Attachment C-1. Changes to Waves A-I Screener Survey
Item |
Currently Approved Question Text |
Currently Approved Responses |
Revision Type |
Revised Question Text |
Revised Responses |
ABS_S3b. |
Are you…? |
1.Male 2.Female |
Revision based on HHS Best Practices for Demographic Questions: Race/Ethnicity (R/E) and Sexual Orientation/Gender Identity (SO/GI), 5/20/21 |
ABS_GEND: What sex were you assigned at birth, on your original birth certificate? |
1. Male 2. Female 3. Refused 4. Don’t know |
ABS_NQRACE1. |
This is about Hispanic ethnicity. Are you of Spanish, Hispanic, or Latino descent? |
1. No, I am not 2. Yes, Mexican, Mexican American, Chicano 3. Yes, Puerto Rican 4. Yes, Cuban 5. Yes, Central American 6. Yes, South American 7. Yes, Caribbean 8. Yes, Other Spanish/Hispanic/Latino |
Revision based on HHS Best Practices for Demographic Questions: Race/Ethnicity (R/E) and Sexual Orientation/Gender Identity (SO/GI), 5/20/21 |
ABS_NQRACE2_FRESH [M] What is your race? |
American Indian or Alaska Native – Type in name of enrolled or principal tribe
Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian – Type in race
Black or African American
Native Hawaiian or Other Pacific Islander Guamanian or Chamorro Samoan Other Pacific Islander – Type in race
White
|
ALL_G1619 |
Would you say that you can…? [GRID]
Carry on a conversation in Spanish, both understanding and speaking
Read a newspaper or book in Spanish
Carry on a conversation in English, both understanding and speaking
Read a newspaper or book in English
|
Very well Pretty well Just a little Not at all |
Deletion: replaced with language questions that are more clear and relevant (listed in next 3 rows) |
|
|
QACSLAN1 |
|
|
Addition to note other languages spoken by participants |
Do you speak a language other than English at home? |
1. Yes 2. No |
QACSLAN2 |
|
|
Addition to note other languages spoken by participants |
What language do you speak at home other than English? |
1. Spanish 2. Chinese (any dialect) 3. Tagalog 4. Vietnamese 5. French 6. German 7. Another language |
QACSLAN3 |
|
|
Addition to assess English language comprehension |
How well do you speak English? |
1. Very well 2. Well 3. Not well 4. Not at all |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Breithaupt, Laura (CDC/DDNID/NCCDPHP/OSH) |
File Modified | 0000-00-00 |
File Created | 2022-10-03 |