive a diploma or degree from the program?

YES 1

NO 0

DON’T KNOW d

REFUSED r


CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

ALL

C8. Since [RA MONTH YEAR/FUP COMP MONTH YEAR], did you participate in any training programs to develop skills for a particular job or occupation? These are sometimes called vocational training programs. Do not include training programs provided by your employer.

YES 1 GO TO C8A

NO 0 GO TO D3a

DON’T KNOW d GO TO D3a

REFUSED r GO TO D3a


CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

C8 = 1

C8a. Are you participating in the program now?

YES 1 GO TO D3a

NO 0 GO TO C8B

DON’T KNOW d GO TO C8B

REFUSED r GO TO C8B





CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

C8=1 AND C8a!=1

C8b. Did you complete the program?

YES 1 GO TO C8C

NO 0 GO TO D3a

DON’T KNOW d GO TO C8C

REFUSED r GO TO C8C


CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

C8=1 AND C8A !=1 AND C8B != 0

C8c. Did you receive a certificate, license, or diploma from the program?

YES 1

NO 0

DON’T KNOW d

REFUSED r








Shape18





CATI: I would like to ask you a few questions about your experience with the criminal justice system. As a reminder, nothing you tell us will be shared or affect the services you receive.

CAWI: The next set of questions are about your experience with the criminal justice system. As a reminder, nothing you tell us will be shared or affect the services you receive.



CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

ALL



D3a. In the past 12 months, were you ever convicted of a crime?

YES 1 GO TO D3b

NO 0 GO TO D4

DON’T KNOW d GO TO D4

REFUSED r GO TO D4

CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

D3a=1

D3b. In the past 12 months, were you convicted of a felony?

YES 1

NO 0

DON’T KNOW d

REFUSED r
























CATI: Now I would like to ask you some questions about your level of education and marital status.

CAWI: The next group of questions is about your level of education and marital status.


CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

ALL

D4. What is the highest level of education you have completed?

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

CODE ONE ONLY

DID NOT COMPLETE HIGH SCHOOL OR GED 1

HIGH SCHOOL: DIPLOMA (NOT GENERAL EDUCATION DEVELOPMENT OR GED) 2

GENERAL EDUCATION DEVELOPMENT OR GED 3

SOME COLLEGE BUT NO DEGREE 4

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

4-YEAR COLLEGE DEGREE (BACHELOR’S DEGREE) 6

GRADUATE OR PROFESSIONAL DEGREE (e.g., MA, MBA, Ph.D., JD, MD) 7

NEVER ATTENDED SCHOOL 8

DON’T KNOW d

REFUSED r



CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

All

D5. What is your current marital status—are you now married, separated, divorced, widowed, or have you never been married?

CODE ONE ONLY

MARRIED 1

SEPARATED 2

DIVORCED 3

WIDOWED 4

NEVER MARRIED 5

DON’T KNOW d

REFUSED r


CATI: Now I would like to ask you some questions about people who live with you.

CAWI: The next set of questions are about people who live with you.



CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

All

D6. How many adults age 18 or older, currently live in your household at least half the time? Please include yourself.

| | | ADULTS

(1-99)


INTERVIEWER: IF THE RESPONDENT SAYS “0” THEN REMIND THEM THAT THEY SHOULD INCLUDE THEMSELVES IN THIS TOTAL.

DON’T KNOW d

REFUSED r



CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

All

D7. How many children under age 18 live with you at least half the time? This includes biological, adopted, foster, step, and any other children.

| | | CHILDREN

(0-99)

DON’T KNOW d

REFUSED r

CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

if comp_status = 0 OR 2FUP_COMP_STATUS = 0



D8. Were you born in…

The United States, 1

Or some other country? 2

DON’T KNOW d

REFUSED r













CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

All

D9. Have you received at least one dose of a COVID-19 vaccine?

YES 1 GO TO D10

NO 0 GO TO E1

DON’T KNOW d GO TO E1

REFUSED r GO TO E1



CATI/CAWI

IF CAWI DO NOT SHOW DK OR REF

D9=1

D10. Did you get the full course of doses for the COVID-19 vaccine you received?

As a reminder, a full course of the Pfizer and Moderna vaccines required two doses while the Johnson & Johnson vaccine required a single dose.





CODE ONE ONLY

YES 1

NO 0

DON’T KNOW d

REFUSED r






Shape19




We are almost finished. I just have a few more questions. These will help us contact you if we need to reach you in the future. We will only use this information if we cannot reach you with the other information you provided us.

all

E1. What is your current address?

PROBE: Is there an apartment number?

PROBE: This is where we will mail your gift card.

STREET 1

STREET 2

APT. #

CITY

STATE

ZIP

DON’T KNOW d

REFUSED r


all

E2. Do you have a current home telephone number?

YES 1

NO 0 GO TO E4

DON’T KNOW d GO TO E4

REFUSED r GO TO E4

E2=1

E3. What is your current home telephone number?

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

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

DON’T KNOW d

REFUSED r




all

E4. Do you have a cell phone?

YES 1

NO 0 GO TO E7

DON’T KNOW d GO TO E7

REFUSED r GO TO E7

E4=1

E4a. What is your cell phone number?

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

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

DON’T KNOW d

REFUSED r


E4a=NE d or r

E5. Is it okay for us to text you at this number? Message and data rates may apply.

YES 1

NO 0

DON’T KNOW d

REFUSED r



ALL

E6. What is another phone number where you can be reached?

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

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

NO OTHER NUMBER 1

DON’T KNOW d

REFUSED r


E6 HAS COMPLETE PHONE NUMBER ENTERED

E6a. Is this number, [E6], for a cell phone?

YES 1

NO 0

DON’T KNOW d

REFUSED r


E6a=1

E6b. Is it okay for us to text you at this number? Message and data rates may apply.

YES 1

NO 0

DON’T KNOW d

REFUSED r


ALL

E7. What is your email address?

INTERVIEWER: ENTER E-MAIL ON NEXT SCREEN



(STRING 50)

DON’T HAVE ONE 0

DON’T KNOW d

REFUSED r


ALL

E8a. We would like to contact you in about a year to see how you are doing. In case we have trouble reaching you, we would like to have the names of two people who would most likely know where you are or who you keep in close contact with, such as a grandmother or grandfather, other relative, or friend. We will not contact these people for any other reason.

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

(STRING 50)

FIRST NAME

(STRING 50)

MIDDLE INITIAL/NAME

(STRING 50)

LAST NAME

DON’T KNOW d GO TO END1

REFUSED r GO TO END1



E8a NE d OR r

E8b. What is (his/her) address?

PROBE: Is there an apartment number?

STREET 1

STREET 2

APT. #

CITY

STATE

ZIP

DON’T KNOW d

REFUSED r

E8a NE d OR r

E8c. What is (his/her) relationship to you?

SPOUSE/PARTNER 1

MOTHER 2

FATHER 3

SISTER/BROTHER 4

GRANDMOTHER/GRANDFATHER 5

SON/DAUGHTER 6

FRIEND 7

OTHER (SPECIFY) 99

_____________________________ (STRING 50)

DON’T KNOW d

REFUSED r


E8a NE d OR r

E8d. What is (his/her) home telephone number?

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

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

NO LANDLINE 0

DON’T KNOW d

REFUSED r



E8a NE d OR r

E8e. Does (he/she) have a cell phone?

YES 1

NO 0 GO TO E8g

DON’T KNOW d GO TO E8g

REFUSED r GO TO E8g

E8e=1

E8f. Can I have that number?

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

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

DON’T KNOW d

REFUSED r


E8 NE d OR r

E8g. What is (his/her) work telephone number?

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

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

NO WORK NUMBER 0

DON’T KNOW d

REFUSED r

E8a NE d OR r

E8h. What is (his/her) email address?

INTERVIEWER: ENTER E-MAIL ON NEXT SCREEN

(STRING 50)

EMAIL ADDRESS

DOESN’T HAVE ONE 0 GO TO E8j

DON’T KNOW d GO TO E8j

REFUSED r GO TO E8j


E8H NE 0, d, OR r

E8i. Does (he/she) have another email address?

INTERVIEWER: ENTER E-MAIL ON NEXT SCREEN

(STRING 50)

EMAIL ADDRESS

DON’T KNOW d

REFUSED r




SECOND CONTACT

E8a NE d OR r

E9a. What is the full name of the second person we should contact?

(STRING 50)

FIRST NAME

(STRING 50)

MIDDLE INITIAL/NAME

(STRING 50)

LAST NAME

DON’T KNOW d GO TO END1

REFUSED r GO TO END1


E9a NE d OR r

E9b. What is (his/her) address?

PROBE: Is there an apartment number?

STREET 1

STREET 2

APT. #

CITY

STATE

ZIP

DON’T KNOW d

REFUSED r




E9a NE d OR r

E9c. What is (his/her) relationship to you?

SPOUSE/PARTNER 1

MOTHER 2

FATHER 3

SISTER/BROTHER 4

GRANDMOTHER/GRANDFATHER 5

SON/DAUGHTER 6

FRIEND 7

OTHER (SPECIFY) 99

_____________________________ (STRING 50)

DON’T KNOW d

REFUSED r


E9a NE d OR r

E9d. What is (his/her) home telephone number?

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

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

NO LANDLINE 0

DON’T KNOW d

REFUSED r


e9a NE d OR r

E9e. Does (he/she) have a cell phone?

YES 1

NO 0 GO TO E9g

DON’T KNOW d GO TO E9g

REFUSED r GO TO E9g

E9E=1

E9f. Can I have that number?

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

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

DON’T KNOW d

REFUSED r




E9a NE d OR r

E9g. What is (his/her) work telephone number?

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

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

NO WORK NUMBER 0

DON’T KNOW d

REFUSED r

E9a NE d OR r

E9h. What is (his/her) email address?

(STRING 50)

EMAIL ADDRESS

DOESN’T HAVE ONE 0 GO TO E9j

DON’T KNOW d GO TO E9j

REFUSED r GO TO E9j

E9h NE 0, d, or R

E9i. Does (he/she) have another email address?

(STRING 50)

EMAIL ADDRESS

DON’T KNOW d

REFUSED r


interview completed

END1. Thank you very much for your time. Those are all the questions I have right now. You will receive a $65 gift card. Thank you for your participation in the study.



If MakeDialphone=5

END2. Please hand the phone back to our field locator.







File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitlePACT Responsible Fatherhood Baseline Survey FOLLOW UP
SubjectCATI
AuthorMathematica Staff
File Modified0000-00-00
File Created2022-04-22

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