ATTACHMENT B - QUEST_OAW Afghan Supplement Survey

Operation Allies Welcome Afghan Supplement Survey

ATTACHMENT B - QUEST_OAW Afghan Supplement Survey

OMB: 0970-0613

Document [docx]
Download: docx | pdf

OMB: 0970-XXXX

Expiration Date: XX/XX/XXXX




AFGHAN SUPPLEMENT

SURVEY QUESTIONNAIRE1








PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to learn how Afghan Operation Allies Welcome evacuees adapt to life in the U.S. Public reporting burden for this collection of information is estimated to average 55 minutes per respondent, including any time you needed to collect information to be able to answer our questions. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of information, please contact Office of Refugee Resettlement at asr@acf.hhs.gov.



AFGHAN SUPPLEMENT

SURVEY QUESTIONNAIRE


MS1. Hi. I’m ________, calling from SSRS, a research company, about a study sponsored by the Office of Refugee Resettlement. How are you today? We are doing a study about Afghan evacuees’ experiences in the United States.


Is this (INSERT NAME FROM SAMPLE)?


(INTERVIEWER: If respondent not on phone, ask “May I speak with him/her?”. Repeat intro if respondent comes to phone.)


1 Respondent is on the phone [CONTINUE TO MS2]

2 Respondent is not available right now [SET UP CALLBACK]

3 Respondent no longer lives here [CONTINUE TO S1a]

9 (DO NOT READ) Refused [THANK & TERM]



(ASK IF MS1=3)

S1A. Do you have a phone number where I can reach (INSERT NAME FROM SAMPLE)?


___________ [Enter new telephone number]

9 (DO NOT READ) Don’t know/Refused



(ASK IF MS1=1 AND CELL SAMPLE)

'CELL1' [CELL2]. Have I reached you on a cell phone?


1 Yes

2 No

9 REFUSED


(ASK IF CELL1=1, 9)

'CELL2' [CELL2]. Are you currently on the road and driving right now?


(INTERVIEWER: Confirm that the respondent is not currently driving while on the phone with you. If they are driving, you will need to schedule another time to conduct the interview.)



1 Yes

2 No

9 REFUSED


(ASK IF CELL2=1, 9 CELL SAMPLE AND DRIVING OR REFUSED)

'CELL3' [CELL3]. When would be a better time to call you?


[IF RESPONDENT INDICATES THAT THEY ARE WILLING TO TALK NOW: “I’m sorry, but for your safety we’re not able to do the interview while you’re driving. When would be a better time to call you?”] [SET CALLBACK]

(ASK IF MS1=1)

MS2. Yes, good (morning/afternoon/evening)!


(INTERVIEWER -- If necessary, confirm the person’s full name and verify age or year of birth)


Great! Hopefully you recently received a letter or email from us telling you about the survey. And just to confirm, were you evacuated from Afghanistan and did you enter the United States through Operation Allies Welcome between July 31, 2021 and December 16, 2022?


[PROBE: either as a Principal Applicant or as part of a family. They would need to have entered through the special program that evacuated Afghans starting July 31, 2021. If they entered as a resettled refugee or through any other admissions programs the answer here would be 2.]


1 Respondent is an Afghan evacuee [CONTINUE TO MS3]

2 Respondent is not an Afghan evacuee [THANK & TERM]

9 (DO NOT READ) Don’t know/Refused [THANK & TERM]




(ASK IF MS2=1)

MS3B. What year were you born?

(DO NOT READ): Year of birth: [INSERT YEAR OF BIRTH FROM SAMPLE]

1 Confirmed year of birth [CONTINUE TO INTRO]

2 Unable to confirm year of birth [THANK & TERM]



IF ‘AGE’ FROM SAMPLE <18


MS3A. What is your age?


INTERVIEWER: PLEASE ENTER AGE AS A 3 DIGIT CODE. FOR INSTANCE 003, 016, 078..ETC.)


1 [ENTER AGE]

9 (DO NOT READ) Refused [INTERVIEWER: IF RESPONDENT REFUSES ONCE, READ PROBE FROM Q*Q. IF STILL REFUSED CONTINUE WITH THE SURVEY]


(ASK IF MS3A<18 or ‘AGE’ FROM SAMPLE IS <18)

MINOR. May I speak with your parent or guardian?


  1. Yes

  2. No [END INTERVIEW AND DISPO AS INITIAL REFUSAL]

  3. Parent/Guardian is not available right now [SET UP CALLBACK]

9 (DO NOT READ) Refused [THANK & TERM]



IF MINOR=1

WHEN PARENT/GUARDIAN COME TO THE PHONE PLEASE READ


PARENT. Hi. I’m ________ calling on behalf of the Office of Refugee Resettlement, how are you today? We are doing a study about Afghan evacuees’ adjustment to life in the United States.


Can you answer questions on behalf of (INSERT NAME FORM SAMPLE)?


  1. Yes

  2. No [DISPO AS INITIAL REFUSAL]

9 (DO NOT READ) Refused [DISPO AS INITIAL REFUSAL]



CREATE ‘PROXY’ VARIABLE AND ASSIGN CODE 1 IF PARENT =1.


PROGRAMMER: IF PROXY =1 PLEASE DISPAY ‘PROXY’ ON THE TOP OF THE SCREEN


INTERVIEWER: PLEASE EDIT INTRODUCTION TEXT AS NECESSARY



INTRO. We would like you to be in a voluntary study about how Afghan evacuees who were resettled through Operation Allies Welcome have adapted to life in the U.S. and how Afghans can be supported better. We are interviewing over 1,100 Afghans like yourself across the country. It is funded by the Office of Refugee Resettlement and being conducted by two research organizations, the Urban Institute and SSRS.

We would like to ask some questions about you and your family - your education, work, community, and access to services such as healthcare, transportation, and housing. It takes up to 55 minutes, but can sometimes be shorter. For your participation, we will send you a $50 gift card.

Before we start, we just need to share a few details. You don’t have to answer any questions you don’t want to answer, and you can stop the interview at any time. The answers you give to us will be private and will not have your name on them. You will continue to receive social services and benefits regardless of your decision to participate in the study. Your responses will be combined with those of other Afghans for analysis. The data will be stored for future research without your name.

Finally, there is no risk associated with your participation because of the care we are taking to keep your name and your answers safe. Please be aware that while there are no direct benefits to you, your participation will help the Office of Refugee Resettlement understand what Afghans like you are going through and how to improve the resettlement experience.

Also, a federal agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number for this information collection is 0970-XXXX and the expiration date is XX/XX/XXXX.

If you have any comments about how long this survey took or any other aspect of this survey, including suggestions for how to reduce the time needed, you can send comments to the Office of Refugee Resettlement at asr@acf.hhs.gov or call and leave a message at 202-401-9246.



Do you have any questions about the study or the interview?

Do you agree to be interviewed?

01 YES è [INTERVIEWER: IF YES, THANK AND CONTINUE]

02 NO è [INTERVIEWER: IF NO, SAY “Ok, thank you for considering.” AND

TERMINATE]

INTRO1a. Next, we would like to ask your permission to record this interview. This is also voluntary. It will help us to get all the information and feedback you provide. We will destroy the recording after this study is completed.

Do we have your permission to record the interview?

01 YES è [INTERVIEWER: IF YES, THANK AND CONTINUE]

02 NO è [INTERVIEWER: IF NO, SAY “Ok, we will not record this interview.” AND CONTINUE. (DO NOT RECORD)

[PN: IF INTRO1a=01 TURN ON RECORDING FOR INTERVIEW, IF INTRO1a=02, DO NOT RECORD]

Now let’s begin.

BEGIN: We would like to start by asking you a few questions about each person who lives in your home, or who is staying or visiting there and has no other home.



(ASK ALL)

[PN: ALLOW UP TO 15 NAMES TO BE ENTERED.]

Q1. Including yourself, how many people are living or staying at this address? Please include family members as well as others not related to you who live in your home.


Enter Number: ________

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q1>1, 98, 99)

Q1A. Not counting you, start with your oldest household members and tell me the names of each household member who lives there. PROBE: Are there other household members living with you?

(INTERVIEWER: If respondent does not want to provide names of members in the household, tell them we are only using the name to refer to the correct person in later questions. Just a first name or initials are fine.)


(PROBE: ARE THERE OTHER PERSONS WHO USUALLY LIVE HERE BUT ARE TEMPORARILY ABSENT?)


01 [AUTO-POPULATE RESPONDENT NAME]

02 [RECORD HH MEMBER #2 IF APPLICABLE]

03 [RECORD HH MEMBER #3 IF APPLICABLE]

04 [RECORD HH MEMBER #4 IF APPLICABLE]

05 [RECORD HH MEMBER #5 IF APPLICABLE]

06 [RECORD HH MEMBER #6 IF APPLICABLE]

07 [RECORD HH MEMBER #7 IF APPLICABLE]

08 [RECORD HH MEMBER #8 IF APPLICABLE]

09 [RECORD HH MEMBER #9 IF APPLICABLE]

10 [RECORD HH MEMBER #10 IF APPLICABLE]

99 (DO NOT READ) NO OTHER HH MEMBERS



[PN: ASK Q2 for each member named in Q1a, including the respondent. COLLECT Q2 FOR ALL HH MEMBERS BEFORE MOVING TO Q3]



[PN: AUTOPOPULATE Q2(a) WITH CODE 01 – SELF]

Q2(a-j). What is (INSERT NAME)’s relationship to you?


(DO NOT READ LIST)


01 Self

02 Husband or wife

03 Unmarried partner

04 Biological son or daughter

05 Adopted son or daughter

06 Stepson or stepdaughter

07 Brother or sister

08 Father or mother

09 Grandchild

10 Parent-in-law

11 Son-in-law or daughter-in-law

12 Foster child

13 Other relative

16 Other

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(FOR ONLY THOSE WITH Q2(a-j)=01-13, I.E., FAMILY MEMBERS, ASK Q3 TO Q4B BEFORE MOVING TO Q5).

INSERT “Now we’d like to get some information on your family living with you” ONLY FOR Q3, I.E. THE SECOND FAMILY MEMBER

(ASK ALL)

Q3(a-j). (Now we’d like to get some information on your family living with you). [Are you/Is (INSERT NAME)] male or female?


(INTERVIEWER: CONFIRM BASED ON NAME; PROBE AS APPROPRIATE AND EXPLAIN NEED FOR ASKING THIS QUESTION]


01 Male

02 Female

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q4A(a-j). What is (your/INSERT NAME)’s age?


(INTERVIEWER: Please report babies as age 0 when the child is less than 1 year old)


___________ [RANGE 1-110]

000 Less than one year

998 (DO NOT READ) Don’t know

999 (DO NOT READ) Refused



(ASK ALL)

Q4B(a-j). What year [were you/was [INSERT NAME]] born?


1 ENTER 4-DIGIT YEAR

8 (DO NOT READ) Don’t know

9 (DO NOT READ) Refused



IF Q4A_1<16 OR Q4B_1 YEAR<2007 PLEASE DISPLAY “(DO NOT READ): Interviewer, please confirm that respondent age is [INSERT AGE FROM Q4A_1] and respondent date of birth is [INSERT DATE OF BIRTH FROM Q4B_1].” IF YES, PROCEED, IF NO, GO BACK TO Q4A_1.



[PN: STARTING WITH RESPONDENT, ASK MQ7 FOR EACH HOUSEHOLD MEMBER in Q2 (if Q2(a-j)<98).]



READ TO ALL: Here we will ask not just about family members but all members of your household.


(ASK ALL. RESPONDENT DOES NOT GET MQ7.)

[PN: AUTO-POPULATE FOR HOUSEHOLD MEMBERS Q2(b-j)<98 WITH RESPONDENT RESPONSE IF MQ7_1 =1]

MQ7(b-j). Was [insert name] evacuated from Afghanistan and did they enter the United States through Operation Allies Welcome between July 31, 2021 and December 16, 2022?


[PROBE: either as a Principal Applicant or as part of a family]


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK OF RESPONDENT ONLY)

[PN: IF MQ7_1=1 DO NOT ASK MQ7(b-j) FOR THE HOUSEHOLD MEMBERS Q2(b-j)<98. IF MQ7_1=2-99 ASK MQ7(b-j) FOR REMAINING HOUSEHOLD MEMBERS]

MQ7_1. Were all members of this household evacuated from Afghanistan and did they enter the United States through Operation Allies Welcome between July 31, 2021 and December 16, 2022?


(INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HH MEMBERS)


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

A1. Were any members of this household born in the United States?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused

(ASK ALL)

A2. Thinking of all members of this household who were not born in the U.S., did any arrive in the U.S. before July 31, 2021?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK RESPONDENT ONLY)

MQ9. In what state and city did you originally resettle, not including any time at a military base?

State, Specify_____________ [PN: SHOW STATE LIST]


Q9A. City, Specify_______________

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

[PN: AUTO-POPULATE FOR PERSONS B-J USING RESPONDENT’S MQ10A RESPONSE IF Q10_1=1]

MQ10(a-j). What is (YOUR/INSERT NAME)’s ethnic origin?


(DO NOT READ LIST)


  1. PASHTUN

  2. TAJIK

  3. HAZARA

  4. UZBEKI

97 OTHER (SPECIFY) _______________

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK OF RESPONDENT ONLY AND IF MQ10=1-97)

[PN: IF Q10_1=1 DO NOT ASK MQ10(B-J). IF Q10_1=2-99 ASK MQ10(B-J) FOR REMAINING HOUSEHOLD MEMBERS WITH Q2(B-J)<98]

Q10_1. Are all members of this household of [INSERT ETHNIC ORIGIN FROM MQ10a] origin?


(INTERVIEWER: IF YES, DO NOT ASK ABOUT OTHER HOUSEHOLD MEMBERS)


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused




(ASKED OF RESPONDENT ONLY)

Q5. What is your current marital status?


(DO NOT READ LIST)


01 Now married, spouse living in household

02 Now married, spouse not living in household

03 Divorced or separated

04 Never married

05 Widowed

97 Other (SPECIFY) _______________

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



[PN: MQ13 AND 14 ARE ONLY ASKED OF THE RESPONDENT]

(ASK OF RESPONDENT ONLY)

MQ13. How many states have you lived in since you arrived in the U.S., not including any time on a military base?


________ [PN: RANGE 1-97]

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



[ASK IF MQ13>1]

MQ14. What was the reason for your first move from the initial state where you were resettled? Was it for:


[MARK ALL THAT APPLY]


  1. Economic opportunity, such as employment,

  2. To be closer to family or friends

  3. To live in a place where there are more people from Afghanistan,

  4. Affordable housing

97 Other (DO NOT READ)

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


READ TO ALL: Now we’re going to ask about the help you received when you were first resettled in a community, not including any time at a military base.


(ASK ALL)

A3. On a scale from 1 to 5, with 1 being very easy and 5 being very hard, how easy or hard was it to get services from your local resettlement agency when you arrived in your first resettlement community?

__ (range 1 to 5)

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused

READ TO ALL: Now I want to ask you some questions about your experience before your arrival in the U.S. These questions are about your experience only.


(ASK ALL)

MQ19. What was your work status in Afghanistan? Were you…


(READ LIST)

(INTERVIEWER: IF THEY SAY THEY WERE TOO YOUNG, A STUDENT, TOO OLD, OR ANY OTHER REASON FOR NOT WORKING, CHOOSE “NOT WORKING FOR PAY”)


01 Not working for pay,

02 Working for paid jobs, SPECIFY occupation:__________

03 Self-employed (DO NOT READ: business, profession, or own farm),

04 OTHER

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



[ASK IF MQ19=1]

MQ20. What is the main reason you were not working for pay in Afghanistan?

(READ LIST)


  1. Too young to work or still in school,

02 Taking care of children or family,

03 Elderly (past retirement age)

04 Safety concerns

05 Poor health or disability

06 Lack of work authorization,

07 No jobs available

08 Other

97 (DO NOT READ) NOT APPLICABLE

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



READ TO ALL: Next I want to ask about your ability in your native language and in English.


(ASK ALL)

Q21A. How well can you read in your native language:


(READ LIST)


01 Very well,

02 Well,

03 Not well,

04 Not at all?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused

(ASK ALL)

Q23. When you arrived in the U.S., how well did you speak English:


(READ LIST)


01 Very well,

02 Well,

03 Not well,

04 Not at all?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK ALL)

Q24. How well do you speak English now:


(READ LIST)


01 Very well,

02 Well,

03 Not well,

04 Not at all?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q25. Since arriving in the US, have you ever taken any ESL or English classes, either online or in a classroom?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK ALL)

Q27. What challenges, if any, have you had taking ESL or English classes in the US?


(INTERVIEWER: WE WANT TO ASK ABOUT CHALLENGES BOTH TO PEOPLE WHO SAID THEY HAD TAKEN ENGLISH CLASSES AND THOSE WHO HAD NOT, SINCE THESE CHALLENGES MAY HAVE PREVENTED SOME PEOPLE FROM TAKING ANY CLASSES)

[PN: ALLOW MULTIPLE RESPONSES – CODES 11, 98-99 MUTUALLY EXCLUSIVE]

(READ LIST)


  1. Cost of classes,

  2. Too busy with work responsibilities,

  3. Too busy with child care or family responsibilities,

  4. Lack of knowledge on classes available,

  5. Lack of transportation,

  6. Poor health or disability

  7. or was there some other reason?

11 (DO NOT READ) NO CHALLENGES

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



READ TO ALL: Next I would like to ask some questions about any programs or classes you may have taken here in the U.S. other than studying English.


(ASK ALL)

Q28. Since arriving in the US, have you participated in a program to prepare you for a job, either online or in a classroom?


(INTERVIEWER: IF NEEDED: JOB TRAINING CLASSES OR PROGRAMS OR JOB SEARCH TRAINING (INTERVIEW AND RESUME PREPARATION, JOB SEARCH TRAINING))


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



READ TO ALL: Next I would like to ask about education that you and your adult family members received before coming to the U.S.



(ASK ALL)

[PN: BEGIN WITH Q30a to Q34 FOR RESPONDENT, AND THEN ASK Q30B-J to Q33B-J FOR FAMILY MEMBERS FOR WHOM Q2(a-j)<14 IF Q4A=16-110,998,999 AND MQ7=1,98,99;)]

Q30(a-j). What was the highest degree or level of school that [YOU/INSERT NAME] completed before coming to the U.S.?


(DO NOT READ LIST)


01 No schooling

02 Primary or elementary school

03 Lower secondary school (or middle school)

04 Upper secondary school (or high school)

05 Some technical or vocational training

06 Some university classes but did not attain degree

07 University (bachelor's degree)

08 Advanced degree (master's, PhD, or professional degree)

09 Religious school

97 Other (SPECIFY)__________________

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK IF Q30(a-j) > 01)

Q31(a-j). Has [YOUR/INSERT NAME’s] education, degree, or certificate earned outside the U.S. been:


(READ LIST)


01 Fully recognized in the U.S,

02 Partially recognized, or

03 Not at all recognized in the U.S.?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



Q32(a-j). Since arriving in the U.S., (have you/has [INSERT NAME]) pursued a degree or certificate by attending school, community college, or college, with classes either online or in a classroom?

(INTERVIEWER: THIS SHOULD INCLUDE ANY DEGREE OR CERTIFICATE THEY HAVE BEGUN AND NOT NECESSARILY COMPLETED; THIS SHOULD NOT INCLUDE ESL OR ENGLISH CLASSES, JOB TRAINING WITH NO PROFESSIONAL CERTIFICATE, OR OTHER CLASSES THAT ARE NOT ASSOCIATED WITH A DEGREE OR CERTIFICATE)


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q32 (a-j)=01)

Q33(a-j). At what level was/is (your/[INSERT NAME]’s) degree or certificate program. Was/is it:


(READ LIST)

(INTERVIEWER: THIS SHOULD NOT INCLUDE ESL, JOB TRAINING WITH NO PROFESSIONAL CERTIFICATE, OR OTHER PROGRAMS NOT LISTED BELOW)


01 GED or high school equivalency,

02 Professional certificate,

03 Associate's degree,

04 Bachelor's degree,

05 An advanced degree (DO NOT READ: master's, PhD, or professional),

97 OTHER

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK ALL) PN: ASK ONLY OF THE RESPONDENT; SKIP TO Q35 FOR FAMILY MEMBERS

Q34 What challenges, if any, have you had getting training or education (not counting ESL or English classes)?


(INTERVIEWER: WE WANT TO ASK ABOUT CHALLENGES BOTH TO PEOPLE WHO SAID THEY HAD PURSUED SOME EDUCATION AND THOSE WHO HAD NOT, SINCE THESE CHALLENGES MAY HAVE PREVENTED SOME PEOPLE FROM PURSUING SUCH TRAINING)

[PN: ALLOW MULTIPLE RESPONSES – CODES 11, 97, 98-99 MUTUALLY EXCLUSIVE]

(READ LIST)

  1. Cost of classes,

  2. Too busy with work responsibilities,

  3. Too busy with child care or family responsibilities,

  4. Lack of knowledge on classes available,

  5. Lack of transportation,

  6. Poor health or disability

  7. or was there some other reason?

11 DO NOT READ: No challenges

97 (DO NOT READ) NOT APPLICABLE

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


READ TO ALL: In this next part of the survey, I’d like to ask about (you/ you and other family members of your household/other family members of your household):

(ASK ALL)

Q35(a-j). Last week, did [you/INSERT NAME] work for pay at a job or business?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK Q38(a-j) IF Q35(a-j)=02; ELSE SKIP TO Q40)

Q38(a-j). During the last 4 weeks, (have you/has [INSERT NAME]) been actively looking for work?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK IF Q38(a-j)=02)

Q39(a-j). Why (have you/has [INSERT NAME]) not been looking for work?

[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]

(READ LIST)


  1. Has a job but was temporarily absent for any reason (e.g., illness, bad weather, vacation, labor-management disputes)

  2. Poor health or disability

03 Limited English ability

04 Attending school or training

05 Providing child care or family caregiving

06 Is elderly (past retirement age)

07 Lack of transportation

  1. OTHER

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q35(a-j)=02 AND Q39(a-j) NOT EQUAL 01)

Q39A(a-j). Although [you/INSERT NAME] did not work last week, did [you/INSERT NAME] have a job or business at any time in the past year?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK IF Q35(a-j)=01 or Q39(a-j)=01 or Q39A(a-j)=01)

Q45(a-j). What kind of work do /does [you/INSERT NAME] do, that is, what is [your/INSERT NAME]’S occupation? For example: plumber, typist, or farmer.


(INTERVIEWER: IF NEEDED: what is the work you/[INSERT NAME] are/is doing?)

(INTERVIEWER: If they say more than one, ask them which one is their principal occupation)


________ (record occupation)

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused

(ASK IF Q35(a-j)=01 OR Q39(a-j)=1 OR Q39A(a-j)=1)

Q40(a-j). What was (your/[INSERT NAME]'s) hourly wage at your/his/her primary job?


________ (RANGE: 0-96)

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



Now I will ask you questions about your/INSERT NAME’s work over the past year.


(ASK IF Q35(a-j)=01or Q39(a-j)=01 or Q39A(a-j)=01)

Q42(a-j). In the past year, how many weeks did [you/INSERT NAME] work, even for a few hours, including paid vacation, paid sick leave, and military service?


(INTERVIEWER: If they’re having difficulty giving you a number of weeks, probe for dates and calculate the number of weeks. If needed, please let them know that a year has 52 weeks. Reassure them their best guess is okay.)


________ (RANGE: 0-52)

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused

(ASK IF Q35(a-j)=01or Q39(a-j)=01 or Q39A(a-j)=01)

Q43(a-j). In the past year, how many hours per week did [you/INSERT NAME] usually work?


________ (RANGE: 0-168)

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q48(a-j). Have you/Has [INSERT NAME] faced any of the following challenges in finding a job in the US?



[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]

(READ LIST)

(ALLOW MULTIPLE RESPONSES

01 Limited English ability,

02 Low literacy in own language,

03 Not knowing how to find a job,

04 Employers not recognizing qualifications or work experience from outside the US,

05 Child care or family responsibilities,

06 Poor health or disability,

07 Lack of transportation,

08 Or some other challenge?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



[ASK IF Q35(a-j)=1 OR Q39(a-j)=1 OR Q39A(a-j)=1)

Q53(a-j): Does your/[INSERT NAME]’s current or most recent job correspond to your/[INSERT NAME]’s level of education?


01 Your/his/her level of education is higher than what is required by you/his/her job.

02 Your/his/her level of education is matched to what is required by your/his/her job.

03 Your/his/her job requires a higher level of education.

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



ASK IF Q35(a-j)=1 OR Q39(a-j)=1 OR Q39A(a-j)=1)

Q55(a-j): Does your/[INSERT NAME]’s current or most recent job come with health insurance benefits?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q35(a-j)=1 OR Q39(a-j)=1 OR Q39A(a-j)=1)

Q56(a-j). Does [your/[INSERT NAME]'s] current or most recent job provide a higher hourly wage than your/his/her first job in the US?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused




[PN: SHIFT BACK HERE TO ASKING ONLY ABOUT THE RESPONDENT, NOT ALL ELIGIBLE FAMILY ADULTS]

READ TO ALL: Now I would like to ask you some questions about your family and how you support yourselves.


(ASK ALL)

Q57. Approximately, what was your family's average monthly net household income in the past year, that is, the money left over after taxes are removed?


________ [RANGE: 0-99997]

99998 (DO NOT READ) Don’t know

99999 (DO NOT READ) Refused



(ASK IF Q57=99998 OR Q57=99999)

Q57A. (IF Q57=99998: Yes, I understand it is hard to estimate this, but)
(IF Q57=99999: I understand that this can be a sensitive question, but)
Would you be able to tell me if your average monthly net household income was:


(READ LIST)


01 less than $2300,

02 more than $2300,

03 or about that amount?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q57A=01)

Q57B. And would you say it was


(READ LIST)


01 less than $1200

02 more than $1200

03 or about that amount?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q57B=01)

Q57C. And would you say it was


(READ LIST)


01 less than $300

02 more than $300

03 or about that amount?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q57B=02)

Q57D. And would you say it was


(READ LIST)


01 less than $1800

02 more than $1800

03 or about that amount?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q57A=02)

Q57E. And would you say it was


(READ LIST)


01 less than $3300

02 more than $3300

03 or about that amount?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q57E=01)

Q57F. And would you say it was


(READ LIST)


01 less than $2700

02 more than $2700

03 or about that amount?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF Q57E=02)

Q57G. And would you say it was


(READ LIST)


01 less than $4500

02 more than $4500

03 or about that amount?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q58. Was your family able to pay its monthly living expenses last month?


(INTERVIEWERS: if necessary: To pay for your housing, utilities, transportation, and other bills)


  1. Yes

  2. No

  1. (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

A4. For which of the following financial issues does your household need assistance?



(READ LIST)

(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)


  1. Yes

  2. No

98 (DO NOT READ) Don’t Know

  1. (DO NOT READ) Refused



a Filing local, state, or federal taxes

b Banking services (like getting a bank account, credit card, or loan)

c Budgeting

d Anything else, Specify_____


READ TO ALL: Next I would like to ask about your family’s receipt of different government benefits. Here we are asking about specific programs that you had to apply for, potentially with help applying from your resettlement agency.


(ASK ALL)

Q60. In the past year, have one or more persons in your family received food stamps? This is when the government gives you vouchers that you exchange for food, also known as “SNAP”.


(INTERVIEWER: Food stamps, now known the Supplemental Nutrition Assistance Program (SNAP), are vouchers issued by the government for low income families or individuals that can be exchanged for food. (IF PROGRAM NAME IS NOT ‘SNAP’ INSERT This program is also known as (INSERT STATE SPECIFIC NAME) in the respondent’s state.)


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK IF THERE ARE CHILDREN <18 in the Household; IF ANY Q4a (B-J)=0-17)

Q61. In the past year, have one or more persons in your family received TANF, also known in your state as [INSERT PROGRAM NAME BASED ON SAMPLE STATE] This is when the government provides cash assistance to families with children to help pay for food, shelter, utilities, and non-medical expenses.


(INTERVIEWER: TANF is a federally funded program run by states that provides limited cash assistance to extremely low-income parents and their children. TANF provides financial assistance to help pay for food, shelter, utilities, and expenses other than medical. Each state in the U.S. has a different name for its TANF program, see list provided to match to respondent’s current state.]


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q62. In the past year, have one or more persons in your family received “SSI” or Supplemental Security Income? This is when the government provides cash assistance to the elderly and disabled.


(INTERVIEWER: Supplemental Security Income (SSI) is a United States government program that provides stipends to low-income people who are either aged 65 or older, blind, or disabled.)


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q63. In the past year, have one or more persons in your family received income from General Assistance or other welfare? This is when the government assists adults in meeting their basic needs for housing, utilities, personal needs, and transportation.


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused

(ASK ALL)

Q64. In the past year, have you or anyone in your family received any other government supports, from federal, state, or local government?


01 Yes, (SPECIFY) ___________

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



READ TO ALL: Next I would like to ask you some questions about your neighborhood and connections to the community.


(ASK ALL)

A5. How would you rate the following characteristics of the area where you currently live on a scale of 1 to 5, with 1 being poor and 5 being excellent?

(RANDOMIZE ORDER of a-j)

(REPEAT THE SCALE IF NEEDED)

___ (RANGE 1-5)

  1. Availability of good jobs?

  2. Access to public transportation?

  3. Ability to get around without driving a car?

  4. Availability of affordable housing?

  5. Quality of housing?

  6. Availability of places to get medical care?

  7. Availability of places to buy religiously appropriate, halal food?

  8. Availability of parks and playgrounds?

  9. Availability of places for religious worship?

  10. Quality of schools?



(ASK ALL)

Q66. Have you visited the home of any friends or neighbors of your same cultural background, or have any visited your home?


(INTERVIEWERS: if necessary: They share the same culture, ethnic group, language, or religion)


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK ALL)

Q67. Have you visited the home of any friends or neighbors of a different cultural background, or have any visited your home?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

MQ69. Which, if any, kinds of groups or organizations have you participated in? Have you participated in:


(INTERVIEWER: IF NEEDED ON GROUP RELATED TO CHILDREN'S SCHOOL: like the PTA or parents' volunteering groups)

(READ LIST)

(INTERVIEWER: PAUSE AND CAPTURE EACH ONE)


  1. Yes

  2. No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


a Group related to children's school?

b Religious organization or group?

c Community or ethnic organization or club?

d Sports club or team?

e Any other group? (SPECIFY) _________



(ASK ALL)

Q70. How welcome do you currently feel in the U.S.? We want to know how welcome you feel in your community today, and not when you first arrived in the

US. Today, do you feel:


(READ LIST)


01 Very welcome,

02 Somewhat welcome,

03 Somewhat unwelcome, or

04 Very unwelcome?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused




READ TO ALL: Next I would like to ask you some questions about immigration and legal help.


(ASK ALL)

A6. What is your current immigration status?


(READ LIST)


  1. Humanitarian parole

  2. Special Immigrant Visa (SIV)

  3. Temporary Protected Status (TPS)

  4. Asylee

  5. Green card

  6. Other, SPECIFY______

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


(ASK ALL)

A7. Since you arrived in the United States, did you apply to adjust your immigration status? This means that you submitted an application for a green card, asylum, Temporary Protected Status, a Special Immigrant Visa, or another type of visa.


01 Yes

02 No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



(ASK IF A7=01)

A8. What status did you apply for?


(READ LIST)


  1. Special Immigrant Visa (SIV)

  2. Temporary Protected Status (TPS)

  3. Asylum

  4. Green card

  5. Other, SPECIFY______

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


(ASK IF A7=01)

A9. When was your application for this new status submitted to the government? Your best estimate is fine.


(INTERVIEWER: Assist respondent in identifying the month and year)


Month___

Year____


(ASK IF A7=01)

A10. Has a decision been made on your [visa type from A8] application?


  1. Yes

  2. No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused





(ASK IF A10=01)

A11. Were you granted the [visa type from A8] status?


01 Yes

02 No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


(ASK ALL)

A12. Have you faced any challenges adjusting your immigration status in the United States?


  1. Yes

  2. No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


(ASK IF A12=01)

A13. Have you faced any of the following challenges adjusting your immigration status in the United States?


[INTERVIEWER: PAUSE AND CAPTURE EACH ONE]

(READ LIST)

(RANDOMIZE ORDER OF LIST)


01 Yes

02 No

98 (DO NOT READ) Don’t Know

  1. (DO NOT READ) Refused


  1. Lack of information

  2. Limited English ability

  3. Cost of applying

  4. Lack of transportation

  5. Lack of immigration attorney or immigration assistance

  6. Lack of required documentation

  7. Medical requirements

  8. Other, SPECIFY______

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


(ASK ALL)

A14. Do you or your family need any of the following types of immigration assistance?

[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]

(READ LIST)


  1. Representation by an immigration attorney or legal provider

  2. Information on how the immigration system works in the U.S.

  3. Assistance with completing applications, interviews, or other processes

  4. Cash to pay for legal costs

  5. Other, SPECIFY_________

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


(ASK ALL)

A15. Do you have family members in Afghanistan or another country whom you would like to permanently move to the U.S.?


(READ LIST)


  1. Yes

  2. No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


(ASK IF A15=01)

A16. Who is that?


[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]


  1. My spouse

  2. One or more of my children

  3. One or more of my parents

  4. Another family member, SPECIFY______

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



(ASK ALL)

MQ73. Are you planning to become a U.S. citizen?


01 Yes, currently a U.S. citizen

02 Yes, planning to become a U.S. citizen

03 No, not planning to become a U.S. citizen

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q74. Do you have a U.S. driver's license?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused







READ TO ALL: Now I will ask you some questions about housing.


(ASK ALL)

A17. How many housing units have you lived in since you arrived in the United States, not including a military base when you first arrived?

__ (range 1 to 15)


98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



(ASK ALL)

A18. How long did you live in temporary housing before moving into a more permanent housing arrangement, not including any time at a military base?


(INTERVIEWER: This could include being assigned to a hotel, AirBnB, dorm, or other temporary arrangement while they waited to be provided a permanent housing arrangement.)


___ RECORD NUMBER OF MONTHS [PN: RANGE 0-30]


97 (DO NOT READ) Still not in a permanent housing arrangement

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



(ASK unless A18=97)

A19. On a scale from 1 to 5, with 1 being very easy and 5 being very hard, how easy or hard was it to secure a more permanent housing arrangement?


__ (range 1 to 5)


98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



(ASK ALL)

A20. When you were first trying to secure a more permanent housing arrangement, did you have available…

(READ LIST)


01 Yes

02 No

97 (DO NOT READ) Was not required/I was not asked for this

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


a Proof of identity, such as a passport, driver’s license, or social security card?

b Proof of employment, such as an employer letter, pay stubs, or bank statements?

c Proof of past rental history, such as a prior lease or references to prior landlords?

d Credit history

e Money for the deposit or application fee?


(ASK ALL)

A21. Which of the following best describes how you found your current apartment or house?


(READ LIST)


01 I found it myself

02 A friend or relative told me about it

03 My resettlement agency found it for me

97 OTHER, Specify______

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK ALL)

A22. How long have you lived in your current apartment or house?


___ RECORD NUMBER OF MONTHS [PN: RANGE 1-30]


Q77. Is your house or apartment where you currently live…


(READ LIST)


01 Owned or being bought by someone in the household

02 Rented

97 OTHER, Specify_______

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q77A. Is this housing unit in a public housing project, that is, is it owned by a local housing authority or other local public agency?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q78. How many bedrooms are there in your current apartment or house?


____________(RANGE 0-97)

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q79. What is the total monthly rent or housing payment for your home?


(INTERVIEWER: HERE YOU WANT TO KNOW WHAT THE MONTHLY RENT IS, NOT JUST WHAT THE INDIVIDUAL RESPONDENT CONTRIBUTES EACH MONTH]


________ [RANGE: 0-9997]

9998 (DO NOT READ) Don’t know

9999 (DO NOT READ) Refused


(ASK ALL)

A23. On a scale from 1 to 5, with 1 being not at all worried and 5 being very worried, how worried are you about being able to pay your rent, mortgage, or other housing costs in the next six months without any outside assistance?

________ (RANGE: 1 to 5)

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


(ASK ALL)

A24. How many motor vehicles are available for use by your family?

___ RECORD NUMBER OF MOTOR VEHICLES [PN: RANGE 0-10]



(ASK ALL)

A25. What is the primary method of transportation you use in your community?


[PN: ALLOW MULTIPLE RESPONSES – CODES 98-99 MUTUALLY EXCLUSIVE]

(READ LIST)


  1. Walking

  2. Bicycle

  3. Ride-share (Uber, Lyft)

  4. Public transportation

  5. Getting rides from family, friends, or neighbors

  6. Driving a motor vehicle

  7. Other, Specify_____

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



(ASK ALL)

Q80. Do you feel safe walking alone at night in the city or area where you live?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused




(ASK ALL)

Q81. How much do you trust your local police?


01 Not at all

02 Somewhat

03 A lot

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q82. Discrimination may happen when people are perceived as being different than others. Since coming to the U.S., have you experienced discrimination or been treated unfairly by others because of your ethnicity, race, skin color, culture, language or accent, gender, or religion in any of the following situations?


[INTERVIEWER: PAUSE AND CAPTURE EACH ONE]

(READ LIST)


01 Yes

02 No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


a On the street?

b In local businesses?

c At work or when applying for a job or promotion?

d When dealing with police or courts?

e In school or class?

f When looking for a place to live or when renting or buying a home?

g When dealing with health care providers?

h In any other place or situation?


READ TO ALL: Next I’d like to talk about your health and your access to health care services.


(ASK ALL)

Q84. Have you visited the doctor for a routine physical exam within the past year?

IF NEEDED: (A routine physical exam includes “well visit” or preventive care. This can include screenings and checkups; to help prevent health problems before you have any symptoms. They do not include tests or services to monitor or manage a condition or disease once it has been diagnosed.)


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused





(ASK ALL)

MQ85. If you received any healthcare in the past year, what kind of place was it? Was it from....?


[PN: ALLOW MULTIPLE RESPONSES – CODES 08, 98-99 MUTUALLY EXCLUSIVE]

(READ LIST)


01 A doctor’s office or private clinic,

02 A community health center or other public clinic,

03 A hospital outpatient department,

04 A hospital emergency room,

05 An urgent care center,

06 A traditional healer from your community,

07 Or, some other place?

08 (DO NOT READ) Did not receive any healthcare in the past year

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


(ASK ALL)

Q86. Which of the following challenges, if any, did you or family members face in receiving medical care in the past year?


[INTERVIEWER: PAUSE AND CAPTURE EACH ONE]

(READ LIST)


  1. Yes

  2. No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused


a Finding a medical provider?

b Limited English ability?

c Lack of transportation?

d Cost of care?

e Any other? (SPECIFY) _____________


(ASK ALL)

Q87. In the past year, have you or family members delayed seeking medical care because of worry about the costs?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q88. Would you say that in general your physical health is:


(READ LIST)


01 Excellent,

02 Very Good,

03 Good,

04 Fair, or

05 Poor?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

A26. If you needed help or someone to talk to about sadness or stress you are feeling, do you know a place in your community where you could go?

  1. Yes

02 No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



(ASK ALL)

A27. In the past year, have you ever felt the need to talk with someone outside your family or close friends about sadness or stress you have felt?

  1. Yes

02 No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



(ASK IF A27=01)

A28. In the past year, have you spoken with any of the following people about any of these issues? Have you spoken to a…

[PN: ALLOW MULTIPLE RESPONSES – CODES 97-99 MUTUALLY EXCLUSIVE]

(READ LIST)

  1. Doctor, psychologist, or psychiatrist

  2. Religious leader

  3. Therapist

  4. Social worker

  5. Other, Specify_______

97 (DO NOT READ) Didn’t speak to anyone

  1. (DO NOT READ) Don’t Know

  2. (DO NOT READ) Refused



[PN: ASK 90-91 FOR FAMILY MEMBERS FOR WHOM Q2(a-j)<14 IF Q4=16-110,998,999 AND MQ7=1,98,99; START WITH RESPONDENT, THEN CYCLE THROUGH FOR EACH FAMILY MEMBER 16+ YRS OLD.]

Q90. What kind of health insurance or health care coverage [do you/does [INSERT NAME]] currently have?

[INTERVIEWER: Medicaid and CHIP are federally funded programs run by states, that provide health care coverage to low-income adults, children, pregnant women, elderly, and people with disabilities. Each state in the U.S. has a different name for its Medicaid and CHIP programs. CHIP is the Children’s Health Insurance Program, which provides health coverage to children]


(READ LIST)


01 (DO NOT READ; USE IF R STATES THEY HAVE NO INSURANCE: No insurance)

02 Insurance through your job,

03 Insurance through a family member’s job,

04 Medicaid, CHIP or Refugee Medical Assistance (RMA) from the government, (INTERVIEWER IF NEEDED: also known in your state as [INSERT PROGRAM NAME BASED ON SAMPLE STATE])

97 or another type?

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



(ASK ALL)

Q91. About how many months in the past year did [you/[INSERT NAME] have health insurance or health care coverage ?


________ [RANGE: 0-12]

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



[PN: Q92-Q95 should be asked if household roster included any children under age of 20 and over the age of 5 and respondent is their parent or guardian (IF ANY Q2(a-j) =4,5,6,12 AND ANY Q4a(a-j) =6 -19)]


READ TO ALL: I’d like to ask a few questions now about your children.


[PN: ASK QUESTIONS IN THIS SECTION ABOUT A RANDOM CHILD IN THE HOUSEHOLD UNDER AGE OF 20 AND OVER AGE 5]


Q92. Was [INSERT CHILD’S NAME] enrolled in school last year?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



MQ94. Has [INSERT CHILD’S NAME] ever experienced any of the following problems in school in the U.S.:


[PN: ALLOW MULTIPLE RESPONSES – CODES 07, 98-99 MUTUALLY EXCLUSIVE]

(READ LIST)


01 Child’s limited English ability,

02 Inadequate school resources to assist child in achieving English proficiency,

03 Teachers not well prepared for children from your culture,

04 Adapting to classroom with both boys and girls

05 Discrimination

06 Bullying

97 Or some other problem? Specify______

07 (DO NOT READ) NO PROBLEMS

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused


A29. Does [INSERT CHILD’S NAME] participate in any activities with other children afterschool or on weekends, such as clubs, sports, or others?

  1. Yes

02 No

98 (DO NOT READ) Don’t Know

99 (DO NOT READ) Refused



[PN: IF ANY Q2(B-O)=2 INSERT “and your spouse’s”]

READ TO ALL: Next I will ask you a question about your [if applicable: and your spouse's] interaction with your children’s school and how you engaged during the last school year.


(ASK IF Q92=01, 98, OR 99)

[PN: IF ANY Q2(B-O)=2 INSERT “or your spouse”]

Q95. Did you [or your spouse] attend a school event? (INTERVIEWER: social, sporting, cultural, or educational activity or event)?


01 Yes

02 No

98 (DO NOT READ) Don’t know

99 (DO NOT READ) Refused



READ TO ALL: Last I want to ask you about your household’s current situation.


(ASK ALL)

A30. On a scale of 1 to 5, with 1 being you don’t need any help, and 5 being you need a lot of help, how much help does your household still need with each of the following?

(RANDOMIZE ORDER)

(REPEAT THE SCALE IF NEEDED)

(READ LIST)


___ (RANGE 1-5)


  1. Adjusting immigration status

  2. Employment

  3. Housing

  4. Food

  5. Childcare

  6. Transportation

  7. Medical needs

  8. Mental health

  9. English language training

  10. Accessing government assistance programs

  11. Community building and networking

  12. Family reunification


READ TO ALL: Thank you for your time participating today.




(ASK ALL)

IN1. We would like to send you $50 for your contribution to this important research. You would receive a gift card in approximately 4 to 6 weeks. Can you confirm we have the correct mailing address?


[PN: INSERT SAMPLE MAILING ADDRESS – FULL NAME, STREET, CITY, STATE, ZIP]


1 Correct name/address

2 Incorrect name/address

3 Respondent does not wish to receive gift card

9 (DO NOT READ) Don’t know/Refused

(ASK IF IN1=2)

IN2. May I please have your name?

(VERIFY SPELLING)


1 Answer given (SPECIFY) _________________

R (DO NOT READ) Refused


May I please have your address?

(VERIFY SPELLING)


1 Street: ______________________________

2 City: _______________________________

3 State: _______________________________

4 Zip code:____________________________

R (DO NOT READ) Don’t know


CLOSE: That was our final question. Thank you very much for your participation in this survey.



1 OAW Afghan Supplement Survey questionnaire will be translated into Dari and Pashto upon OMB approval.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKarin Kowalski
File Modified0000-00-00
File Created2023-08-02

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