Download:
pdf |
pdfSurvey Contents and Modules
SECTION A: CATI INTRODUCTION SCRIPTS .................................................................... 2
SECTION B: WEB INTRODUCTION SCREENS ................................................................... 9
Deleted: 12
SECTION C: JOB HISTORY, WORK SEARCH, & BARRIERS TO EMPLOYMENT ....... 11
Deleted: 14
SECTION D: HOUSEHOLD COMPOSITION & CHILD CARE ......................................... 20
Deleted: 24
SECTION E: INCOME, FOOD SECURITY, & MATERIAL HARDSHIP ........................... 22
Deleted: 26
SECTION G: HOUSING AND MOVING............................................................................... 30
Deleted: 34
SECTION H: PROGRAM GROUP EXPERIENCES.............................................................. 32
Deleted: 36
SECTION I: PROGRAM GROUP EXPERIENCES ............................................................... 37
Deleted: 40
SECTION Z: CLOSING SECTION/INCENTIVE PAYMENT .............................................. 40
Deleted: 43
1
SECTION A: CATI INTRODUCTION SCRIPTS
CATI: RECORD START DATE (SECASTDT) AND TIME (SECASTTM)
INT10. Is this an incoming call, or outgoing call?
IC
OK
09
Incoming Call (GO TO CI_INTRO)
Outgoing Call (GO TO INT00)
Not dialed or attempted – need to exit case (GO TO CNOTES)
INT00.
NUMBER TO DIAL: [PHONE]
YOU ARE CALLING RESPONDENT: [FLNAME]
WHAT IS THE RESULT OF THIS CALL?
OK
10
50
48
49
55
53
54
56
01
SOMEONE IS ANSWERING YOUR CALL (GO TO INTRO_RESP)
ANSWERING MACHINE – RESPONDENT SCRIPT (GO TO INT01)
NO ANSWER (GO TO CNOTES)
REGULAR BUSY (GO TO CNOTES)
FAST BUSY (GO TO CNOTES)
NUMBER DISCONNECTED, NO LONGER IN SERVICE (GO TO CNOTES)
FAX/DATA LINE (GO TO CNOTES)
NUMBER TEMPORARILY DISCONNECTED (GO TO CNOTES)
UNABLE TO CONNECT TO NUMBER AT THIS TIME (GO TO CNOTES)
ADDITIONAL OUTCOME CODES (GO TO INT)
INT01. Hello, my name is INTERVIEWER NAME and I am trying to reach [FLNAME] for a
short, paid interview about the [STEPPED/TIERED] rent study at [PHA NAME].
Please have [FLNAME] call us at (XXX) XXX-XXXX. Thank you.
11
17
14
OK
ANSWERING MACHINE – RESPONDENT NAME (FIRST/LAST FULL) (GO
TO CNOTES)
ANSWERING MACHINE – NO MESSAGE LEFT (GO TO CNOTES)
ANSWERING MACHINE – OTHER (GO TO CNOTES)
SOMEONE ANSWERS (GO TO INTRO_RESP)
2
CI_INTRO. Hello, my name is INTERVIEWER NAME. How may I help you?
1
Continue
INTERVIEWER: PLEASE PRESS “NEXT” TO CONTINUE.
CATI: IF A_TYPE=2, GO TO SRCE1; ELSE GO TO Q_CONT
SRCE1.
Are you...
1
2
3
7
8
Responding to a ‘Sorry I Missed You’ card that was left at your door? OR
Responding to a letter or postcard you received in the mail? OR
Responding to a voicemail message from someone here at DIR?
DON’T KNOW
REFUSED
CATI: ALL GO TO Q_CONT
INTRO_RESP. Hello, my name is INTERVIEWER NAME and I am trying to reach
[FLNAME] for a short, paid interview about the [STEPPED/TIERED] rent study at
[PHA NAME]. May please speak to [FLNAME]?
INTERVIEWER: IF NECESSARY, READ: “[FLNAME] is participating in a study
about the [PHA NAME]’s [STEPPED/TIERED] rent.”
01
02
03
04
05
08
RESPONDENT ON THE PHONE – CONTINUE (GO TO Q_CONT)
RESPONDENT IS COMING TO THE PHONE (GO TO Q_CONT)
RESPONDENT NOT AVAILABLE (GO TO NOTAVAIL1)
REFUSED – (GO TO END_INT)
WRONG NUMBER FOR R (CODE AS 71 AND GOTO CNOTES)
RESPONDENT BREAKOFF – HANG-UP/DISCONNECT (GO TO
CNOTES)
Q_CONT.
[IF INTRO_RESP=02, DISPLAY: Hello, my name is INTERVIEWER NAME and I am
trying to reach [FLNAME] for a short, paid interview about the [STEPPED/TIERED] rent
study at [PHA NAME]. May please speak to [FLNAME]?]
Thank you for taking the time to speak with me today.
INTERVIEWER: IF R INDICATES READINESS TO PARTICIPATE AFTER THIS POINT
OR SEEMS TO BECOME IMPATIENT WITH THE SCRIPT, STOP READING AND
CONTINUE ON.
3
Decision Information Resources is conducting follow-up surveys with families who were
enrolled in the [STEPPED/TIERED] rent studyHUD Stepped and Tiered Rent Demonstration
study. The survey should take about 15 minutes. You will receive a $[INCENTIVE] gift card as
a thank you for completing the survey.
You entered the study beginning with your recertification that was effective on [REF_DATE].
You may have received a letter recently to let you know that the survey was available and we
might be calling soon.
01
02
08
CONTINUE (GO TO SCRN1)
NOT NOW (GO TO INT20)
RESPONDENT REFUSED (GO TO UE)
NOTAVAIL1
Is this the best number to reach ?
INTERVIEWER: IF NECESSARY, READ: “[FLNAME] is participating in a study about
the [PHA NAME]’s [STEPPED/TIERED] rent study.”
01. YES – SET CALLBACK FOR R AT THIS NUMBER (GOTO INT20)
02. NO – R NO LONGER LIVES HERE OR USES THIS NUMBER (GO TO INT04)
03. WRONG NUMBER – DOESN’T KNOW R (CODE 71 AND GOTO CNOTES)
INT20
IF SPEAKING WITH R: What is the best time for us to call you back to complete the survey?
IF R UNAVAILABLE: Thanks, what is the best time to call back?
23. SPOKE TO R – CALL BACK (GO TO CNOTES)
20. HARD APPOINTMENT (GO TO CB)
21. SOFT APPOINTMENT (GO TO CB)
CB.
INTERVIEWER: ENTER DATE AND TIME
CATI: DISPLAY CALENDAR TO ALLOW INTERVIEWER TO CHOOSE DATE &
TIME FOR CALLBACK
Thank you. We will call back then.
GO TO CNOTES
INT04
4
Is there a different number where he/she can be reached?
IF PERSON PERIODICALLY HEARS FROM R, SAY: “Could I leave our toll-free number
with you so he/she can call us? It is .”
57. YES, NEW NUMBER AVAILABLE FOR R (CODE 57 AND GO TO
NEWPHONE)
01. NO, NO NEW NUMBER AVAILABLE FOR R (GO TO INT05)
71. WRONG NUMBER FOR R (CODE AS 71 AND GOTO CNOTES)
INT05
Is there someone else I could call who might know his/her address or phone number or who
might be able to get a message to him/her?
IF PERSON PERIODICALLY HEARS FROM R, SAY: “Could I leave our toll-free number
with you so he/she can call us? It is .”
57. YES – ADD NEW CONTACT (GOTO NEWPHONE)
71. WRONG NUMBER FOR R (GOTO CNOTES)
NEWPHONE. What is the new phone number?
INTERVIEWER: ENTER NEW PHONE NUMBER (FORMAT 9999999999)
TZ_02. Please confirm the time zone of the phone number.
00 UNKNOWN
02 Midway Island, Samoa
03 Hawaii
04 Alaska
05 Pacific Time (PST)
07 Mountain Time (MT)
08 Arizona
12 Central Time (CST)
12 Eastern Time (EST)
19 Atlantic/Puerto Rico
INTERVIEWER: IF PERSON ON THE PHONE DOESN’T KNOW THE TIME ZONE FOR
THE PHONE, ASK IN WHAT STATE DOES THE OWNER OF THIS PHONE LIVE IN?
AND SELECT BEST OPTION
PHTYPE02. Is this a home, work or cell number?
5
1 HOME
2 WORK
3 CELL
5 OTHER
6 UNKNOWN
EMAIL02. What is their email address? (GOTO NN_CB)
NN_CB. Is there a specific date or time when we should call?
20 HARD APPOINTMENT (GOTO CB)
21 SOFT APPOINTMENT (GOTO CB)
A2 SPOKE TO GK- CALL BACK (GOTO CNOTES)
CB.
INTERVIEWER: ENTER DATE AND TIME
CATI: DISPLAY CALENDAR TO ALLOW INTERVIEWER TO CHOOSE DATE &
TIME FOR CALLBACK
Thank you. We will call back then.
GO TO CNOTES
END_INT. Thank you for taking the time to speak with me today. I’m sorry that you
aren’t able to participate in our study. If you change your mind and decide you
would like to participate, please call (XXX) XXX-XXXX .
INTERVIEWER: PLEASE PAUSE A MOMENT TO GIVE R TIME TO WRITE
NUMBER DOWN AND REPEAT IF NEEDED
01 CONTINUE (GO TO INT03)
INT03. WAS THIS A SOFT OR HARD REFUSAL?
60. SOFT REFUSAL (GOTO CNOTES)
61. HARD REFUSAL (GOTO CNOTES)
SCRN1.
Before we begin, I’d like to confirm that I am speaking with the correct person.
In order to do so, could you please tell me your date of birth?
6
DOB: ____ ____ ____ ____
INTERVIEWER: ENTER MONTH AND DAY, E.G. “May 15th, 1974” = 0515
9997
9998
DON’T KNOW (GOTO INT3)
REFUSED (GOTO INT3)
CATI:
IF SCRN1= DOB FROM SAMPLE FILE GO TO INFORMCONSNT
IF (SCRN1 ≠ DOB) RMNCONF = 2; GOTO DENY_TX
DENY_TX.
There seems to be a technical problem with your file. Thank you for your time
and patience. We will contact you as soon as we resolve this problem. Your
information is important to us and to the success of this study. Have a nice
day/evening.
INTERVIEWER: PRESS NEXT TO END SURVEY
INFORMCONSNT.
Decision Information Resources (DIR) is working with MDRC, to conduct a study on the
Stepped and Tiered Rent Demonstration at the [PHA NAME] on behalf of the U.S. Department
of Housing and Urban Development, authorized by Section 501 of the Housing and Urban
Development Act of 1970. Your responses will help the Study Team understand how the new
rent policies affect the families participating in this study.
Your responses will not be shared with the [PHA NAME]. After the study is complete or at
HUD’s request, the Study Team will transfer your data with your responses to HUD, which will
be combined with other study information we have collected from you. HUD intends to use your
information only for research. We recognize that this information is sensitive and protected by
the Privacy Act. HUD has published a System of Records Notice entitled Stepped and Tiered
Rent Demonstration Evaluation Data Files, which describes how the information collected is
protected and to whom it may be disclosed. The notice is available at hud.gov/privacy.
Only surveys that are approved by Office of Management and Budget (OMB) may be fielded in
this study. This survey is approved by the OMB, and assigned OMB Approval No. 2528-0339.
Completing the questionnaire is voluntary and you may skip any questions you do not wish to
answer. Your participation in this survey will not affect your participation in the [voucher/public
housing] program, the Stepped and Tiered Rent Demonstration, or any benefits you may receive
now or in the future.
7
The survey should take about 15 minutes.
***We must also ensure effective communication and provide reasonable accommodations for
individuals with disabilities throughout this study. Please let us know if you require a reasonable
accommodation and the best method to use to communicate with you. We will also provide
meaningful access to persons with limited English proficiency. You can complete the survey in
English, Spanish, and Arabic. Please let us know if you would like to complete the survey in a
different language. The survey can be completed over the phone or online, and the online survey
is accessible for individuals with disabilities.
Do you have any questions or concerns about completing the survey?
[If no questions or concerns with proceeding] Great. Thank you. Let’s get started.
[If not able to or does not want to complete the questionnaire during study enrollment]
Would you be willing to complete the questionnaire over the phone at a later time?
[If agreeing to complete the questionnaire over the phone at a later date] Thanks,
someone from the Study Team will call you sometime soon.
01. CONTINUE
02. SET AN APPOINTMENT WITH RESPONDENT (GO TO INT20)
03. R REFUSED PARTICIPATION (GO TO INT03)
CATI: RECORD END DATE (SECAEDDT) AND TIME (SECAEDTM)
8
SECTION B: WEB INTRODUCTION SCREENS
PIN PAGE
Welcome to the Stepped and Tiered Rent Demonstration Study. Please enter your unique PIN
below to complete a short, paid survey.
PIN: _______________
Footer to be displayed at the bottom of each survey screen:
For technical assistance, please call (XXX) XXX-XXXX or email XXXXXXX.
INFORMCONSNT_WEB
Decision Information Resources (DIR) is working with MDRCn, to conduct a study on the
Stepped and Tiered Rent Demonstration at the [PHA NAME] on behalf of the U.S. Department
of Housing and Urban Development, authorized by Section 501 of the Housing and Urban
Development Act of 1970. Your responses will help the Study Team understand how the new
rent policies affect the families participating in this study.
Your responses will not be shared with the [PHA NAME]. After the study is complete or at
HUD’s request, the Study Team will transfer your data with your responses to HUD, which will
be combined with other study information we have collected from you. HUD intends to use your
information only for research. We recognize that this information is sensitive and protected by
the Privacy Act. HUD has published a System of Records Notice entitled Stepped and Tiered
Rent Demonstration Evaluation Data Files, which describes how the information collected is
protected and to whom it may be disclosed. The notice is available at hud.gov/privacy.
Only surveys that are approved by Office of Management and Budget (OMB) may be fielded in
this study. This survey is approved by the OMB, and assigned OMB Approval No. 2528-0339.
Completing the questionnaire is voluntary and you may skip any questions you do not wish to
answer. Your participation in this survey will not affect your participation in the [voucher/public
housing] program, the Stepped and Tiered Rent Demonstration, or any benefits you may receive
now or in the future.
The survey should take about 15 minutes.
***We must also ensure effective communication and provide reasonable accommodations for
individuals with disabilities throughout this study. Please let us know if you require a reasonable
accommodation and the best method to use to communicate with you. We will also provide
meaningful access to persons with limited English proficiency. You can complete the survey in
English, Spanish, and Arabic. Please let us know if you would like to complete the survey in a
different language. The survey can be completed over the phone or online, and the online survey
is accessible for individuals with disabilities.
9
Please select NEXT to begin.
SCRN1_WEB. Before we begin, we want to confirm that you are the correct person.
In order to do so, please confirm your date of birth. Please enter only the month and day
as MMDD.
DOB: ____ ____ ____ ____
9997
9998
DON’T KNOW (GOTO INT3)
REFUSED (GOTO INT3)
CATI:
IF SCRN1_WEB = DOB FROM SAMPLE FILE GO TO INFORMCONSNT_WEB
IF (SCRN1 ≠ DOB) RMNCONF = 2; GOTO DENYTX_WEB
DENYTX_WEB.
There seems to be a technical problem with your file. Thank you for your
time and patience. We will contact you as soon as we resolve this problem. Your
information is important to us and to the success of this study.
10
SECTION C: JOB HISTORY, WORK SEARCH, & BARRIERS TO
EMPLOYMENT
CATI: RECORD START DATE (SECCSTDT) AND TIME (SECCSTTM)
C1.
In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR -1],
have you worked for pay or were self-employed? Please don't count unpaid work
experience or unpaid volunteer work.
01
02
97
98
YES (GO TO C2)
NO
DON’T KNOW
REFUSED
C1a.
A lot of people have irregular, odd, or side jobs, or do extra work to make ends
meet. Have you done any work like that for pay in the last 12 months?
Again, I want to assure you that none of your answers will be discussed with
anyone.
01
02
97
98
C2.
YES
NO (GO TO C23)
DON’T KNOW (GO TO C25)
REFUSED (GO TO C25)
Are you currently working for pay, or self-employed?
01
02
03
97
98
YES
YES, CURRENTLY ON LEAVE, TEMPORARY LAY-OFF, OR VACATION
NO
DON’T KNOW
REFUSED
CATI: IF C2=01, 02 use “current”/present tense for text fills below; else use “most
recent”/past tense for text fills
C3.
I'd like to ask you some questions about your [current/most recent] job.
[CATI: IF C1=1, ADD] “If you have multiple jobs, please focus on the job at which you work
the most hours.”
Moved down [1]: How would you best describe this job?
C3b. Would you say you…
01
[work/worked] for an employer, or
11
02
97
98
[are/were] self-employed?
DON’T KNOW
REFUSED
C3c. How would you best describe this job? Select all that apply.
01
a permanent job,
02
a temporary job,
03
a seasonal job,
04
a gig job (for example, driving for Uber), or
05
an odd job?
97
DON’T KNOW
98
REFUSED
C5.
[IF C2 = 3, 97, OR 98, ADD "Now/Just before you left,"] including overtime, how
many hours per week [do/did] you usually work on this job?
INTERVIEWER: IF GREATER THAN 84, CODE THE RESPONSE AS 84
HOURS/WEEK:
[RANGE: 1- 84] (IF HOURS ARE <=10 OR >60 GO
C5_CONFIRM; ELSE GO TO C6)
97
98
DON’T KNOW (GO TO C5a)
REFUSED (GO TO C5a)
C5_CONFIRM. Just to confirm, you said that you usually hours per week.
Is that correct?
1. Yes, it is correct (GO TO C6)
2. No, that is incorrect (GO TO C5 TO CORRECT RESPONSE)
C5a. Would you say that you usually [work/worked]…
01
02
03
97
98
C6.
1 to 20 hours per week,
21 to 34 hours per week, or
35 or more hours per week?
DON’T KNOW
REFUSED
How many days per week [do/did] you usually work?
DAYS/WEEK:
[RANGE: 1- 7]
12
Deleted: , or
Deleted: 03 [are/were] working at a seasonal, temporary,
or odd job?¶
Moved (insertion) [1]
97
98
C7.
DON’T KNOW
REFUSED
What [are/were] your earnings from your job or income from self-employment
[now/just before you left] before taxes? Please include tips, commissions, and regular
overtime pay.
INTERVIEWER: IF R’S JOB IS ON AN IRREGULAR SCHEDULE OR A COMMISSION
BASIS, PROBE FOR HOW MUCH R MAKES IN A TYPICAL WEEK.
$ ___ ___ ___, ___ ___ ___.___ ___ [RANGE 000000.01 – 999999.94]
AMOUNT
999999.97
DON’T KNOW (GO TO C10)
999999.98
REFUSED (GO TO C10)
C8.
[Is/Was] that…
01
02
03
04
05
06
07
08
97
98
Per hour,
Per week,
Every 2 weeks,
Twice a month,
Once a month,
Per year,
Per day, or
Some other way?
DON’T KNOW
REFUSED
CATI: IF C8=8, ASK C8_O;
ELSE GO TO C7_CONFIRM IF AMOUNT REPORTED AT C7/C8 IS ANY OF
THE FOLLOWING:
GREATER THAN $20/HOUR
$200/DAY
$1,000/WEEK
$2,000/EVERY 2 WEEKS OR TWICE A MONTH
$4,000/MONTH
$50,000/YEAR;
ELSE GO TO C9
C8_O. How often did you receive that amount?
01
________________________________________
13
97
98
DON’T KNOW
REFUSED
CATI: GO TO C7_CONFIRM IF AMOUNT REPORTED AT C7/C8 IS ANY OF THE
FOLLOWING:
GREATER THAN $20/HOUR
$200/DAY
$1,000/WEEK
$2,000/EVERY 2 WEEKS OR TWICE A MONTH
$4,000/MONTH
$50,000/YEAR;
ELSE GO TO C9
C7_CONFIRM. Just to confirm, you said your earnings were $ , is that correct?
01
02
03
C9.
YES (GO TO C9)
NO, CORRECT $ AMOUNT IN C7 (GO TO C7)
NO, CORRECT TIME PERIOD IN C8 (GO TO C8)
[Is/Was] that before or after taxes?
01
02
97
98
BEFORE
AFTER
DON’T KNOW
REFUSED
CATI: IF C3b=2, GO TO C27.
C10.
Now I’d like to ask a few questions about benefits that may be available at your job.
Through your employer are you eligible for any of the following benefits? By eligible we
mean the benefit is available for you now, even if you have decided to not receive it or
have not needed it.
INTERVIEWER: SELECT “YES” IF R REPORTS THAT R WILL BE OFFERED
BENEFITS AT A FUTURE TIME UPON REACHING A MILESTONE, SUCH AS
COMPLETING A PROBATION PERIOD FOR NEW EMPLOYEES OR TRANSITIONING
FROM PART-TIME TO FULL-TIME HOURS.
YES NO DON’T REFUSED
KNOW
1
2
97
98
1
2
97
98
C10a. Any sick days with full pay?
C10b. Any vacation days with full pay?
14
C10c. Paid overtime?
C10d. A plan that gives you money for retirement?
C10e. A health plan or medical insurance, including any
offered at a cost to you?
1
1
2
2
97
97
98
98
1
2
97
98
GO TO C27
C23.
Some people may not be able to get a job even if they want to work. Other people may
have personal or other reasons for not working for pay. What is the main reason you are
not working for pay?
INTERVIEWER: DO NOT READ LIST; SELECT ONLY ONE RESPONSE.
INTERVIEWER: IF YOU ARE UNCERTAIN HOW TO CODE THE RESPONSE, READ
THE OPTIONS ALOUD TO THE RESPONDENT.
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
97
98
ILLNESS, DISABILITY, SELF
ILLNESS, DISABILITY OTHER
TAKING CARE OF HOME OR FAMILY MEMBERS
UNABLE TO FIND (ADEQUATE) AND/OR AFFORDABLE CHILD CARE
GOING TO SCHOOL, IN TRAINING
UNABLE TO FIND WORK
PREGNANCY
CRIMINAL RECORD MAKES FINDING WORK HARD
POOR CREDIT SCORE MAKES FINDING WORK HARD
TEMPORARILY LAID OFF/ TEMPORARY LEAVE
INADEQUATE TRANSPORTATION OPTIONS
RETIRED OR TOO OLD
NEED MORE EDUCATION
NEED MORE WORK EXPERIENCE
NEED/PREFER TO STAY HOME WITH CHILDREN
HAS JOB BUT TEMPORARILY ABSENT
WAITING FOR JOB TO BEGIN
DOES NOT WANT TO WORK
OTHER SPECIFY
DON’T KNOW
REFUSED
CATI: IF C23=19 ASK C23_O, ELSE GO TO C24
C23_O.
What is the main reason you are not working for pay?
01
97
98
_______________________________
DON’T KNOW
REFUSED
15
CATI: IF C23=97 OR 98, GOTO C25
C24.
Are there any other reasons for not working for pay?
INTERVIEWER: DO NOT READ LIST; SELECT ALL THAT APPLY.
INTERVIEWER: IF YOU ARE UNCERTAIN HOW TO CODE THE RESPONSE, READ
THE OPTIONS ALOUD TO THE RESPONDENT.
CATI: ELIMINATE RESPONSE FROM C23 FROM LIST
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
97
98
ILLNESS, DISABILITY, SELF
ILLNESS, DISABILITY OTHER
TAKING CARE OF HOME OR FAMILY MEMBERS
UNABLE TO FIND (ADEQUATE) AND/OR AFFORDABLE CHILD CARE
GOING TO SCHOOL, IN TRAINING
UNABLE TO FIND WORK
PREGNANCY
CRIMINAL RECORD MAKES FINDING WORK HARD
POOR CREDIT SCORE MAKES FINDING WORK HARD
TEMPORARILY LAID OFF/ TEMPORARY LEAVE
INADEQUATE TRANSPORTATION OPTIONS
RETIRED OR TOO OLD
NEED MORE EDUCATION
NEED MORE WORK EXPERIENCE
NEED/PREFER TO STAY HOME WITH CHILDREN
HAS JOB BUT TEMPORARILY ABSENT
WAITING FOR JOB TO BEGIN
DOES NOT WANT TO WORK
OTHER SPECIFY
NO OTHER REASON
DON’T KNOW
REFUSED
CATI: IF C23a=19 ASK C23a_O, ELSE GO TO C25
C24_O.
What are the other reasons you are not working for pay?
01
97
98
C25.
_______________________________
DON’T KNOW
REFUSED
In the last four weeks, have you looked for a full-time or part-time work?
01
YES
16
02
97
98
C26.
NO (GO TO C27)
DON’T KNOW (GO TO C27)
REFUSED (GO TO C27)
Were you looking for full-time work, that is, 35 or more hours a week, or part-time
work?
01
02
03
97
98
Full-time
Part-time
Both
DON’T KNOW
REFUSED
CATI: IF (C2 = 1 or 2 and (C1d <> 1 and C2b <35)) and C25=1 AND C26=1 or 3 GO TO
D1
IF C2 = 1 or 2 and (C1d = 1 or C2b >=35) GO TO D1
C27.
CATI: IF (C2 = 1 or 2 and C1d<>1 and C2b < 35 AND C25<>1) OR (C2 = 1 or 2 and
C1d<>1 and C2b < 35 AND C25=1 AND C26<>1 or 3) ASK "According to what you’ve told
us, you are currently working less than 35 hours per week and you are not looking for full-time
work. Some people may not be able to get a full-time job even if they want to. Other people may
have personal or other reasons for not working full-time. What is the main reason why you are
not working full-time or looking for full-time work? "
CATI: IF ((C1>1 AND C1a>1) or C2 <>1 or 2) AND C25=1 ASK "According to what you’ve
told us, you are not currently working but you are looking for work. Some people may not be
able to get a job even if they want to work. Other people may have personal or other reasons for
not working for pay. What is the main reason why you are not working? "
CATI: IF ((C1>1 AND C1a>1) or C2 <>1 or 2) AND C25>1 ASK "According to what you’ve
told us, you are not currently working or looking for work. Some people may not be able to get a
job even if they want to work. Other people may have personal or other reasons for not
working for pay. What is the main reason why you are not looking for work? "
INTERVIEWER: DO NOT READ LIST; SELECT ONLY ONE RESPONSE.
01
02
03
04
05
YOU CAN’T FIND A JOB THAT PAYS ENOUGH.
YOU CAN’T FIND ANY JOB.
YOU CAN’T FIND SATISFACTORY CHILD CARE AT A REASONABLE
COST.
YOU CAN’T ARRANGE TRANSPORTATION TO GET TO WORK.
YOU ARE AFRAID YOU WILL LOSE YOUR CURRENT HEALTH
INSURANCE.
17
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
97
98
YOU ARE AFRAID YOU WILL LOSE YOUR HOUSING SUBSIDY OR
THAT YOUR RENT WOULD GO UP.
YOU ARE AFRAID YOU WILL LOSE OTHER BENEFITS YOU MAY
HAVE, SUCH AS FOOD STAMPS.
YOU NEED MORE SKILLS OR EDUCATION.
YOU NEED MORE EXPERIENCE.
YOU ARE PREGNANT OR HAD A BABY WITHIN THE PAST 3 MONTHS.
YOU WANT TO STAY HOME WITH YOUR CHILDREN.
YOU HAVE A CHILD WITH HEALTH PROBLEMS OR A DISABILITY.
YOU NEED TO CARE FOR SOMEONE IN YOUR FAMILY OTHER THAN A
CHILD.
YOU HAVE HEALTH PROBLEMS.
YOU ARE CURRENTLY IN A SCHOOL OR TRAINING PROGRAM.
YOU ARE ON SSI OR DISABILITY.
YOU ARE GETTING FINANCIAL SUPPORT FROM A HUSBAND OR
PARTNER.
A FORMER HUSBAND OR PARTNER IS HARASSING YOU OR
OTHERWISE INTERFERING WITH YOUR ATTEMPT TO WORK.
YOU ARE FEELING DEPRESSED OR OVERWHELMED.
YOU ARE DEALING WITH A DRINKING OR DRUG PROBLEM.
OTHER
DON'T KNOW
REFUSED
CATI: IF C27=21 ASK C27_O, ELSE GO TO C28.
C27_O.
ENTER VERBATIM RESPONSE
01
97
98
C28.
______________________________
DON’T KNOW
REFUSED
CATI: IF (C2 = 1 or 2 and C1d<>1 and C2b < 35 AND C25<>1) OR (C2 = 1 or 2
and C1d<>1 and C2b < 35 AND C25=1 AND C26<>1 or 3) ASK "Are there any other
reasons why you are not working full-time or looking for full-time work?"
CATI: IF ((C1>1 AND C1a>1) or C2 <>1 or 2) AND C25=1 ASK "Are there any other
reasons why you are not working?"
CATI: IF ((C1>1 AND C1a>1) or C2 <>1 or 2) AND C25>1 ASK "Are there any other
reasons why you are not looking for work?"
INTERVIEWER: DO NOT READ THE LIST, CHECK ALL THAT APPLY FROM
REASONS R PROVIDES
CATI: ELIMINATE RESPONSE FROM C27 FROM LIST
18
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
97
98
YOU CAN’T FIND A JOB THAT PAYS ENOUGH.
YOU CAN’T FIND ANY JOB.
YOU CAN’T FIND SATISFACTORY CHILD CARE AT A REASONABLE
COST.
YOU CAN’T ARRANGE TRANSPORTATION TO GET TO WORK.
YOU ARE AFRAID YOU WILL LOSE YOUR CURRENT HEALTH
INSURANCE.
YOU ARE AFRAID YOU WILL LOSE YOUR HOUSING SUBSIDY OR
THAT YOUR RENT WOULD GO UP.
YOU ARE AFRAID YOU WILL LOSE OTHER BENEFITS YOU MAY
HAVE, SUCH AS FOOD STAMPS.
YOU NEED MORE SKILLS OR EDUCATION.
YOU NEED MORE EXPERIENCE.
YOU ARE PREGNANT OR HAD A BABY WITHIN THE PAST 3 MONTHS.
YOU WANT TO STAY HOME WITH YOUR CHILDREN.
YOU HAVE A CHILD WITH HEALTH PROBLEMS OR A DISABILITY.
YOU NEED TO CARE FOR SOMEONE IN YOUR FAMILY OTHER THAN A
CHILD.
YOU HAVE HEALTH PROBLEMS.
YOU ARE CURRENTLY IN A SCHOOL OR TRAINING PROGRAM.
YOU ARE ON SSI OR DISABILITY.
YOU ARE GETTING FINANCIAL SUPPORT FROM A HUSBAND OR
PARTNER.
A FORMER HUSBAND OR PARTNER IS HARASSING YOU OR
OTHERWISE INTERFERING WITH YOUR ATTEMPT TO WORK.
YOU ARE FEELING DEPRESSED OR OVERWHELMED.
YOU ARE DEALING WITH A DRINKING OR DRUG PROBLEM.
OTHER
NO OTHER REASON
DON'T KNOW
REFUSED
CATI: IF C28=21 ASK C28_O, ELSE GO TO D1
C28_O.
ENTER VERBATIM RESPONSE
01
97
98
_______________________________
DON’T KNOW
REFUSED
CATI: RECORD END DATE (SECCEDDT) AND TIME (SECCEDTM)
19
SECTION D: HOUSEHOLD COMPOSITION & CHILD CARE
CATI: RECORD START DATE (SECDSTDT) AND TIME (SECDSTTM)
D1.
Now I’m going to ask you some questions about you and your household.
Which situation best describes your marital status. Are you currently…
INTERVIEWER: READ LIST
01
02
03
04
05
97
98
Married, living with spouse (GO TO D2)
Single, never married
Separated or living apart from your spouse
Divorced
Widow/Widower
DON’T KNOW
REFUSED
D1a.
Are you currently living with a partner?
01
02
97
98
D2.
YES
NO
DON’T KNOW
REFUSED
Next, think about the people who lived in your household at least two nights a week last
month.
How many adults age 18 years or older lived in your household for at least two nights a
week during the month of [PRIOR MONTH]? Please include yourself, [CATI: IF D1 =
1, INSERT “your spouse” IF D1a = 1, INSERT “your partner”], adult family members, and
any other adults age 18 years or older who lived in your household for at least two nights a
week during the month of [PRIOR MONTH]?
INTERVIEWER: IF R SAYS ZERO, REMIND R TO INCLUDE SELF IN THE
COUNT.
INTERVIEWER: IF GREATER THAN 10, CODE THE RESPONSE AS 10
# ADULTS: _________ [RANGE 1-10]
97
DON’T KNOW
98
REFUSED
20
IF (D1=1 OR D1a=1) AND D2=1, ASK
D2_CONF.
Earlier you said you lived with a spouse or partner but now you are saying
only 1 adult, you, live in your household. Can you help me with this?
INTERVIEWER: IF R DOES NOT LIVE WITH SPOUSE:
1) SELECT OPTION 01 R DOES NOT LIVE WITH SPOUSE
2) DO NOT RE-READ D1, AND
3) SELECT OPTION 03 SEPARATED OR LIVING APART FROM
YOUR SPOUSE AND CLICK NEXT TO CONTINUE
IF R DOES LIVE WITH SPOUSE:
1) SELECT OPTION 02 R DOES LIVE WITH SPOUSE
2) DO NOT RE-READ D2
3) ENTER THE NUMBER 2 AND CLICK NEXT TO CONTINUE
01
02
D3.
R DOES NOT LIVE WITH SPOUSE/PARTNER (GO TO D1
AND REVISE
ANSWER)
R DOES LIVE WITH SPOUSE/PARTNER (GO TO D2 AND
REVISE ANSWER)
How many children, age 17 or younger lived in your household for at least two nights a
week during the month of [PRIOR MONTH]? Please include your own children and
any other children who lived in your household.
INTERVIEWER: IF GREATER THAN 10, CODE THE RESPONSE AS 10
# ANY CHILDREN: ___ [RANGE 0-10]
97
DON’T KNOW
98
REFUSED
CATI: CREATE VARIABLE “OHHMBR” WHERE
IF D2=2-10 OR D3=1-10, OHHMBR=1 (YES OTHERS IN HHLD)
ELSE OHHMBR=0 (NO OTHERS IN HHLD OR UNKNOWN)
CATI: RECORD END DATE (SECDEDDT) AND TIME (SECDEDTM)
21
SECTION E: INCOME, FOOD SECURITY, & MATERIAL HARDSHIP
CATI: RECORD START DATE (SECESTDT) AND TIME (SECESTTM)
CATI: IF OHHMBR=0, USE FIRST TEXT FILL THROUGHOUT SECTION. ELSE USE
SECOND TEXT FILL.
E1_INTRO: Now, I am going to ask you some questions about the income that came into your household
in [PRIOR MONTH].
CATI: OHHMBR=1, ADD:
Unless the question concerns income for a specific person, like you, please include any income from all
adults and children who lived together in your household for at least two nights a week in [PRIOR
MONTH].
Again, I want to assure you that none of your answers will be discussed with anyone.
INTERVIEWER: PRESS NEXT TO CONTINUE
Monthly Income
E1.
During [PRIOR MONTH]:
Did you work for pay?
01
02
97
98
YES
NO
DON’T KNOW
REFUSED
CATI: IF OHHMBR=1, ASK E1a. ELSE GO TO E2.
E1a.
Did any other adults or children who lived in your household work for pay or were selfemployed?
01
02
97
98
E2.
YES
NO
DON’T KNOW
REFUSED
In [PRIOR MONTH], did you [CATI: IF OHHMBR=1, INSERT “or anyone else in
your household”] receive:
22
YES
NO
DON’T
KNOW
REFUSED
1
2
97
98
1
2
97
98
1
2
97
98
1
2
97
98
1
2
97
98
1
2
97
98
1
2
97
98
1
1
1
2
2
2
97
97
97
98
98
98
1
2
97
98
E2a. SNAP, also known as Food
Stamps, including EBT cards from the
government that can be used at the store to
buy food?
E2b. Child Support?
E2c. TANF or any cash assistance, not
including child support money or child
care payments?
E2d. Unemployment Insurance Benefits
or UI?
E2e. Social Security Disability Insurance
benefits, or SSDI
E2f. Supplemental Security Income
benefits, or SSI
E2g. The Special Supplemental Nutrition
Program for Women, Infants, and
Children or WIC?
E2h. Heating or Cooling Assistance?
E2i. Free or reduced-price school lunch?
E2j. Alimony?
E2k. Medicaid, CHIP, [STATE
HEALTH INSURANCE PROGRAM]
or other government health insurance?
E3.
In [PRIOR MONTH] did you [CATI: IF OHHMBR=1, INSERT “or anyone else in
your household”] receive money from any other source, such as rent from boarders, a
pension, other government benefits, or any other income we have not already talked about?
01
02
97
98
E4.
YES
NO
DON’T KNOW
REFUSED
What was the total monthly income for you [CATI: IF OHHMBR=1, INSERT: “and
everyone else living together in your household”] in [PRIOR MONTH]? Please include
income from all of the sources that you just mentioned, plus any other income.
PROBE: Your best estimate is fine.
AMOUNT: $ ___ ___ ___, ___ ___ ___.
999997
DON’T KNOW
999998
REFUSED
CATI:
23
[RANGE = 0 – 999996]
IF E4 IS LESS THAN OR EQUAL TO $10,000, GO TO E6.
IF E4 IS GREATER THAN $10,000 AND LESS THAN 999997, ASK E4_confirm.
IF E4 = 999997 OR 999998, GO TO E5a.
E4_confirm. Just to confirm, you said that the total monthly income for you [CATI: IF
OHHMBR=1, INSERT: “and everyone else living together in your household”]
in [PRIOR MONTH] was [INSERT E4]. Is that correct?
01
02
97
98
E4_revised.
YES (GOTO E6)
NO
DON’T KNOW (GO TO E5a)
REFUSED (GO TO E5a)
What would you say was the correct amount of total monthly income for everyone
living together in your household?
AMOUNT: $ ___ ___ ___, ___ ___ ___.
999997
DON’T KNOW
999998
REFUSED
[RANGE = 0 – 999996]
CATI: IF E4_revised IS 0 - 999997, GO TO E6. ELSE, CONTINUE WITH E5a.
E5a.
Would you say it was more or less than $1,500?
INTERVIEWER: DO NOT READ LIST
01
02
03
97
98
E5b.
MORE THAN $1,500 (GO TO E5b)
EXACTLY $1,500 (GO TO E6)
LESS THAN $1,500 (GO TO E5c)
DON’T KNOW (GO TO E6)
REFUSED (GO TO E6)
Would you say it was:
INTERVIEWER: READ LIST
01
02
03
97
98
More than $1,500 but less than $2,000,
At least $2,000 but less than $2,500, or
$2,500 or more?
DON’T KNOW
REFUSED
CATI: ALL E5b GO TO E6
24
E5c.
Would you say it was:
INTERVIEWER: READ LIST
01
02
03
04
97
98
At least $1,200 but less than $1,500,
At least $800 but less than $1,200,
At least $500 but less than $800, or
Less than $500?
DON’T KNOW
REFUSED
GO TO E10
Financial Strain
E10.
How much do you agree or disagree with the following statement?
My financial situation is better than it was last year at this time.
Would you say you…
01
02
03
04
05
97
98
Strongly Agree
Agree Somewhat
Neither Agree nor Disagree
Disagree Somewhat, or
Strongly Disagree?
DON’T KNOW
REFUSED
Material Hardship Scale
E11a. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR1], was there ever a time when, [you/you or your household] did not pay the full
amount of the rent that you are responsible for?
01
02
97
98
YES
NO (GO TO E11b)
DON’T KNOW (GO TO E11b)
REFUSED (GO TO E11b)
E11a.1 In the last 12 months, about how many months has this happened?
INTERVIEWER: DO NOT READ LIST
01
02
03
1
2-3
4-6
25
04
97
98
7 OR MORE
DON’T KNOW
REFUSED
E11b. In the last 12 months, has there been a time when [you/you or your household]
had service turned off by the gas or electric company, or the oil company would
not deliver oil because payments were not made?
01
02
97
98
E11b.1.
YES
NO (GO TO E11c)
DON’T KNOW (GO TO E11c)
REFUSED (GO TO E11c)
In the last 12 months, that is since [CURRENT MONTH] [CURRENT
YEAR-1], about how many months has this happened?
INTERVIEWER: DO NOT READ LIST
01
02
03
04
97
98
1
2-3
4-6
7 OR MORE
DON’T KNOW
REFUSED
E11c. In the last 12 months, have [you/you or your household] had cellular or landline
service disconnected because payments were not made?
01
02
97
98
YES
NO (GO TO E11d)
DON’T KNOW (GO TO E11d)
REFUSED (GO TO E11d)
E11c.1 In the last 12 months, about how many months has this happened?
INTERVIEWER: DO NOT READ LIST
01
02
03
04
97
98
1
2-3
4-6
7 OR MORE
DON’T KNOW
REFUSED
E11d. In the last 12 months, was there ever a time when, because of cost, [you/you or
your household] were not able to buy food?
01
02
YES
NO (GO TO E11e)
26
97
98
DON’T KNOW (GO TO E11e)
REFUSED (GO TO E11e)
E11d.1 In the last 12 months, about how many months has this happened?
INTERVIEWER: DO NOT READ LIST
01
02
03
04
97
98
1
2-3
4-6
7 OR MORE
DON’T KNOW
REFUSED
E11e. In the last 12 months, that is since [CURRENT MONTH] [CURRENT YEAR1], was there ever a time when, because of cost, [you/you or your household]
were not able to buy prescription medicine?
01
02
97
98
YES
NO
DON’T KNOW
REFUSED
E11f. In the last 12 months, was there ever a time when, because of cost, [you/you or
members of your household] were not able to see a doctor or get medical
assistance?
01
02
97
98
YES
NO
DON’T KNOW
REFUSED
Assistance/Services & Transportation Assistance
E12. Do you have reliable access to a vehicle?
01
02
97
98
YES
NO
DON’T KNOW
REFUSED
Food Insufficiency
E14.
Which of these statements best describes the food eaten by [you/you and the people in
your household who usually ate with you] in [PRIOR MONTH]: Did you have…
01
Enough of the kinds of food you wanted,
27
02
03
04
97
98
Enough but not always the kinds of food you wanted to eat,
Sometimes not enough to eat, or
Often not enough to eat?
DON’T KNOW
REFUSED
E14a. In [PRIOR MONTH], did [you/you or anyone in your household] ever skip a
meal because there wasn't enough money for food?
01
02
97
98
YES
NO (GO TO E15)
DON’T KNOW (GO TO E15)
REFUSED (GO TO E15)
[CATI: ASK IF E14a=1, ELSE GO TO E15]
E14b. In the past 12 months, about how many months has this happened?
01
02
03
04
97
98
1 Month
2 or 3 months
4 to 6 months
7 or more months
DON’T KNOW
REFUSED
Overall Financial Well-Being
E15.
In general, how do [your/your household] finances usually work out at the end of the
month? Is there…
01
02
03
97
98
Some money left over,
Just enough to make ends meet, or
Not enough money to make ends meet?
DON’T KNOW
REFUSED
E15a. Do you ever borrow from family and/or friends to get cash for basic household
necessities, such as food, rent, or utilities?
01
02
97
98
YES
NO (GO TO F1)
DON’T KNOW (GO TO F1)
REFUSED (GO TO F1)
E15b. How often do you do this?
28
INTERVIEWER: IF R SAYS “JUST ONE TIME” SELECT OPTION 05 ONCE A
YEAR
01
02
03
04
05
97
98
Every week
A couple times a month
Every month
A couple times a year
Once a year
DON’T KNOW
REFUSED
CATI: RECORD END DATE (SECEEDDT) AND TIME (SECEEDTM)
29
SECTION G: HOUSING AND MOVING
CATI: RECORD START DATE (SECGSTDT) AND TIME (SECGSTTM)
Housing Assistance
G1. When you were enrolled in the study, you were receiving housing assistance from
[PHA NAME]. Are you still receiving assistance from [PHA NAME], such as
receiving a housing voucher or living in public housing?
01
02
97
98
YES (GO TO NEXT SECTION)
NO (GO TO G4a)
DON’T KNOW (GO TO NEXT SECTION)
REFUSED (GO TO NEXT SECTION)
Assistance with Housing/Landlord Issues
G4a. What would you say was the main reason you no longer receiving housing
assistance?
01
02
03
04
05
06
07
08
09
97
98
NEVER ABLE TO USE VOUCHER (VOUCHER NEW ADMISSIONS
ONLY)
INCOME TOO HIGH/OVER INCOME
EVICTED
HOUSING AUTHROITY TERMINATED SUBSIDY DUE TO A
PROBLEM (BROKE PROGRAM RULES,
VIOLATED LEASE, ETC.)
LEFT SUBSIDIZED HOUSING TO BUY A HOME
NO LONGER NEEDED IT
DISSATISFIED WITH SUBSIDIZED HOUSING
OTHER (SPECIFY)
DON'T KNOW
REFUSED
CATI: IF G4a<>8 GO TO G4b
G4a_O. ENTER VERBATIM RESPONSE
01
________________________________
97
DON’T KNOW
98
REFUSED
CATI: IF G4a<>4 GO TO G5
30
G4b. Why did you lose your housing assistance? Was it because of…
01
02
03
04
05
06
07
08
09
97
98
NONPAYMENT OF RENT OR LATE RENT,
NONPAYMENT OF MORTGAGE BY YOU OR SOMEONE ELSE
ABSENT FROM UNIT FOR 90 OR MORE DAYS,
PROBLEMS WITH VISITORS (STAYED MORE THAN 7 DAYS OR
BEHAVIOR),
DAMAGING UNIT,
HOUSEKEEPING VIOLATIONS,
ONE-STRIKE VIOLATION,
INCOME INCREASE, OR
SOME OTHER REASON, SPECIFY____________________
DON’T KNOW
REFUSED
CATI: IF G4b<>9 GO TO SECTION H
G4b_O. ENTER VERBATIM RESPONSE
01
97
98
________________________________
DON’T KNOW
REFUSED
CATI: RECORD END DATE (SECGEDDT) AND TIME (SECGEDTM)
31
SECTION H: PROGRAM GROUP EXPERIENCES
CATI: RECORD START DATE (SECHSTDT) AND TIME (SECHSTTM)
CATI: IF G1=1 USES FIRST (PRESENT TENSE) TEXT FILL, ELSE USE SECOND
(PAST TENSE) TEXT FILL
Stepped and Tiered Groups Only:
H_INTRO.
[Recertifying households only:] You may recall that starting in [REF_DATE] [PHA
NAME] changed the way it calculated your rent. [PHA NAME] may have referred to this
as the [STEPPED/TIERED] rent.
[All respondents] I would like to ask you a few questions about the way in which your rent
is being calculated and how that affects you.
[HCV only] When I use the word “rent,” I will be referring to the portion of the rent that
you pay to your landlord.
I will also use the term “income review” OR “recertification.” This is when you provide
information on your income to the housing authority to determine whether you’re still
eligible for housing assistance and how much you have to pay in rent.
INTERVIEWER: PRESS NEXT TO CONTINUE
Formatted: Underline
Knowledge and awareness
Formatted: Indent: First line: 0.5"
H1. [CATI: IF RULES=”STEPPED”] Thinking about how [PHA NAME]
[calculates/calculated] the amount your household [pays/paid in rent. which of the
following rent rules [apply to you /applied to you while you {HCV:} still had a
voucher/{PH:} were living in public housing]? For each one, would you say…..Yes,
no, or you’re not sure?
H1a. My rent [increases/increased] every year by a fixed
amount.
H1b. If my family’s income goes up, my rent share won’t go
up.
H1c. My family’s eligibility for the [HCV/PH] program will be
checked every three years instead of every year.
H1d. If I [have/had] difficulty paying my rent, I may [be/have
been] able to have my rent lowered through a hardship request
to the housing authority.
32
Yes
No
Not Sure
Refused
1
2
97
98
1
2
97
98
1
2
97
98
1
2
97
98
Deleted: W
Deleted: at your most recent recertification
Deleted:
Deleted: household
Deleted:
Deleted: household
H1e. If another adult [moves/moved] into my household and
[goes/went] on the lease, their income [will/would] not affect
my rent.
1
2
97
98
[CATI: IF RULES=”TIERED”] Thinking about how [PHA NAME]
[calculates/calculated] the amount your household [pays/paid] in rent, which of the
following rent rules [apply to you /applied to you while you {HCV:} still had a
voucher/{PH:} were living in public housing]? For each one, would you say…..Yes,
no, or you’re not sure?
Deleted: ’s
Deleted: rental assistance
Formatted: Font: Not Bold
Deleted: at your most recent recertification
Deleted: ¶
H1a. Recertifications are now conducted every three years – in
other words, my household only [needs/needed] to have its
income reviewed every three years instead of every year.
H1b. If my family’s income [goes/went] up in between the
three-year recertifications, my rent [won’t/wouldn’t] go up
until my next three-year recertification.
H1c. If my family’s income [goes/went] up in between the
three-year recertifications, I don’t need to report my change in
income to the housing authority until my next three-year
recertification.
H1d. If I [have/had] difficulty paying my rent, I may [be/have
been] able to have my rent lowered through a hardship request
to the housing authority.
H1e. If another adult [moves/moved] into my household and
[goes/went] on the lease, their income [will/would] not affect
my rent until my next three-year recertification.
Yes
No
Not Sure
Refused
1
2
97
98
1
2
97
98
1
2
97
98
1
2
97
98
1
2
97
98
Control Group Only:
[CATI: IF RULES=”STANDARD”] Thinking about how [PHA NAME]
[calculates/calculated] the amount your household [pays/paid] in rent, which of the
following rent rules [apply to you /applied to you while you {HCV:} still had a
voucher/{PH:} were living in public housing]? For each one, would you say…..Yes,
no, or you’re not sure?
H1a. Recertifications [are/were] conducted yearly, and my rent
[is/was] adjusted for my family’s income at each yearly
recertification.
33
Yes
No
Not Sure
Refused
1
2
97
98
H1b. If my family’s income [goes/went] up in between the
yearly recertifications, my rent [will/would] go up at or before
my next recertification.
H1c. If my family’s income [goes/went] up in between the
yearly recertifications, I [need/needed] to report my change in
income to the housing authority.
H1d. If I [have/had] difficulty paying my rent, I may [be/have
been] able to have my rent lowered through a request for an
interim certification to the housing authority.
H1e. If another adult [moves/moved] into my household and
[goes/went] on the lease, my rent will be adjusted based on my
new family income including that new household member’s
income.
1
2
97
98
1
2
97
98
1
2
97
98
1
2
97
98
Stepped and Tiered Groups Only:
Hardships
H4.
At any point in the past two years, did you face any financial circumstance where you
needed a hardship to lower your rent?
01
02
97
98
H5.
[IF YES] At any point in the past two years, did you request a hardship from the [PHA
NAME] to lower your rent?
01
02
97
98
H6.
YES
NO (GO TO H10a)
DON’T KNOW (GO TO H10a)
REFUSED (GO TO H10a)
YES
NO (GO TO H9)
DON’T KNOW (GO TO H10a)
REFUSED (GO TO H10a)
On how many different occasions did you submit a hardship request for a reduction?
Would you say:
01
02
03
04
05
97
98
Just once
Two or three times
Four or five times
Six to ten times, or
More than ten times?
DON’T KNOW
REFUSED
34
H7.
[CATI: IF H6=2, 3, 4, 5, 8, 9 SHOW] Thinking about [when/the last time] you
submitted a request, did the housing authority lower your rent?
01
02
97
98
H8.
YES (GO TO H10a)
NO
DON’T KNOW (GO TO H10a)
REFUSED (GO TO H10a)
Were you told any of the following reasons why the housing authority did not reduce your
rent?
01
02
03
04
97
98
Your income wasn’t low enough (GO TO H10a)
You didn’t have the right documentation (GO TO H10a)
Some other reason (GO TO H8_0)
Or, they never gave you a reason (GO TO H10a)
DON’T KNOW (GO TO H10a)
REFUSED (GO TO H10a)
CATI ASK IF H8=3, ELSE GO TO H10a
H8_O. What was the reason?
01
97
98
H9.
___________________________________________ (GO TO H10a)
DON’T KNOW (GO TO H10a)
REFUSED (GO TO H10a)
Why didn’t you request a hardship from the [PHA NAME] to lower your rent?
01 You didn’t know that such hardship exemptions to reduce rent were available.
02 You didn’t think you qualified for the hardship request policy.
03 You didn’t think the hardship exemption would lower the rent enough to be worth
requesting.
04 You didn’t want to deal with the housing authority .
05 You never got around to submitting a request.
06 Some other reason (Please specify:___________)
97 DON’T KNOW
98 REFUSED
CATI ASK IF H9=5, ELSE GOTO H10a
H9_O. What was the reason?
01
___________________________________________
97
DON’T KNOW
98
REFUSED
35
Formatted: Underline
Retrospective Income
Formatted: Indent: First line: 0.5"
H17. [Currently/at your most recertification], to calculate your rent and subsidy, the housing
authority [uses/used] your family income from the 12 months before your income review.
Compared with the old rules, how much harder was it for you to provide the income
documentation required under the alternative rules? Would you say it was:
01
02
03
04
97
98
Much harder
Somewhat harder
About the same, or (GOTO H19)
Not as hard? (GOTO H19)
DON’T KNOW (GOTO H19)
REFUSED (GOTO H19)
Formatted: Underline
Overall impressions
Formatted: Indent: First line: 0.5"
H21. [CATI: Recertifying households only]
Before you switched to the [STEPPED/TIERED] rent rules, [PHA NAME] checked your
income every year and calculated your rent share as a percent of your household income
each year. If you had a choice, would you prefer to continue with the way the [PHA
NAME] calculates your rent now, or would you prefer to go back to the old rules?
01
02
97
98
Continue with current way
Go back to the old rules
DON’T KNOW
REFUSED
CATI: RECORD END DATE (SECHEDDT) AND TIME (SECHEDTM)
36
SECTION I: BENEFITS CLIFFS, PHA COMMUNICATION AND TRUST, AND
STRESS
CATI: RECORD START DATE (SECHSTDT) AND TIME (SECHSTTM)
Benefits Cliff
I1.
Government benefits (things like SNAP and housing benefits) are often reduced
when people increase their income—for example, by getting a new job, getting a
promotion or raise, or working additional hours.
In the past [2.5 years], did you ever not increase your income because you were
worried about losing government benefits or having them reduced?
01
02
97
98
YES
NO
DON’T KNOW
REFUSED
I2. [IF YES] I’m going to ask about how the potential reduction of different types of
government benefits influenced your decision.
A lot
Somewhat
Not
at all
Was not
receiving
Not
Sure
Refused
1
2
3
9
97
98
1
2
3
9
97
98
1
2
3
9
97
98
1
2
3
9
97
98
1
2
3
9
97
98
1
2
3
4
97
98
I2a. How much did your worry about having
SNAP benefits reduced influence your
decision not to increase your income?
I2b. How much did your worry about having
child care assistance reduced influence your
decision not to increase your income?
I2c. How much did your worry about having
Medicaid reduced influence your decision
not to increase your income?
I2d. [Voucher households only]: How much
did your worry about having your Section 8
voucher amount reduced influence your
decision not to increase your income?
I2e. [Public housing households only]: How
much did your worry about your public
housing rent going up influence your decision
to not increase your income?
12f. How much did your worry about having
another government benefit reduced influence
your decision not to increase your income?
PHA communication and trust
37
Deleted: PROGRAM GROUP EXPERIENCES
Formatted: Indent: Left: 0.5", First line: 0"
I3.
How much do you agree or disagree with the following statements?
I3a.
I can count on [PHA] to give me the information I need about my housing
subsidy.
01
02
03
04
97
98
I3b.
I feel confident about making decisions about work based on the
information [PHA] gives me about how it calculates my rent.
01
02
03
04
97
98
I3c.
Strongly agree
Somewhat agree
Somewhat disagree
Strongly disagree
DON’T KNOW
REFUSED
Strongly agree
Somewhat agree
Somewhat disagree
Strongly disagree
DON’T KNOW
REFUSED
I feel confident that [PHA] is correctly administering the rent policy that
applies to me.
01
02
03
04
97
98
Strongly agree
Somewhat agree
Somewhat disagree
Strongly disagree
DON’T KNOW
REFUSED
Stress
I4. In the last month, how often have you felt that you were unable to control the
important things in your life?
01
02
97
97
YES
NO
DON’T KNOW
REFUSED
I5. In the last month, how often have you felt confident about your ability to handle your
personal problems?
01
02
97
97
YES
NO
DON’T KNOW
REFUSED
38
I6. In the last month, how often have you felt that things were going your way?
01
02
97
97
YES
NO
DON’T KNOW
REFUSED
I7. In the last month, how often have you felt difficulties were piling up so high that you
could not overcome them?
01
02
97
97
YES
NO
DON’T KNOW
REFUSED
CATI: RECORD END DATE (SECHEDDT) AND TIME (SECHEDTM)
39
SECTION Z: CLOSING SECTION/INCENTIVE PAYMENT
CATI: RECORD START DATE (SECZSTDT) AND TIME (SECZSTTM)
INCNTV_OPTN. Those are all the questions I have to ask you today. Thank you for the time
you’ve spent talking with me and for your participation in this study. You will receive
for completing the survey with us today. You can receive this
payment as a Visa gift card that we will send you in the mail that will arrive in about 3
weeks, or as an electronic gift card that we will email to you within 24 hours. Which do
you prefer?
01
02
97
Z1.
A mailed Visa gift card
or an electronic gift card?
DON'T KNOW/NO PREFERENCE
In order to send your gift card, I need to confirm your name and address.
I have your name listed as [FLNAME] and spelled as (INTERVIEWER: SPELL
NAME). Is that correct?
01
02
98
Z2.
YES
NO
REFUSED
(GO TO Z4)
(GO TO Z3)
(GO TO Z2)
In order to send your gift card, I am required to verify the spelling of your name. I have
your name listed as [FLNAME] and spelled as [INTERVIEWER: SPELL NAME]. Is
that correct?
01
02
98
YES
NO
REFUSED
(GO TO Z4)
(GO TO Z3)
(GO TO Z4)
CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED NAME WHILE
ORIGINAL NAME IS DISPLAYED FOR COMPARISON PURPOSES
Z3.
INTERVIEWER: ENTER CORRECTED NAME.
[FLNAME]
Z4.
Is this your current address? [FULLADD, RCITY, RSTATE, RZIP]
INTERVIEWER: READ ADDRESS TO R, SPELLING EACH WORD.
INTERVIEWER, IF R REFUSES SAY: We won’t be able to send your gift card without a
correct mailing address.
40
01
02
98
YES
NO
REFUSED
(GO TO Z6)
(GO TO Z5)
(GO TO Z6)
CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED ADDRESS WHILE
ORIGINAL ADDRESS IS DISPLAYED FOR COMPARISON PURPOSES
CATI: CREATE CDMO USING DATA ENTERED AT Z5 TO REPLACE:
FULLADD – FULL ADDRESS
RCITY – CITY
RSTATE – STATE
RZIP – ZIP
Z5.
Please tell me your address.
ADDRESS
CITY
STATE
ZIP
_________________________
_________________________
_________________________
_________________________
INTERVIEWER: ENTER CORRECTED ADDRESS. READ BACK THE ADDRESS
INFORMATION TO R, SPELLING THE WORDS.
INTERVIEWER, IF R REFUSES SAY: We won’t be able to send your gift card without a
correct mailing address.
IF INCNTV OPTN=02, SKIP TO Z8, ELSE ASK Z6
Z6.
Is there another address you would like me to use to send your $[INCENTIVE] gift card?
01
02
98
YES
NO
REFUSED
(GO TO Z8)
(GO TO Z8)
CATI: PROVIDE TEXT BOX FOR ENTRY OF SUPPLEMENTAL ADDRESS
Z7.
What address would you like me to use?
STREET:
CITY:
STATE:
ZIP:
__________________________
__________________________
__________________________
__________________________
41
Z8.
I also need to confirm your phone number in case we have any questions about the
interview.
CATI: DISPLAY RPHONE1
INTERVIEWER: READ THE PHONE NUMBER. Is this correct?
01
02
98
YES
NO
REFUSED
Z9. INTERVIEWER:
(GO TO Z10)
(GO TO Z9)
(GO TO THANK)
ENTER CORRECTED PHONE NUMBER. READ BACK TO R
TO CONFIRM.
9999999999 REFUSED
CATI: PROVIDE TEXT BOX FOR ENTRY OF CORRECTED PHONE NUMBER.
DISPLAY ORIGINAL PHONE NUMBER FOR COMPARISON PURPOSES
Z10.
Is this a home, work, or cell phone number?
01
02
03
98
HOME
WORK
CELL
REFUSED
TEXT_CONF. May we text you at this phone number?
01 YES
02 NO
CATI: IF EMAIL ADDRESS ON FILE, DISPLAY EMAIL_CONF; ELSE GO TO
GC_EMAIL.
EMAIL_CONF. Is this your current email address?
01 YES
02 NO
GC_EMAIL. What is your current email address?
01. ENTER EMAIL: ____________________
CATI: IF INCNTV_OPTN=02, GO TO EP_CHOICE; ELSE GO TO GC_CHOICE.
42
GC_CHOICE. OK, we will send you a Visa gift card in the mail. It will
arrive in about three weeks.
01. CONTINUE (GO TO THANK)
EP_CHOICE. Okay, we will email you an electronic gift card.
INTERVIEWER: CLICK ON RYBBON HYPERLINK TO NAVIGATE TO RYBBON
BROWSER. FILL IN R’S EMAIL ADDRESS AND SUBMIT.
INTERVIEWER:IF RESPONDENT HAS QUESTIONS OR NEED FURTHER
ASSISTANCE, PROVIDE NUMBER FOR HELP LINE: (XXX) XXX-XXXX.
[ENTER RYBBON LINK HERE]
INTERVIEWER:AFTER CLOSING RYBBON BROWSWER, PLEASE HIT ENTER TO
CONTINUE SURVEY.
THANK.
Thank you very much for your time and assistance.
[IF INCNTV_OPTN=01,98 DISPLAY: You should receive your gift card in
about 3 weeks. ELSE DISPLAY: You should receive your gift card within 24
hours.]
If you have any questions about the study or your gift card, can contact [STUDY
CONTACT] at DIR, the company in charge of conducting this survey. The tollfree number is (XXX) XXX-XXXX.
INTERVIEWER: PRESS “NEXT” TO END SURVEY.
CATI: RECORD END DATE (SECZEDDT) AND TIME (SECZEDTM)
FIELD_GC. Was the R given a gift card in the field?
1
YES (GO TO GIFTCARD1)
2
NO (GO TO CNOTES)
GIFTCARD1.
INTERVIEWER: ENTER THE 16 DIGIT GIFT CARD NUBERS, SEPARATING EACH 4
DIGITS WITH A HYPEN (-) OR A SPACE.
43
PLEASE ENTER THE 3-DIGIT SECURITY CODES (CVV) FROM THE BACK OF THE
GIFT CARD.
GIFT CARD #1:
_ _ _ _-_ _ _ _-_ _ _ _-_ _ _ _
CVV #1:
___
GIFT CARD #2:
_ _ _ _-_ _ _ _-_ _ _ _-_ _ _ _
CVV #2:
___
44
| File Type | application/pdf |
| File Title | Microsoft Word - 1f 2025-PD_R-PRA-65 STRD 30m survey instrument 8-4-25_TRACKED CHANGES.docx |
| Author | H03483 |
| File Modified | 2025-09-04 |
| File Created | 2025-09-04 |