INTERVIEWER: IN WHAT LANGUAGE WAS THIS INTERVIEW CONDUCTED?
| 1 | English | |
| 2 | Spanish | |
| 3 | Other (SPECIFY) |
Lead-In: INTV-END [Default]
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 |
Lead-In: QIR-3 [Default]
INTERVIEWER: IN GENERAL, WAS THE RESPONDENT'S UNDERSTANDING OF THE QUESTIONS GOOD, FAIR OR POOR?
| 1 | Good? | |
| 2 | Fair? | |
| 3 | Poor? |
Lead-In: QIR-4 [Default]
([interview was done by telephone or in-person]=2);
/* Is this an in-person interview? */
| 1 | CONDITION APPLIES ...(Go To QIR-6) | |
| 0 | CONDITION DOES NOT APPLY |
| If Answer =1 | Then Go To: QIR-6 |
Lead-In: QIR-5 [Default]
INTERVIEWER: WAS ANYONE ELSE PRESENT OTHER THAN SMALL CHILDREN (AGE 3 AND UNDER) DURING ANY PORTION OF THE INTERVIEW?
| 1 | Yes ...(Go To QIR-6A) | |
| 0 | No |
Lead-In: QIR-5A [1:1]
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) |
Lead-In: QIR-6 [1:1]
INTERVIEWER: PLEASE LIST QUESTION NUMBERS THAT CONFUSED, ANGERED, OR CAUSED DISCOMFORT TO THE RESPONDENT OR QUESTIONS THAT YOU FEEL RESPONDENT DID NOT ANSWER TRUTHFULLY.
| 1 | SELECT TO ENTER QUESTION | |
| 0 | NO QUESTIONS CAUSED RESPONDENT PROBLEMS ...(Go To QIR-8) |
Lead-In: QIR-5A [Default], QIR-6 [Default], QIR-6A [Default]
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.
Lead-In: QIR-7 [Default]
INTERVIEWER: ENTER CLEAR DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN QIR-7A. PRESS <PG-UP> TO REVIEW QIR-7A.
Lead-In: QIR-7A [Default]
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 QIR-8) |
Lead-In: QIR-7B [Default]
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.
Lead-In: QIR-7C [Default]
INTERVIEWER: ENTER CLEAR DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN QIR-7D. PRESS <PG-UP> TO REVIEW QIR-7D.
Lead-In: QIR-7D [Default]
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 QIR-8) |
Lead-In: QIR-7E [Default]
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.
Lead-In: QIR-7F [Default]
INTERVIEWER: ENTER CLEAR DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN QIR-7G. PRESS <PG-UP> TO REVIEW QIR-7G.
Lead-In: QIR-7G [Default]
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 QIR-9) |
Lead-In: QIR-7H [Default], QIR-7 [0:0], QIR-7C [0:0], QIR-7F [0:0]
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.
Lead-In: QIR-8 [Default]
INTERVIEWER: ENTER CLEAR DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN QIR-8A. PRESS <PG-UP> TO REVIEW QIR-8A.
Lead-In: QIR-8A [Default]
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 QIR-9) |
Lead-In: QIR-8B [Default]
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.
Lead-In: QIR-8C [Default]
INTERVIEWER: ENTER CLEAR DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN QIR-8D. PRESS <PG-UP> TO REVIEW QIR-8D.
Lead-In: QIR-8D [Default]
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 QIR-9) |
Lead-In: QIR-8E [Default]
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.
Lead-In: QIR-8F [Default]
INTERVIEWER: ENTER CLEAR DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN QIR-8G. PRESS <PG-UP> TO REVIEW QIR-8G.
Lead-In: QIR-8G [Default]
INTERVIEWER: DID THE RESPONDENT HAVE ANY OF THE SPECIAL CHARACTERISTICS THAT COULD AFFECT [his/her] ABILITY TO ANSWER ANY PORTION OF THIS QUESTIONNAIRE?
| 1 | Yes ...(Go To QIR-9A) | |
| 0 | No |
Lead-In: QIR-8H [Default], QIR-8 [0:0], QIR-8C [0:0], QIR-8F [0:0]
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) |
Lead-In: QIR-9 [1:1]
INTERVIEWER: IN GENERAL, WHAT WAS THE RESPONDENT'S ATTITUDE ABOUT THE USE OF A COMPUTER IN THE INTERVIEW? PLEASE DESCRIBE BELOW.
IF RESPONDENT HAD NO NOTICEABLE REACTION, ENTER "NONE" AND PRESS <ENTER> TO CONTINUE.
Lead-In: none
INTERVIEWER: HAVE YOU INTERVIEWED THIS RESPONDENT IN PRIOR YEARS?
| 1 | Yes | |
| 0 | No |
Lead-In: QIR-9 [Default], QIR-9A [Default], QIR-10 [Default]
INTERVIEWER: WAS THERE ANY DIFFERENCE IN THIS RESPONDENT'S ATTITUDE TOWARD THIS YEAR'S SURVEY AND PRIOR SURVEYS BECAUSE A COMPUTER WAS BEING USED THIS YEAR?
| 1 | Yes ...(Go To QIR-11B) | |
| 0 | No |
Lead-In: none
INTERVIEWER: PLEASE DESCRIBE ANY DIFFERENCE YOU NOTICED IN THIS RESPONDENT'S ATTITUDE TOWARD THIS YEAR'S SURVEY AND PRIOR SURVEYS, BECAUSE A COMPUTER WAS BEING USED THIS YEAR.
Lead-In: QIR-11A [1:1]
INTERVIEWER: PLEASE CHOOSE THE CORRECT STAFF IDENTIFICATION NUMBER FOR THIS CASE FROM THE LIST PROVIDED.
Lead-In: QIR-11 [Default], QIR-11A [Default], QIR-11B [Default]
INTERVIEWER: PLEASE TYPE YOUR NAME ON THE LINE PROVIDED. THEN PRESS <ENTER> TO END SURVEY.
Lead-In: QIR-12 [Default]