Study participants baseline interview

Baseline Interview: Employment & Income History
Record ID.

SHIPS
Page 1

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Baseline Interview: Employment & Income History
(Please repeat the reminder below if it has not been provided during this interview session.)
Reminder about resources to help you cope with distress.  
When you enrolled in this study, you were provided with a list of resources to help you cope
with negative feelings and reactions to these interviews.  These resources can also help you
with other problems in your life not related to the study.
If you do not remember receiving this information, we will provide it to you immediately
following this interview.
Interview prompt:
"Now I'll ask you some questions about your past employment and income."
Have you worked any jobs in the last five years
(including volunteer and paying jobs at a mental
health agency)?

We'll begin with your most recent job and work
backwards. What job did you do most recently, before
any current work?
Job 1: What is the name of where you worked?
Job 1: What do you do on the job (job title, job
description, responsibilities, etc.)?

Job 1: How much did you make an hour?

Job 1: When did you start working at this job?
(approximate start date)

Job 1: When did you finish working at this job?
(approximate end date)

Did you work a job before that?

05/01/2024 12:09pm

Yes
No
Refuse
n/a

__________________________________

__________________________________________

__________________________________

__________________________________
(day-month-year)

__________________________________
(day-month-year)
Yes
No
(If unsure, answer "no".)

projectredcap.org

Page 2

Job 2: What is the name of where you worked?

Job 2: What do you do on the job (job title, job
description, responsibilities, etc.)?

Job 2: How much did you make an hour?

Job 2: When did you start working at this job?
(approximate start date)

Job 2: When did you finish working at this job?
(approximate end date)

Did you work a job before that?

Job 3: What is the name of where you worked?

Job 3: What do you do on the job (job title, job
description, responsibilities, etc.)?

Job 3: How much did you make an hour?

Job 3: When did you start working at this job?
(approximate start date)

Job 3: When did you finish working at this job?
(approximate end date)

Did you work a job before that?

Job 4: What is the name of where you worked?

Job 4: What do you do on the job (job title, job
description, responsibilities, etc.)?

Job 4: How much did you make an hour?

05/01/2024 12:09pm

__________________________________

__________________________________________

__________________________________

__________________________________
(day-month-year)

__________________________________
(day-month-year)
Yes
No
(If unsure, answer "no".)

__________________________________

__________________________________________

__________________________________

__________________________________
(day-month-year)

__________________________________
(day-month-year)
Yes
No
(If unsure, answer "no".)

__________________________________

__________________________________________

__________________________________

projectredcap.org

Page 3

Job 4: When did you start working at this job?
(approximate start date)

Job 4: When did you finish working at this job?
(approximate end date)

Did you work a job before that?

Job 5: What is the name of where you worked?

Job 5: What do you do on the job (job title, job
description, responsibilities, etc.)?

Job 5: How much did you make an hour?

Job 5: When did you start working at this job?
(approximate start date)

Job 5: When did you finish working at this job?
(approximate end date)

If you have not worked in a paying job in the past
five years, have you ever had a job for pay? (not
sheltered, must be competitive)

What was the longest paying job you ever had?
Longest job: What is the name of where you worked?
Longest job: What do you do on the job (job title, job
description, responsibilities, etc.)?

Longest job: How much did you make an hour?

Longest job When did you start working at this job?
(approximate start date)

Longest job: When did you finish working at this job?
(approximate end date)

Have you ever worked in competitive employment for 12
consecutive months? (Probe until confident)

05/01/2024 12:09pm

__________________________________
(day-month-year)

__________________________________
(day-month-year)
Yes
No
(If unsure, answer "no".)

__________________________________

__________________________________________

__________________________________

__________________________________
(day-month-year)

__________________________________
(day-month-year)
Yes
No
Refuse
n/a

__________________________________

__________________________________________

__________________________________

__________________________________
(day-month-year)

__________________________________
(day-month-year)
Yes
No
Refuse
n/a

projectredcap.org