Form 1 Questionnaire

GQ ISR Suitability Survey Questionnaire

Greetings, and thank you for taking our Group Quarters Feedback Survey.

The Census Bureau is responsible for enumerating all persons living in the United States, including those persons living in various types of group quarters. Group quarters are places where people live or stay in a group living arrangement that is owned or managed by an organization providing housing and/or services for the residents. Examples of group quarters include residential treatment centers, workers' group living quarters, and college student housing.

For the next census, we are considering a plan to allow residents of some types of group quarters to complete their census questionnaire online. We would like to ask you some questions to assess whether our plan for an online census questionnaire will be appropriate for the residents of your group quarters. Use the "next" button below to start the survey.

AUTHORITY AND CONFIDENTIALITY

By law, the Census Bureau is required to keep your answers confidential (Title 13, United States Code, Section 9). We are conducting this voluntary survey under the authority of Title 13, United States Code, Sections 141 and 193. This collection has been approved by the Office of Management and Budget (OMB). This eight-digit OMB approval number, 0607-0971, confirms this approval. We are required to display this number to conduct this survey. We estimate that this survey will take about 5 minutes. Send comments regarding this estimate or any aspect of this survey, including suggestions for reducing the time it takes to complete this survey to adrm.pra@census.gov. By proceeding with this study, you give your consent to participate in this study. The Privacy Act of 1974 (5 U.S.C. Section 552a) allows the sharing of information you provided with Census Bureau staff for the work-related purposes identified in this statement.

(IF GQ type = 501 start with Q6)

1. How many of your residents have access to the internet?

• None

• A few residents

• Some residents

• Most residents

• All residents

• Don’t know

(if Q1 = none, end survey with this message:)

Thank you for sharing that information. Based on your response, an online census questionnaire would not be a good option for the residents of your group quarters.

The survey is complete. Click “Next” to submit your response.

2. Would any of your residents require assistance with completing an online census questionnaire asking for basic demographic information, such as date of birth, race, sex, etc.?

• Yes

• No

(if Q2 = no go to Q6)

3. (if Q2 = yes) How many of your residents would require assistance with completing an online census questionnaire?

• A few residents

• Some residents

• Most residents

• All residents

4. (if Q2 = yes) Would your staff be able to assist residents in completing the online census questionnaire?

• Yes

• No

5. (if Q2 = yes and Q4 = no) What are the reasons that your staff would not be able to assist residents with completing the census questionnaire? (write-in)

6. The Census Bureau’s current plans for providing an online census questionnaire for residents of group quarters involve sending a link to the questionnaire via email.

Do your residents have active email accounts which they could use to receive a link to the online census questionnaire?

• Yes, most or all residents have email accounts

• Yes, some residents have email accounts

• No, none of our resident have email accounts

• Don’t know

(If Q6 ne yes, go to Q9)

7. In your opinion, is email a good way to notify your residents about the online census questionnaire?

• Yes

• No

• Don’t know

8. (if Q7 = no) Please tell us the reasons that email is not a good way to notify your residents about the online census questionnaire. (write-in)

9. Which of the following options could your residents use to access the online census questionnaire? Select all that apply.

• (suppress if Q6 ne yes all or yes most; if Q7 = no) Email with link to the questionnaire

• Type in link from a paper letter or flyer

• QR code (requires a mobile phone)

• Text message with link to the questionnaire (requires a mobile phone)

• Other – specify _________

9b. Please rank the online access options you selected from most (top) to least preferred (bottom) by clicking on an option and dragging it to the desired location.

(response options selected in Q10 display)

10. Do your residents know the street address for the building they live in, including address number, street name, city, state, and ZIP code?

• Yes

• No

• Don’t know

(if Q6 = yes) Start of question block about staff assistance with ISR – Q11-Q12

The next few questions ask about you or your staff’s ability and willingness to assist the Census Bureau with making the online census questionnaire available for residents.

11. Can you or your staff provide residents’ email addresses to the Census Bureau for the purpose of sending emails with information and a link to the census questionnaire?

• Yes

• No

• Don’t know

11. Another option would be for the Census Bureau to provide links to the online census questionnaire that you or your staff would then share with the residents by email.

Can you or your staff send emails to residents with the links to the online census questionnaire?

• Yes

• No

End of staff assistance block

(ALL)

11. The Census Bureau would also provide information about who has and has not completed the online census questionnaire and ask you or your staff to make efforts to get residents who have not completed the questionnaire to do so.

In your opinion, would you or your staff be willing to provide reminders and encouragement to residents who have not completed the questionnaire?

• Yes

• No

11. Group quarters staff who have access to Census Bureau information that is protected by law must swear an oath pledging to uphold the confidentiality of the information. Taking the oath must be witnessed by Census Bureau staff.

Would you or your staff be able to participate in a virtual meeting that would require a face-to-face interaction via a computer, tablet or mobile device with a camera?

• Yes

• No

11. As we continue to develop our plans for the next census, we will be gathering input and feedback from group quarters representatives to ensure that our systems and procedures work the way people expect them to.

May we contact you to see if you would be available to assist with one of our future research and development projects?

• Yes

• No

11. (if Q15 = yes) Please provide your name and contact information. (first and last name, email address, telephone number)

11. Is there anything else you would like to let us know about collecting census data from your residents.

End of survey

Thank you for completing our survey. Your feedback is valuable in helping us with our plans to ensure all residents of group quarters will be counted in the 2030 Census.

Click “Next” to submit your response.