SHIPS Interviews: participants

Supportive Housing & Individual Placement and Support (SHIPS) Study

ICAP SHIPS PATHLocalServicesParticipation V2

SHIPS Interviews: participants

OMB: 0960-0840

Document [pdf]
Download: pdf | pdf
PATH local services participation measure
Record ID.

What is the interview period?

Data Entry Date

SHIPS Study ID

Interview Date

SHIPS
Page 1

__________________________________

__________________________________

__________________________________

__________________________________

__________________________________

Participation in PATH local vocational services. The enrollee's case manager will complete this
measure monthly.
Did the case manager have a face-to-face contact with
the participant?

Yes
No

Did the case manager review the participant's
employment status this month?

Yes
No

Was the participant employed in a competitive job at
least 1 day in the past 30 days?

Yes
No
Unknown

Did the participant start a competitive job this
month?

Yes
No
Unknown

Did the participant end a job this month?

Yes
No
Unknown

Is the participant currently looking for competitive
employment?

Yes
No
Unknown

Did the case manager help the participant with any
activities that will contribute to the participant
finding a job? Examples of such activities include
conversations about personal hygiene, dress codes,
transportation, organizational skills, time
management/promptness, digital literacy/technology,
and communication with potential employers.

Yes
No

Did the case manager refer the participant to a
Worksource Center for vocational or other employment
services?

Yes
No

05/01/2024 12:10pm

projectredcap.org

Page 2

To which Worksource Center location did the case
manager refer the participant?
Did the case manager refer the participant to any
organizations other than Worksource Center for
vocational or other employment services?
To what other outside organization(s) did the case
manager refer the participant for vocational or
employment services?

__________________________________
Yes
No

__________________________________________

Did the participant receive any vocational or other
services from a Worksource Center?

Yes
No
Unknown

Did the participant receive any vocational or other
services from any other organization?

Yes
No
Unknown

From what other outside organiations did the
participant receive vocational or employment services?

05/01/2024 12:10pm

__________________________________________

projectredcap.org


File Typeapplication/pdf
File Modified0000-00-00
File Created2024-05-01

© 2024 OMB.report | Privacy Policy