Feasibility Testing of Online Annual Survey of Refugees Mode

OMB #: 0970-0355 Expiration Date:

[OPEN UP ZOOM LINK and greet participant]

INTRO AND CONSENT. Hello, thank you for joining me today. As I explained on our phone call, we are conducting a study to try out questions for a survey of refugees in the U.S. It is funded by the Office of Refugee Resettlement, which is a federal agency, and being conducted by two independent research organizations, the Urban Institute and Research Support Services. The purpose of the Annual Survey of Refugees is to understand how refugees adapt to life in the United States. The survey questions are about your family, your education, work, community, and access to help and healthcare. If you agree to participate, you will be completing the survey online and I’ll be asking you about how you understood the questions and how hard or easy it was to answer some of the questions.

This is not a test and there are no right or wrong answers. We are only gathering information to see how well the questions work. Observing how participants answer the questions and asking them about their answers allows us to figure out which questions are working well, and which need to be improved.

The interview will take 75 minutes. Once it is completed, you will receive an electronic $40 token of appreciation to thank you for your participation. You will receive the link to claim it by email or text message, whichever you prefer.

As you know, we will do this interview online here, on Zoom. We need to audio and video record the interview. Only the people who work on this study will view the recording. It will help us make sure we have understood your answers.

Participation in this interview is voluntary. You can choose to participate or not to participate. You also don’t have to answer any questions you don’t want to answer, and you can stop the interview at any time. If you choose to participate, the answers you give will be private and will not have your name on them. Federal law keeps your answers private. You will continue to receive social services and benefits regardless of your decision to participate or not in the study.

Finally, there is little risk associated with your participation because of the care we are taking to keep your name and your answers safe. Your information will not be shared with the Office of Refugee Resettlement. Since this is on Zoom, I encourage you to participate in a private setting away from hearing or viewing by others. While we are using the appropriate security measures, it is important that you know that no system such as Zoom is 100 percent secure. We will be recording the video and audio for this interview, and it will only be seen by the research team and will be destroyed at the end of the project. There is always a small risk that digital recordings could be seen or used by non-research team members, but we are confident that our data security measures will keep your information private.

There are no direct benefits to you, but you will be helping the Office of Refugee Resettlement understand how the survey questionnaire is working and improve their knowledge of refugee experiences.

If you have any questions or decide that you want to change your mind about participating in the next two weeks, you can email me at [xxx] or call me at [xxx], and I will let the Study Director know.

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 XXXX and the expiration date is XXXXX.

If you have any comments about how long this survey took or any other aspect of this survey, including suggestions for how to improve the survey, 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?

I want to say again that your decision to participate is voluntary; you can choose whether you want to participate. Do you agree or not agree to be interviewed?

AGREE

DO NOT AGREE - “Ok, thank you for considering.” [Terminate Interview]

Do we have your permission to audio- and video-record the interview?

YES

NO - “Ok, thank you for considering.” [Terminate Interview]

Do you prefer to receive the $40 token of appreciation by email or text?

Email, specify email if not already recorded through recruitment

Text, specify number if not already recorded through recruitment

Thank you. I will now turn on the recording.

Now that the recording is on, please repeat for the recording that I have your permission to record.

DIRECTIONS.

To access the survey, you will need to click on a link that I am now putting in the Zoom Chat box. Do you see it? [TROUBLESHOOT AS NEEDED]

[ONCE R. HAS ACCESSED THE SURVEY] Now I need you to share your screen so I can see the survey as you are answering it. [ASSIST R IN SHARING SCREEN.]

Great, you are all set! Now, let’s imagine you are at home, by yourself, answering the survey and that there is no interviewer with you. Please read each question – either aloud or just to yourself – and tell me your response. If there is something that you don’t understand, something that is not clear or that you don’t know how to answer, please say something and I will make a note. I will ask you about it later.

After you answer a group of questions, I will ask you to stop so we can talk about the questions you just answered. For example, I might ask you what a particular term or phrase means or ask you, or I may ask you to put the question in your own words. There are no right or wrong answers to any of the questions that I might ask. I am not trying to test or quiz you about these terms. We just want to make sure that everyone is understanding these survey questions in the same way. Your participation is important because it will help us improve the survey questions.

Before we begin, do you have any questions?

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.

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: ________

(ASK IF Q1>1)

Q1A. Not counting you, start with your oldest family members and tell me the names of each family member who lives there. Also include those who usually live here but are temporarily absent.

(If you do not want to provide names of family members in the household, we are only using the name to refer to the correct person in later questions. So, just a first name or initials are fine.)

|___|___|

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

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 Don’t know

“Now we’d like to get some information on your family living with you” ONLY FOR Q3B, I.E. THE SECOND FAMILY MEMBER

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

01 Male

02 Female

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

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

___________ [RANGE 1-110]

000 Less than one year

998 Don’t know

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

1 ENTER 4-DIGIT YEAR

8 Don’t know

Q6(a-j). What is (YOUR/INSERT NAME)’s country of birth?

01 United States

02 Afghanistan

03 Bhutan

04 Burma

05 Burundi

06 Cuba

07 Democratic Republic of the Congo

08 Eritrea

09 Ethiopia

10 Iran

11 Iraq

12 Jordan

13 Kenya

14 Malaysia

15 Nepal

16 Rwanda

17 Somalia

18 Sudan

19 Syria

20 Tanzania

21 Thailand

22 Uganda

23 Ukraine

24 Armenia

97 Other (SPECIFY) _______________

98 Don’t know

Q6_1. Were all family members of this household born in [INSERT COUNTRY NAME FROM Q6]?

01 Yes

02 No

98 Don’t know

Q7( b-o). Did [insert name] enter as a refugee?

01 Yes

02 No

98 Don’t know

Q7_1. Did all members of this household arrive in the U.S. as a refugee?

01 Yes

02 No

98 Don’t know

Q8(a-j). In what year did (YOU/INSERT NAME) arrive in the U.S.?

01 [ENTER 4-DIGIT YEAR]

98 Don’t know

Q8_1. Did all members of this household arrive in the U.S. in [INSERT YEAR FROM Q8]?

01 Yes

02 No

98 Don’t know

Q9(a-j). In what state and city did [YOU/insert name] originally resettle?

State, Specify_____________

Q9A(a-j). City, Specify_______________

98 Don’t know

Q9_1. When first arriving in the U.S., did all family members of this household originally resettle in [INSERT STATE NAME FROM Q9]?

01 Yes

02 No

98 Don’t know

Q10(a-j). What is (YOUR/INSERT NAME)’s ethnic origin?

[FOR DARI LANGUAGE]

1. Pashtun

2. Hazara

3. Tajik

4. Uzbek

97 OTHER (SPECIFY) _______________

98 Don’t know

[FOR UKRAINIAN LANGUAGE]

5. Ukrainian

6. Russian

97 OTHER (SPECIFY) _______________

98 Don’t know

[FOR KISWAHILI LANGUAGE]

7. Bembe/Bemba/Mbembe

8. Banyamulenge/Banyamulengue

9. Mkongo

10. Tutsi

11. Hutu

12. Mushi

13. Bantu

14. Luba

97 OTHER (SPECIFY) _______________

98 Don’t know

[FOR ARABIC LANGUAGE]

15. Arab

16. Kurd

17. Chaldean

18. Siryac

97 OTHER (SPECIFY) _______________

98 Don’t know

Q10_1. Are all family members of this household of [INSERT ETHNIC ORIGIN FROM Q10a] origin?

01 Yes

02 No

98 Don’t know

Q11(a-j). What is [YOUR/insert name]'s race or ethnicity?

[MARK ALL THAT APPLY]

01 White,

02 Black or African American,

03 Asian,

04 Middle Eastern or North African,

05 American Indian or Alaska Native

06 Latino/Hispanic

97 Other (Specify) _______________

98 Don’t know

Q11_1. Are all family members of this household [INSERT RACE FROM Q11a]?

01 Yes

02 No

98 Don’t know

Q5. What is your current marital status?

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) _______________

Q13. How many states have you lived in since you arrived in the U.S.?

________

Q14. 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,

02 To be closer to family or friends

03 To live in a place where there are more people from your home country,

4. Affordable housing

97 Other

End of Chunk1

Let’s stop here for a few minutes as I want to find out how the questions are working for you. Do you have any general comments?

I have some specific questions for you.

P1. At the very beginning of the survey, there was an instruction saying “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.”

• What do you think they are saying there? Who will the survey be asking about? [PROBE AS NEEDED ON TERMS FOR STAYING AND VISITING AND THEIR DIFFERENCE WITH LIVING.]

• Can you give me an example of someone who is staying and has no other home?

P2. Let’s look at Q9.

Q9(a-j). In what state and city did [YOU/insert name] originally resettle?

State, Specify_____________

• You answered X. Tell me more about that.

• What do you think they mean here by ‘resettling’?

P3. Now let’s look at Q10.

Q10(a-j). What is (YOUR/INSERT NAME)’s ethnic origin?

• [READ As appropriate: You seemed unsure of what to answer/You did not answer.] Tell me what made this question difficult to answer.

P4. [IF RELEVANT] I see in question [x], not everyone in the family shared the same characteristic.

• Can you tell me more about your answer there?

Now we will continue with the survey questions. Please go ahead and continue answering.

These next questions are about your experience before your arrival in the U.S. These questions are about your experience only.

Q17. Just before coming to the U.S. were you living in a refugee camp?

01 Yes

02 No

Q18. How long did you live in a refugee camp?

1. Your whole life (born in the camp)

2. Less than a year

3. ___________ (RECORD NUMBER OF YEARS) [PN: RANGE 1-96]

98 Don’t know

Q19. What was your work status in your home country? Were you…

NOTE: This could be the work status before you had to flee or faced persecution.

Not working for pay includes being too young, a student, too old or any other reason for not working for pay

01 Not working for pay,

02 Working for paid jobs, SPECIFY occupation: __________

03 Self-employed (business, profession, or own farm),

04 OTHER

98 Don’t know

Q20. What is the main reason you were not working for pay in your home country?

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

These next questions are about your ability to speak English.

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

01 Very well,

02 Well,

03 Not well,

04 Not at all?

Q24. How well do you speak English now:

01 Very well,

02 Well,

03 Not well,

04 Not at 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

Q26. Where have you taken ESL or English classes in the U.S.?

[MARK ALL THAT APPLY]

01 At work,

02 At a local school or college,

03 At a library,

04 At a church or other religious organization,

05 At a refugee resettlement organization,

97 Other

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

[MARK ALL THAT APPLY]

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 NO CHALLENGES

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

NOTE: THIS INCLUDES JOB TRAINING CLASSES OR PROGRAMS, JOB SEARCH TRAINING OR INTERVIEW AND RESUME PREPARATION.

01 Yes

02 No

Q29. Where did you take this job preparation program in the U.S.?

[MARK ALL THAT APPLY]

01 At work,

02 At a local school or college,

03 At a library,

04 At a church or other religious organization,

05 At a refugee resettlement organization,

97 Other

End of Chunk2

Let’s stop again here for a few minutes as I want to find out how this group of questions worked for you. Do you have any general comments?

I have some specific questions for you.

P5. Let’s look at q.19

Q19 What was your work status in your home country? Were you…

NOTE: Not working for pay includes being too young, a student, too old or any other reason for not working for pay

01 Not working for pay,

02 Working for paid jobs, SPECIFY occupation: __

03 Self-employed (business, profession, or own farm),

04 OTHER

98 Don’t know

• Here you answered XX. Tell me more about your answer.

P6. Let’s look at q.20:

Q20. What is the main reason you were not working for pay in your home country?

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

• Here you answered XX. Tell me more about your answer.

• Was it difficult to find one main reason?

• Was there another reason on the list that you wished you could also choose?

P7. Let’s look at Q27:

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

[MARK ALL THAT APPLY]

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 NO CHALLENGES

• Here you answered XX and XX and XX [LIST ALL THE ANSWERS R CHOSE]. Tell me more about (your/each) answer.

• If NO CHALLENGES, ASK: Tell me how it’s been taking English classes for you?

You can continue answering the survey questions now.

These next questions are about education that you and your adult family members received before coming to the U.S.

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

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 Don’t know

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

01 Fully recognized in the U.S,

02 Partially recognized, or

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

98 Don’t know

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?

NOTE: 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 Don’t know

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

NOTE: 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 (master's, PhD, or professional),

97 OTHER

98 Don’t know

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

[MARK ALL THAT APPLY]

1. Cost of classes,

2. Too busy with work responsibilities,

3. Too busy with childcare 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 No challenges

97 NOT APPLICABLE

This next part of the survey is about (you/ you and other family members of your household/other family members of your household):

First we will talk about [your/[INSERT NAME]’s] employment in the last week and month.

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

01 Yes

02 No

98 Don’t know

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

01 Yes

02 No

98 Don’t know

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

[MARK ALL THAT APPLY]

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 childcare or family caregiving

06 Is elderly (past retirement age)

07 Lack of transportation

97. OTHER

98 Don’t know

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 Don’t know

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.

Note: If more than one occupation, choose the principal occupation

________ (record occupation)

98 Don’t know

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

________ (RANGE: 0-96)

98 Don’t know

These next questions are about your/INSERT NAME’s work over the past year.

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?

Note: A year has 52 weeks and your best guess is okay

________ (RANGE: 0-52)

98 Don’t know

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

________ (RANGE: 0-168)

97. Don’t know

End of Chunk3

Let’s stop again here for a few minutes and discuss this group of questions. Do you have any general comments?

I have some specific questions for you.

P8. Let’s look at q.30:

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

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 Don’t know

• Tell me about your studies before coming to the US. IF NECESSARY: How many years of schooling was that?

• You answered XX. How did you choose your answer?

• How certain are you that you chose the right answer?

P9. Let’s look at q.39:

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

[MARK ALL THAT APPLY]

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

4. Poor health or disability

03 Limited English ability

04 Attending school or training

05 Providing childcare or family caregiving

06 Is elderly (past retirement age)

07 Lack of transportation

97. OTHER

98 Don’t know

• You answered XX. Tell me more about your answer.

• Did you easily find a response that was good for your situation? Why/Why not?

P10. Then you answered Q.40.

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

• How did you figure out your hourly wage?

Let’s keep going with the questionnaire.

These next questions are about your/INSERT NAME’s work since arriving in the US (in [INSERT ARRIVAL YEAR FROM RESPONSE IN Q8 A-J IF AVAILABLE]).

Q46(a-j). Since arriving in the US, have you/has [INSERT NAME] ever worked for pay since coming to the U.S.?

01 Yes

02 No

98 Don’t know

Q47(a-j). Since arriving in the U.S., (have you/has [INSERT NAME]) ever actively looked for work?

01 Yes

02 No

98 Don’t know

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

[MARK ALL THAT APPLY]

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 Childcare or family responsibilities,

06 Poor health or disability,

07 Lack of transportation,

08 Or some other challenge?

98 Don’t know

Now think about (your/INSERT NAME’s) first job that (you/he/she) got in the U.S.

Q49a. Who was the most helpful to you in getting your first job in the U.S.?

01 Got it myself/himself/herself

02 Friends or relatives

03 Case worker/Refugee resettlement organization

97 OTHER

Q50(a-j). What kind of work did [you/INSERT NAME] do in that first job you had in the U.S., that is, what was [your/INSERT NAME]’s occupation? (For example: plumber, typist, or farmer.)

_______ (RECORD RESPONSE)

98 Don’t know

Q51(a-j). Did that first job come with health insurance benefits?

01 Yes

02 No

98 Don’t know

Q52(a-j). Is (your/[INSERT NAME]’s) current or most recent job the same as that first job in the U.S.? (that means working for the same employer and still having the same work title)

01 Yes

02 No

98 Don’t know

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.

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

98 Don’t know

Q54(a-j): Overall, how would you describe your/[INSERT NAME]’s skills in relation to what is required to do in your/[INSERT NAME]’s current or most recent job?

01 Your/his/her skills are higher than what is required by your/his/her job

02 Your/his/her skills are matched to what is required by your/his/her job

03 Some of your/his/her skills need to be further developed for your/his/her job

98 Don’t know

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

01 Yes

02 No

98 Don’t know

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 Don’t know

Now, the following questions ask about your family and how you support yourselves.

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?

Note: Please provide the average monthly income, not the yearly income

________ [RANGE: 0-99997]

99998 Don’t know

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

01 less than $2300,

02 more than $2300,

03 or about that amount?

98 Don’t know

Q57B. And would you say it was

01 less than $1200

02 more than $1200

03 or about that amount?

98 Don’t know

Q57C. And would you say it was

01 less than $300

02 more than $300

03 or about that amount?

98 Don’t know

Q57D. And would you say it was

01 less than $1800

02 more than $1800

03 or about that amount?

98 Don’t know

Q57E. And would you say it was

01 less than $3300

02 more than $3300

03 or about that amount?

98 Don’t know

Q57F. And would you say it was

01 less than $2700

02 more than $2700

03 or about that amount?

98 Don’t know

Q57G. And would you say it was

01 less than $4500

02 more than $4500

03 or about that amount?

98 Don’t know

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

(Note: by living expenses we mean paying for your housing, utilities, transportation, and other bills)

1. Yes

2. No

98. Don’t know

Next, are some questions about your family’s receipt of different government benefits.

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”.

Note: 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 Don’t know

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.

Note: 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 Don’t know

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.

(Note: 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 Don’t know

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 Don’t know

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 Don’t know

End of Chunk4

Let’s stop now so I can ask you about some of the questions you just answered.

P11. Let’s look at Q48

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

[MARK ALL THAT APPLY]

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 Childcare or family responsibilities,

06 Poor health or disability,

07 Lack of transportation,

08 Or some other challenge?

98 Don’t know

• (First) You answered XX. Tell me more about your answer. [REPEAT FOR EVERY ANSWER THEY GAVE.]

P12. Let’s look at Q53 and Q54

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.

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

98 Don’t know

Q54(a-j): Overall, how would you describe your/[INSERT NAME]’s skills in relation to what is required to do in your/[INSERT NAME]’s current or most recent job?

01 Your/his/her skills are higher than what is required by your/his/her job

02 Your/his/her skills are matched to what is required by your/his/her job

03 Some of your/his/her skills need to be further developed for your/his/her job

98 Don’t know

• You answered X and Y. What do you think they are asking in these two questions?

• Is this the right job for someone like you? Why/Why not?

P13. Let’s look at Q57

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?

Note: Please provide the average monthly income, not the yearly income

________ [RANGE: 0-99997]

99998 Don’t know

• You answered XXX. How did you know what to answer?

P14. No let’s look at Qs. 60-63

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”.

Note: 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 Don’t know

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.

Note: 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 Don’t know

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.

(Note: 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 Don’t know

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 Don’t know

• What is this group of questions asking?

• Were you familiar with SNAP or food stamps? What do you know about that?

• What about TANF? What can you tell me about it?

• Had you heard about SSI? What do you know about it?

• Had you heard about General Assistance? Tell me what you have heard.

Thank you. Now let’s continue with the survey.

Next, are some questions about your neighborhood and connections to the community.

Q65. To what extent do people in your community share your cultural background? Is it:

(Note: That is sharing the same culture, ethnic group, language, or religion)

01 All or most,

02 About half,

03 Only a few, or

04 None?

98 Don’t know

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

Note: That is sharing the same culture, ethnic group, language, or religion

01 Yes

02 No

98 Don’t know

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 Don’t know

Q68. How did you meet this person (or these people) (of a different cultural background)?

[MARK ALL THAT APPLY]

01 Through work,

02 Through children's school,

03 In the neighborhood,

04 Through friends or relatives,

05 Through church or other religious organization

97 or some other way?

Q69. Which, if any, kinds of groups or organizations have you participated in? Have you participated in: Group related to children's school? (like the PTA or parents' volunteering groups)

1. Yes

2. No

Q69b. Church or other religious organization or group?

01 Yes

02 No

Q69c. Community or ethnic organization or club?

01 Yes

02 No

Q69d. Sports club or team?

01 Yes

02 No

Q69e. Any other group?

01 Yes (SPECIFY) _________

02 No

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:

01 Very welcome,

02 Somewhat welcome,

03 Somewhat unwelcome, or

04 Very unwelcome?

Q71. After your first year in the U.S., did [you/[INSERT NAME]] apply for a green card? (become a permanent resident)

01 Yes

02 No

98 Don’t know

Q72: Have you faced any challenges applying for a green card?

01 Yes

02 No

98 Don’t know

Q72a. What challenges have you had applying for a green card?

[MARK ALL THAT APPLY]

1. Lack of information

2. Limited English ability

3. Cost of applying

4. Medical requirements

5. Lack of transportation

97 OTHER

98 Don’t know

Q73. Are you currently or 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

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

01 Yes

02 No

The following are questions about where you currently live.

(ASK ALL)

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

01 Owned or being bought by someone in the household

02 Rented

97 OTHER

98 Don’t know

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 Don’t know

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

____________(RANGE 0-97)

98 Don’t know

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

Note: WE WANT TO KNOW WHAT THE MONTHLY RENT IS, NOT JUST WHAT THE YOU CONTRIBUTES EACH MONTH

________ [RANGE: 0-9997]

9998 Don’t know

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

1. Yes

2. No

98 Don’t know

Q81. How much do you trust your local police?

01 Not at all

02 Somewhat

03 A lot

98 Don’t know

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?

Q82a. On the street?

1. Yes

2. No

98 Don’t Know

Q82b. In local businesses?

01 Yes

02 No

98 Don’t Know

Q82c. At work or when applying for a job or promotion?

01 Yes

02 No

98 Don’t Know

Q82d. When dealing with police or courts?

01 Yes

02 No

98 Don’t Know

Q82e. In school or class?

01 Yes

02 No

98 Don’t Know

Q82f. When looking for a place to live or when renting or buying a home?

01 Yes

02 No

98 Don’t Know

Q82g. When dealing with health care providers?

01 Yes

02 No

98 Don’t Know

Q2h. In any other place or situation?

01 Yes

02 No

98 Don’t Know

End of Chunk5

Let’s stop now so I can ask you about some of the questions you just answered.

P15. Let’s look at Q68

Q68. How did you meet this person (or these people) (of a different cultural background)?

01 Through work,

02 Through children's school,

03 In the neighborhood,

04 Through friends or relatives,

05 Through church or other religious organization

97 or some other way?

• You answered XX. Tell me more about that.

P16. Let’s look at Q72a

Q72a. What challenges have you had applying for a green card?

[MARK ALL THAT APPLY]

1. Lack of information

2. Limited English ability

3. Cost of applying

4. Medical requirements

5. Lack of transportation

97 OTHER

98 Don’t know

• You answered X (and X, and X). Tell me more about that.

P17. Let’s look at Q77A

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 Don’t know

• You answered X. What do you think they are asking here?

Now you can continue with the survey questions.

Next, are some questions about your physical and mental health and your access to health care services.

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

(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 Don’t know

Q85. If you received any healthcare in the past year, what kind of place was it? Was it from...?

[MARK ALL THAT APPLY]

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 such as a dhami, jakhri, or curandero,

07 Or, some other place?

08 Did not receive any healthcare in the past year

98 Don’t know

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

Q86a. Finding a medical provider?

1. Yes

2. No

98 Don’t Know

Q86b. Limited English ability?

01 Yes

02 No

98 Don’t Know

Q86c. Lack of transportation?

01 Yes

02 No

98 Don’t Know

Q86d. Cost of care?

01 Yes

02 No

98 Don’t Know

Q86e. Any other challenges?

01 Yes (SPECIFY) _____________

02 No

98 Don’t Know

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 Don’t know

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

01 Excellent,

02 Very Good,

03 Good,

04 Fair, or

05 Poor?

Q89. During the past 30 days, how often did you feel so sad that nothing could cheer you up:

01 All of the time,

02 Most of the time,

03 Some of the time,

04 A little of the time, or

6. None of the time?

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

(Note: 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]

01 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, (also known in your state as [INSERT PROGRAM NAME BASED ON SAMPLE STATE])

97 or another type?

98 Don’t know

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

________ [RANGE: 0-12]

98 Don’t know

Next are a few questions about your children.

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

01 Yes

02 No

98 Don’t know

Q94. Has [INSERT CHILD’S NAME] ever experienced any of the following problems in school in the U.S.:

[MARK ALL THAT APPLY]

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 Discrimination

05 Bullying

06 No Problems

97 Or some other problem?

98 Don’t know

Next is 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.

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

01 Yes

02 No

98 Don’t know

You are now done answering survey questions. Let’s talk about some of the questions you just answered.

P18. Let’s look at Q84.

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

(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 Don’t know

• You answered X. What kind of health care is this question asking about?

P19. Let’s look at Q85.

Q85. If you received any healthcare in the past year, what kind of place was it? Was it from...?

[MARK ALL THAT APPLY]

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 such as a dhami, jakhri, or curandero,

07 Or, some other place?

08 Did not receive any healthcare in the past year

98 Don’t know

• You answered X (and X, and X). Tell me about the healthcare you received this past year. [PROBE TO MATCH NARRATIVE WITH SPECIFIC PLACES.]

P20. Let’s look at Q90

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

(Note: 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]

01 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, (also known in your state as [INSERT PROGRAM NAME BASED ON SAMPLE STATE])

97 or another type?

98 Don’t know

• You answered X. How did you decide what answer to select?

P21. Let’s look at Q91.

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

________ [RANGE: 0-12]

98 Don’t know

• You answered X. How did you know what to answer?

P22. Let’s look at Q94.

Q94. Has [INSERT CHILD’S NAME] ever experienced any of the following problems in school in the U.S.:

[MARK ALL THAT APPLY]

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 Discrimination

05 Bullying

06 No Problems

97 Or some other problem?

98 Don’t know

• You answered X (and X, and X). Tell me about the problems (CHILD) experienced in school.

Thank you very much for your thoughtful responses. I really appreciate your help to make us find any questions that are not working the way it was intended.

P23. We are almost done. I just want to ask you what it was like for you to complete this survey online. Please tell me how it was?

P24. What difficulties did you experience?

P25. What would make answering online better or easier?

P26. If you received a letter in the mail from the Office of Refugee Resettlement asking you to answer the survey online, do you think you would do it or would you prefer to have an interviewer call you on the phone? Why?

Thank you so much! We will send you the electronic card as you requested within two business days.

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to conduct a feasibility test for implementing an online version of the Annual Survey of Refugees (ASR). Public reporting burden for this collection of information is estimated to average 1.5 hours per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. 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. The OMB # is 0970-0355 and the expiration date is XX/XX/XXXX. If you have any comments on this collection of information, please contact asr@acf.hhs.gov.