INT-MODE [R57345.00] | Section: Interviewer Remarks |
COMMENT: MODE OF ADMINISTRATION FOR INTERVIEW
| 71 COMPLETED PERSONAL |
| 72 COMPLETED TELEPHONE |
| 74 CONVERTED PERSONAL |
| 75 CONVERTED TELEPHONE |
Q15-1 [R57346.00] | Section: Interviewer Remarks |
INTERVIEWER: WHAT IS RESPONDENT'S RACE?
Q15-2 [R57347.00] | Section: Interviewer Remarks |
INTERVIEWER: WHAT IS RESPONDENT'S GENDER?
Q15-3 [R57348.00] | Section: Interviewer Remarks |
INTERVIEWER: IN WHAT LANGUAGE WAS THIS INTERVIEW CONDUCTED?
| 1 English |
| 2 Spanish |
| 3 Other (SPECIFY) |
Q15-4 [R57349.00] | Section: Interviewer Remarks |
INTERVIEWER: IN GENERAL, WHAT WAS THE RESPONDENT'S ATTITUDE TOWARD THE
INTERVIEW?
| 1 Friendly and interested |
| 2 Cooperative but not particularly interested |
| 3 Impatient and restless |
| 4 Hostile |
Q15-5 [R57350.00] | Section: Interviewer Remarks |
INTERVIEWER: IN GENERAL, WAS THE RESPONDENT'S UNDERSTANDING OF THE
QUESTIONS GOOD, FAIR OR POOR?
Q15-6 [R57351.00] | Section: Interviewer Remarks |
INTERVIEWER: WAS ANYONE ELSE PRESENT OTHER THAN SMALL CHILDREN (AGE 3 AND
UNDER) DURING ANY PORTION OF THE INTERVIEW?
| 1 YES ...(Go To Q15-6A) |
| 0 NO |
| 2 TELEPHONE INTERVIEW |
Q15-6A [R57352.03] | Section: Interviewer Remarks |
INTERVIEWER: WHO WAS PRESENT?
(CODE ALL THAT APPLY)
| 5 Spouse/partner |
| 1 R's parent(s) |
| 2 Other member(s) of R's household |
| 3 R's friend(s) |
| 4 Other (SPECIFY) |
Q15-7 [R57353.00] | Section: Interviewer Remarks |
INTERVIEWER: PLEASE LIST QUESTIONS THAT CONFUSED, ANGERED, OR CAUSED
DISCOMFORT TO THE RESPONDENT OR QUESTIONS THAT YOU FEEL THE
RESPONDENT DID NOT ANSWER TRUTHFULLY.
| 1 SELECT TO ENTER QUESTION |
| 0 NO QUESTIONS CAUSED RESPONDENT PROBLEMS ...(Go To Q15-8) |
Q15-7A [] | Section: Interviewer Remarks |
INTERVIEWER: LIST SECTION AND QUESTION NUMBER OF FIRST QUESTION THAT
CAUSED RESPONDENT PROBLEMS. IF DON'T KNOW SECTION OR
QUESTION NUMBER, RECORD DESCRIPTION OF QUESTION.
Q15-7B [] | Section: Interviewer Remarks |
INTERVIEWER: ENTER DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN
Q15-7A. PRESS <PG-UP> TO REVIEW Q15-7A.
Q15-7C [R57354.00] | Section: Interviewer Remarks |
INTERVIEWER: WERE THERE ANY OTHER QUESTIONS THAT CONFUSED, ANGERED, OR
CAUSED DISCOMFORT TO THE RESPONDENT OR QUESTIONS THAT YOU
FEEL THE RESPONDENT DID NOT ANSWER TRUTHFULLY?
| 1 SELECT TO ENTER QUESTION |
| 0 NO OTHER QUESTIONS CAUSED RESPONDENT PROBLEMS ...(Go To Q15-8) |
Q15-7D [] | Section: Interviewer Remarks |
INTERVIEWER: LIST SECTION AND QUESTION NUMBER OF NEXT QUESTION THAT
CAUSED RESPONDENT PROBLEMS. IF DON'T KNOW SECTION AND
QUESTION NUMBER, RECORD DESCRIPTION OF QUESTION.
Q15-7E [] | Section: Interviewer Remarks |
INTERVIEWER: ENTER DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN
Q15-7D. PRESS <PG-UP> TO REVIEW Q15-7D.
Q15-7F [R57355.00] | Section: Interviewer Remarks |
INTERVIEWER: WERE THERE ANY OTHER QUESTIONS THAT CONFUSED, ANGERED, OR
CAUSED DISCOMFORT TO THE RESPONDENT OR QUESTIONS THAT YOU
FEEL THE RESPONDENT DID NOT ANSWER TRUTHFULLY?
| 1 SELECT TO ENTER QUESTION |
| 0 NO OTHER QUESTIONS CAUSED RESPONDENT PROBLEMS ...(Go To Q15-8) |
Q15-7G [] | Section: Interviewer Remarks |
INTERVIEWER: LIST SECTION AND QUESTION NUMBER OF NEXT QUESTION THAT
CAUSED RESPONDENT PROBLEMS. IF DON'T KNOW SECTION AND
QUESTION NUMBER, RECORD DESCRIPTION OF QUESTION.
Q15-7H [] | Section: Interviewer Remarks |
INTERVIEWER: ENTER DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN
Q15-7G. PRESS <PG-UP> TO REVIEW Q15-7G.
Q15-8 [R57356.00] | Section: Interviewer Remarks |
INTERVIEWER: PLEASE LIST QUESTIONS WITH SKIP ERRORS, QUESTIONS THAT WERE
CONFUSING TO YOU, OR QUESTIONS THAT OTHERWISE DID NOT WORK.
| 1 SELECT TO ENTER QUESTION |
| 0 NO QUESTIONS CAUSED INTERVIEWER PROBLEMS ...(Go To Q15-9) |
Q15-8A [] | Section: Interviewer Remarks |
INTERVIEWER: LIST SECTION AND QUESTION NUMBER OF FIRST QUESTION THAT
CAUSED INTERVIEWER PROBLEMS. IF DON'T KNOW SECTION OR
QUESTION NUMBER, RECORD DESCRIPTION OF QUESTION.
Q15-8B [] | Section: Interviewer Remarks |
INTERVIEWER: ENTER DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN
Q15-8A. PRESS <PG-UP> TO REVIEW Q15-8A.
Q15-8C [R57357.00] | Section: Interviewer Remarks |
INTERVIEWER: WERE THERE ANY OTHER QUESTIONS WITH SKIP ERRORS, QUESTIONS
THAT WERE CONFUSING TO YOU, OR QUESTIONS THAT OTHERWISE DID
NOT WORK?
| 1 SELECT TO ENTER QUESTION |
| 0 NO OTHER QUESTIONS CAUSED INTERVIEWER PROBLEMS ...(Go To Q15-9) |
Q15-8D [] | Section: Interviewer Remarks |
INTERVIEWER: LIST SECTION AND QUESTION NUMBER OF NEXT QUESTION THAT
CAUSED INTERVIEWER PROBLEMS. IF DON'T KNOW SECTION OR
QUESTION NUMBER, RECORD DESCRIPTION OF QUESTION.
Q15-8E [] | Section: Interviewer Remarks |
INTERVIEWER: ENTER DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN
Q15-8D. PRESS <PG-UP> TO REVIEW Q15-8D.
Q15-8F [R57358.00] | Section: Interviewer Remarks |
INTERVIEWER: WERE THERE ANY OTHER QUESTIONS WITH SKIP ERRORS, QUESTIONS
THAT WERE CONFUSING TO YOU, OR QUESTIONS THAT OTHERWISE DID
NOT WORK?
| 1 SELECT TO ENTER QUESTION |
| 0 NO OTHER QUESTIONS CAUSED INTERVIEWER PROBLEMS ...(Go To Q15-9) |
Q15-8G [] | Section: Interviewer Remarks |
INTERVIEWER: LIST SECTION AND QUESTION NUMBER OF NEXT QUESTION THAT
CAUSED INTERVIEWER PROBLEMS. IF DON'T KNOW SECTION OR
QUESTION NUMBER, RECORD DESCRIPTION OF QUESTION.
Q15-8H [] | Section: Interviewer Remarks |
INTERVIEWER: ENTER DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN
Q15-8G. PRESS <PG-UP> TO REVIEW Q15-8G.
Q15-9 [R57359.00] | Section: Interviewer Remarks |
INTERVIEWER: DID THE RESPONDENT HAVE ANY OF THE SPECIAL CHARACTERISTICS
THAT COULD AFFECT [his/her] ABILITY TO ANSWER ANY PORTION
OF THIS QUESTIONNAIRE?
Q15-9A [R57360.02] | Section: Interviewer Remarks |
INTERVIEWER: WHICH CHARACTERISTIC(S) DID THE RESPONDENT HAVE?
(CODE ALL THAT APPLY)
| 1 Respondent deaf |
| 2 Respondent blind |
| 3 Respondent mentally handicapped or retarded |
| 4 Respondent's English is very poor |
| 5 Respondent cannot read |
| 6 Respondent physically handicapped (SPECIFY HANDICAP) |
| 7 Other (SPECIFY) |
Q15-11 [R57361.00] | Section: Interviewer Remarks |
INTERVIEWER: HAVE YOU INTERVIEWED THIS RESPONDENT IN PRIOR YEARS?
Q15-12 [R57362.00] | Section: Interviewer Remarks |
INTERVIEWER: PLEASE PRESS *<F4>* TO CHOOSE YOUR NAME FROM LIST.
(PRESS <ENTER> TO END SURVEY)