SAMPLE READ-IN
Cross-section......1
Oversample.............2
State: ____________
County: _____________________ Metro Status: _____
Date: ________________
CATI ID: ____________________
Interviewer:_________________________________________
Telephone Number:
__________________________________________________________
Time Start: _____________
Time End: _____________ TOTAL TIME: ___________
____________________________________________________________________________
INTRODUCTION
Hello, I'm _______________
calling for the U.S. Department of Transportation. We are conducting
a national study of Americans' driving habits and their attitudes
about current driving laws.
DUMMY QUESTION
FOR BIRTHDAY QUESTIONS
Has had the most
recent.......1
Will have the next................2
IF SAMPLE
TYPE EQ 1, ASK A, ELSE ASK B.
A. In
order to select just one person to interview, could I speak to the
person in your household, 16 or older, who (has had the most recent/will
have the next) birthday?
Respondent is
the person.................1 SKIP
TO Q.1
Other respondent comes to phone..............2 SKIP
TO D
Respondent is not available..............3 ARRANGE
CALLBACK
IF SAMPLE
TYPE EQ 2 ASK B
B. Is
there anyone aged 16 to 39 years old living in your household?
Yes..................1
No........................2 THANK AND
SCREEN OUT
C. Could
I speak to the person aged 16 to 39 years old living in your household
who (has had the most recent/will have the next) birthday?
Respondent is
the person...............1
Other respondent comes to phone............2
Respondent not available...............3 ARRANGE
CALLBACK
D. Hello,
I'm __________________ calling for the U.S. Department of Transportation.
We are conducting a national study of Americans' driving habits and
their attitudes about current driving laws. The interview is completely
confidential. It takes fifteen to twenty minutes. Could we begin now?
CONTINUE
INTERVIEW............1 SKIP TO Q1
Arrange Callback....................2 CALLBACK
Refused.......................3
D1. Would you
please tell me why you do not want to do the interview?
__________________________________________________________
Q.1 How
often do you drive a motor vehicle? Almost every day, a few days a
week, a few days a month, a few days a year, or do you never drive?
Almost every
day.............1
Few days a week..................2
Few days a month.............3
Few days a year..................4
Never........................5 SKIP
TO Q.12B
Other............................6
___________________________
(VOL) Don't know...........7
(VOL) Refused..................8
Q.2 Is
the vehicle you drive most often a car, van, motorcycle, sport utility
vehicle, pickup truck, or other type of truck? (NOTE: IF RESPONDENT
DRIVES MORE THAN ONE VEHICLE OFTEN, ASK:) "What kind of vehicle
did you LAST drive?"
Car...................................................1
Van or minivan............................................2
Motorcycle............................................3 SKIP
TO Q.12B
Pickup truck..............................................4
Sport utility vehicle (Jeep/Explorer/Trooper/etc).....5
Other (SPECIFY _____________________________________......10
Other truck (SPECIFY).................................11
______________________________________________________
INTERVIEWER
INSTRUCTION: SEATBELT QUESTIONS REFER TO DRIVER SIDE SEATBELTS.
Q.3 For
the next series of questions, please answer only for the (car/truck/van)
you said you usually drive. Do the seat belts in the front seat of
the (car/truck/van) go across your shoulder only, across your lap
only, or across both your shoulder and lap?
Across shoulder......................1 SKIP
TO Q.6
Across lap................................2 SKIP
TO Q.9
Across both..........................3
Vehicle has no belts......................4 SKIP
TO Q.12B
(VOL) Don't know...................5 SKIP
TO Q.10a
(VOL) Refused...........................6 SKIP
TO Q.10a
Q.4 Are
the shoulder and lap belt one piece or are they two separate belts?
One piece..........................1 SKIP
TO Q.6
Two separate belts.......................2
(VOL) Don't know.................3
(VOL) Refused..........................4
Q.5 Are
both the shoulder and lap belt automatic, is only the shoulder belt
automatic or is neither the shoulder or lap belt automatic?
Both are automatic......................1
SKIP TO Q.7
Only shoulder is automatic....................2
SKIP TO Q.7
Neither are automatic...................3
SKIP TO Q.8
(VOL) Don't know............................4 SKIP
TO Q.8
(VOL) Refused.........................5
SKIP TO Q.8
Q.6 Is
the shoulder belt automatic or do you have to fasten it?
Automatic.....................1
Manual..............................2 SKIP
TO Q.8
(VOL) Don't know............3 SKIP
TO Q.8
(VOL) Refused.....................4 SKIP
TO Q.8
Q.7 When
you drive, do you always wear your automatic belt or is it ever disconnected,
disabled, or placed behind you?
Always wear it....................1
Disconnected............................2
Disabled..........................3
Placed behind me........................4
(VOL) Don't know................5
IF Q3=1
OR 3 ASK Q8, ELSE SKIP TO Q9
Q.8 When
driving this (car/truck/van) how often do you wear your shoulder belt...
(READ LIST)
ALL OF THE TIME.........1
MOST OF THE TIME.............2 < BR> SOME OF THE TIME........3
RARELY OR....................4
NEVER...................5
(VOL) Don't know...........6
(VOL) Refused.........7
IF Q.3=2
OR 3 ASK Q.9, ELSE SKIP TO Q.10a
Q.9 When
driving this (car/truck/van), how often do you wear your lap belt...(READ
LIST)
ALL OF THE TIME..........1
MOST OF THE TIME.............2
SOME OF THE TIME.........3
RARELY OR....................4
NEVER....................5
(VOL) Don't know...........6
(VOL) Refused..........7
IF Q.8=1-4
OR Q.9=1-4 ASK Q.10a, ELSE SKIP TO Q.12B
Q.10a
When was the last time you did NOT wear your seat belt (neither lap
nor shoulder belt) when driving?
Today................1
Within past week...........2
Within past month....3
Within past 12 months......4
A year or more ago/
I always wear it...5
(VOL) Don't know.........6
(VOL) Refused......7
ASK
Q.10b IF DON'T KNOW/REFUSED IN Q.10a
Q.10b
Has there been any occasion in the past 12 months when you did not
wear your seat belt(neither lap nor shoulder belt) when driving?
Yes..............1
No...................2
Q11 and
12a MOVED TO DEMOGRAPHICS
Q.12b To ask the
next series of questions, I need to know how many children AGE 15
OR YOUNGER are living in your household at least half of the time
or consider it their primary residence?
________ NONE=0
REFUSED=99
IF ONE
OR MORE IN Q.12b, ASK Q.13a, ELSE GO TO Q.17
NOTE: TWINS (TRIPLETS, ETC.) MUST EACH BE ENTERED SEPARATELY,
YOUNGEST FIRST
Q.13a What
is the age of the YOUNGEST CHILD (15 or younger) living in the household?
(ENTER TO THE NEAREST YEAR)
Newborn/less
Than 1 year old.....1
1 year old.................2
2 year old...........3
3 year old.................4
4 year old...........5
5 year old.................6
6 year old...........7
7 year old.................8
8 year old...........9
9 year old.................10
10 year old..........11
11 year old................12
12 year old..........13
13 year old................14
14 year old..........15
15 year old................16
Q.13b Is
the (AGE) a boy or a girl?
Boy..................1
Girl......................2
Q.13c How
is the (AGE) related to you?
Child/Stepchild................1
Grandchild...........................2
Sibling (brother/sister).......3
Other relative.......................4
Not related....................5
(VOL) Refused......................6
IF MORE
THAN ONE IN Q.12b, ASK Q.14a, ELSE GO TO Q.17
Q.14a What
is the age of the NEXT OLDEST CHILD (15 or younger) living in the
household? (ENTER TO THE NEAREST YEAR)
Less than 1 year.....1
1 year old.................2
2 year old...........3
3 year old.................4
4 year old...........5
5 year old.................6
6 year old...........7
7 year old.................8
8 year old...........9
9 year old.................10
10 year old..........11
11 year old................12
12 year old..........13
13 year old................14
14 year old..........15
15 year old................16
Q.14b Is
the (AGE) a boy or a girl?
Boy....................1
Girl........................2
Q.14c How
is the (AGE) related to you?
Child/Stepchild...............1
Grandchild..........................2
Sibling (brother/sister)......3
Other relative......................4
Not related...................5
(VOL) Refused.....................6
IF Q.1=NEVER,
SKIP TO Q.51
ALL RESPONDENTS WHO HAVE SONS/DAUGHTERS UNDER AGE 6 GO TO
Q.20
IF CHILDREN IN HOUSEHOLD UNDER 6 BUT NONE ARE SONS/DAUGHTERS
ASK Q.15
Q.15 Do
you ever drive with (the child/ at least one of the children under
6)that you just mentioned in your (car/truck/van)?
Yes, one child
in household....1 SKIP
TO Q.20
Yes, more than one child.............2
No.............................3 SKIP
TO Q.17
(VOL) Don't know...................4 SKIP
TO Q.17
Q.16 Which
of the children under six do you ever drive with? (ENTER AGE
OF EACH CHILD DRIVE AT LEAST SOMETIMES BELOW )
Age of child
#1 ______
Age of child #2 ______
Age of child #3 ______
Age of child #4 ______
Age of child #5 ______
Age of child #6 ______
ALL WHO
DRIVE WITH CHILDREN UNDER SIX GO TO Q20
IF NO
CHILDREN UNDER AGE 6 ASK Q.17
Q.17 In
the past 12 months, have you driven with any children under age 6?
Yes........................1
No..............................2 SKIP
TO Q.51
(VOL) Don't know.........3 SKIP
TO Q.51
(VOL) Refused.................4 SKIP
TO Q.51
Q.18a
How often do you drive with children under six?
Is it.......
Almost every
day.............1
Few days a week..................2
Few days a month.............3
Few days a year..................4
Never........................5 SKIP
TO Q.51
Other.________________________...6
(VOL) Not sure.............7
SKIP TO Q.51
(VOL) Refused..................8 SKIP
TO Q.51
Q.18b What
is your relationship to the child or children under age 6 that you
at least sometimes drive with? MULTIPLE RECORD
Child/stepchild....................1 ASK
AGE OF CHILDREN (Q18A1)
Brother/sister..........................2
Grandchild.........................3
Other relative..........................4
Teacher/bus driver.................5
Other non-relative......................6
(VOL) Don't know.................7
(VOL) Refused.........................8
Q.19 When
you are driving and children under age 6 are riding with you, would
you say that they are in a child car seat or a seat belt all of the
time, most of the time, some of the time, rarely or never?
All of the time...............1 SKIP
TO Q.51
Most of the time...................2
SKIP TO Q.51
Some of the time..............3 SKIP
TO Q.51
Rarely.............................4 SKIP
TO Q.51
Never.........................5 SKIP
TO Q.51
(VOL) Depends
on child...........6 SKIP TO Q.51
(VOL) Don't know............7
SKIP TO Q.51
(VOL) Refused....................8 SKIP
TO Q.51
DRIVERS
WITH CHILDREN UNDER SIX IN THE HOUSEHOLD CONTINUE
RANDOM SELECTION OF ONE ELIGIBLE CHILD: DUMMY WITH SELECTED
AGE
Q.20 The
following questions are for (your/the) (AGE), only. How much does
(he/she) weigh?
(NOTE: IGNORE REFERENCES TO OUNCES; ONLY RECORD POUNDS).
________ lb.
(Range=5-60 lbs)
(IF DON'T KNOW/REFUSED, PROBE: N.20b Is he/she....)
Less than 20
pounds......1
20 to 29 pounds..............2
30 to 39 pounds..........3
40 pounds or more............4
Don't know..........5
Refused.................6
Q.21 How
tall is he/she? (RECORD BOTH FEET AND INCHES)
_________ FEET
(Range: 1-4 feet)
_________ INCHES (Range: 0-12 inches)
COMPUTE
DUMMY HEIGHT IN INCHES AS (FEET X 12) + INCHES.
CONSISTENCY CHECK BETWEEN HEIGHT IN INCHES AND WEIGHT.
IF HEIGHT
LT 13 INCHES, REPEAT HEIGHT QUESTION
IF HEIGHT 13-24 INCHES, WEIGHT=( 5-19 LBS)
IF HEIGHT 25-36 INCHES, WEIGHT=(20-39 LBS)
IF HEIGHT 37-48 INCHES, WEIGHT=(40-60 LBS)
IF HEIGHT GT 48 INCHES, REPEAT HEIGHT QUESTION
IF FAILS CONSISTENCY CHECK THEN RECHECK WEIGHT AND HEIGHT
Q.22 When
you are driving and (AGE) rides in the vehicle with you, how often
does (he/she) ride in a child car seat. Child car seats include infant
seats, toddler seats and booster seats. Would you say (he/she) rides
in a child car seat... (READ LIST)
ALL OF THE TIME....................1
MOST OF THE TIME........................2
SOME OF THE TIME...................3
RARELY, OR..............................4
NEVER..............................5 SKIP
TO Q.46
(VOL) Never drive
with child..........6 SKIP TO Q.51
(VOL) Don't know.................7 SKIP
TO Q.51
(VOL) Refused.........................8 SKIP
TO Q.51
Q.23a
When was the last time (he/she) did not ride in a child car seat when
you were driving? READ LIST OF NECESSARY
Today................1
Within past week...........2
Within past month....3
Within past 12 months......4
A year or more ago/
always wears it....5
(VOL) Don't know.........6
(VOL) Refused......7
ASK
IF DON'T KNOW IN Q.23a
Q.23b Has
there been any occasion in the past 12 months when (he/she) did
not ride in a car seat when you were driving?
Yes..................1
No.......................2
Q.24 When
(he/she) is fastened in the child car seat, are there straps over
both shoulders, a strap across only one shoulder, or are there no
straps over either shoulder?
Two straps................1
One strap.......................2
No straps.................3
(VOL) Don't know..............4
(VOL) Refused...........5
Q.25 S
When you are driving and (he/she) rides in the child car seat, is
it usually in the front seat or the back seat?
Front seat.............1 SKIP
TO Q.27
Back seat...................2
(VOL) Don't know.....3
(VOL) Refused.............4
Q.26
Is the child car seat usually behind the driver, behind the passenger
or in the middle of the back seat?
Behind the
driver.........1
Behind the passenger..........2
In the middle.............3
(VOL) Don't
know............4
(VOL) Refused...........5
IF Q.24
IS ONE OR NO STRAPS, GO TO N28b
Q.27
When you are driving and (he/she) is riding in the child car seat,
is it usually front facing or rear facing?
Front....................1
Rear..........................2
(VOL) Don't know.......3
(VOL) Refused...............4
LOGIC
CHECK: IF KID AGE GE 1 AND Q.27=2, REPEAT Q27.
IF STILL "REAR FACING" ASK THE CHILD'S AGE AND ENTER IN NOTES.
Q.28a
Can the seat be used in a front facing position only, a rear facing
position only, or can it be used in either position?
Front facing
only...............1
Rear facing only.....................2
Either front or rear facing.....3
(VOL) Don't know...................4
(VOL) Refused.................5
N28b.
How many days out of the past thirty days did your (AGE) ride in a
vehicle that you drove?
________ DAYS
(Range=0-30) NOT SURE=31 REFUSED=32
Q.28b
During the past thirty days, has your (AGE) ridden in a vehicle where
someone outside of your household was driving (includes school buses,
taxis and other private vehicle)?
Yes.......1
No.............2 SKIP TO Q.29
Q.28c How
many days out of the past thirty days did this child ride in a vehicle
driven by someone outside of your household?
____________
(Range=0-30)
Q.28d Who
were those drivers? (What is their relationship to the child? (MULTIPLE
RECORD)
Parent/step-parent........1
Brother/sister................2
Grandparent...............3
Other relative................4
Teacher/Bus driver........5
Parent of friends.............6
Other non-relative........7
(VOL) Don't
know............8
(VOL) Refused...........9
Q.29 Where
would you say it is safest to place a child car seat in the vehicle...in
the front seat or in the back seat?
Front seat....................................1
Back seat..........................................2
(VOL) Depends
on type of child car seat.......3
(VOL) Don't know.................................4
(VOL) Refused...............................5
Q.30 Some
child car seats are designed so that the child faces backward, to
the rear of the motor vehicle. Suppose a child is riding in a child
car seat facing backward. If the vehicle has a passenger side airbag,
is it safe or unsafe to have the child car seat in the front seat?
Safe...............................1
Unsafe.................................2
Have no idea how air bags work.....3
(VOL) Don't know.....................4
(VOL) Refused....................5
Q.31
Now thinking again about the child car seat the (AGE) usually rides
in, did you get the child car seat new or used?
New........................1
Used............................2
(VOL) Don't know.........3
(VOL) Refused.................4
Q.32 Did
you purchase the child car seat, did you get it as a gift or loaner
from a relative or friend or did you get it from a loaner program?
(NOTE: IF RESPONDENT HAD USED THE CHILD CAR SEAT PREVIOUSLY,
PROBE
TO DETERMINE WHERE CHILD CAR SEAT ORIGINALLY CAME FROM)
Purchased.................1
Gift/Loan......................2
Loaner program............3
Other (SPECIFY)................9
____________________________
(VOL) Don't know........10
IF Q.32=PURCHASED
ASK Q.33, ELSE GO TO Q.34
Q.33
Where did you purchase it from?
Retail store...........................1
Second-hand store/consignment shop.........2
Garage sale/neighborhood sale..........3
Other(SPECIFY).............................4
___________________________________
(VOL) Don't know.....................5
Q.34 When
you are driving and (he/she) is riding in the child car seat, are
there ever any times when the child car seat is not attached to the
car's seat belt?
Yes.....................1
No...........................2
Q.35 Did
you ever read or hear of any information or receive any advice about
the need to use child car seats from any of the following sources?
Did you get any information...
| |
|
YES |
NO |
[VOL]
NOT SURE |
[VOL]
REFUSED |
| a. |
FROM A DOCTOR OR NURSE................. |
1 |
2 |
3 |
4 |
| b. |
FROM A BOOK OR ARTICLE ON CHILD CARE... |
1 |
2 |
3 |
4 |
| c. |
FROM ANY OTHER KIND OF BOOK
OR ARTICLE............................ |
1 |
2 |
3 |
4 |
| d. |
FROM INFORMATION ON TV OR RADIO........ |
1 |
2 |
3 |
4 |
| e. |
FROM A FAMILY MEMBER OR FRIEND........ |
1 |
2 |
3 |
4 |
| f. |
FROM A SAFETY HOTLINE.................. |
1 |
2 |
3 |
4 |
IF
YES IN Q35f ASK Q35g, ELSE SKIP TO Q35h
Q.35g Whose
safety hotline?
_______________________________________________
Q.35h Did
you hear or read about the need to use child car seats from anywhere
else?
Yes....................1
No..........................2
SKIP TO Q.36
(VOL) Don't
know.....3 SKIP TO Q.36
Q.35i Where?
_______________________________________________________
Q.36 How
did you learn to attach the child car seat to the vehicle?
(MULTIPLE RECORD)
Read the instructions...............1
Relative or friend showed me..............2
Loaner program showed me............3
Health professional showed me.............4
Figured it out myself...............5
Car seat came attached to car.............6 SKIP
TO Q.39C
(VOL) Don't know..................12
(VOL) Refused...........................13
IF Q.36=1
or 6, THEN GO TO N37c ELSE GO TO Q.37
Q.37 Did
you ever read the instructions?
Yes...............................1 SKIP
TO N37c
No....................................2
(VOL) Don't know................4
SKIP TO Q38
(VOL) Refused.......................5 SKIP
TO Q38
N37b. Were
any instructions available?
Yes...............................1
SKIP TO Q38
No....................................2 SKIP
TO Q38
(VOL) Don't know................3
SKIP TO Q38
(VOL) Refused.......................4 SKIP
TO Q38
N37c.
How easy or difficult were the instructions to understand.
Would you say that the instructions were very easy, somewhat easy,
somewhat difficult, or very difficult to understand?
Very easy............1
Somewhat easy.............2
Somewhat difficult...3
Very difficult............4
(VOL) Not sure.....5
(VOL) Refused...........6
Q.38 How
easy is it for you to attach the child car seat to the vehicle you
usually drive...(READ LIST)
VERY EASY...............................1 SKIP
TO Q.39b
SOMEWHAT EASY OR.............................2
NOT EASY AT ALL.........................3
(VOL) Not sure...........................4 SKIP
TO Q.39b
(VOL) Refused.......................5 SKIP
TO Q.39b
Q.39a What
is difficult about attaching the child car seat to the vehicle?
(RECORD VERBATIM RESPONSES ON SAF NEXT TO Q.39a, THEN ENTER
"1" TO CONTINUE)
Gave response
to Q.39a.............1
Don't know/not sure/no answer...........2
Q.39b How
confident are you that the car seat is securely attached to the
vehicle that you usually drive? Are you usually........
Very confident............1
Fairly confident..............2
Not too confident.........3
Q.39c Have
you ever driven with the child in the car seat and later found that
the car seat was not securely attached?
Yes.................1
No......................2 SKIP
TO Q40
(VOL) Not sure....3
SKIP TO Q40
N39d.
Why did this happen?
__________________________________________________
Q.40 How
easy is it for you to properly buckle your child into the child car
seat? (READ LIST)
VERY EASY.....................1 SKIP
TO Q.41b
SOMEWHAT EASY OR................2
NOT EASY AT ALL...............3
(VOL) Child buckles
him/
herself in.................4 SKIP
TO Q.41b
(VOL) Don't know..........5 SKIP TO
Q.41b
Q.41a What
is difficult about buckling your child into the child car seat?
(RECORD VERBATIM RESPONSES ON SAF NEXT TO Q.41a,
THEN ENTER "1" TO CONTINUE)
Gave response
to Q.41a.................1
Don't know/not sure/no answer................2
Q.41b How
confident are you that the child is properly buckled into the seat?
Are you usually........
Very confident............1
Fairly confident..............2
Not too confident.........3
Q.42 Has
the (AGE) ever gotten himself/herself out of that child car seat when
riding with you?
Yes....................1
No..........................2
(VOL) Don't know.....3
(VOL) Refused.............4
IF Q.22=ALL
THE TIME & Q.23a=>1 YR AGO/ALWAYS SKIP TO Q.50b ELSE Q.43
Q.43 Please
answer yes or no to each of the following statements. When my (AGE)
doesn't ride in a child car seat, it is sometimes because...)
| |
|
YES |
NO |
[VOL]
NOT SURE |
[VOL]
REFUSED |
| a. |
HE/SHE IS TOO BIG..................... |
1 |
2 |
3 |
4 |
| b. |
HE/SHE DOESN'T LIKE IT................ |
1 |
2 |
3 |
4 |
| c. |
HE/SHE WON'T STAY IN IT............... |
1 |
2 |
3 |
4 |
| d. |
THERE IS NO ROOM FOR THE SEAT
IN THE CAR............................ |
1 |
2 |
3 |
4 |
| e. |
HE/SHE WILL ONLY BE IN THE CAR
A SHORT TIME.......................... |
1 |
2 |
3 |
4 |
| f. |
WE ARE IN A HURRY..................... |
1 |
2 |
3 |
4 |
| g. |
THE CHILD CAR SEAT ISN'T AVAILABLE.... |
1 |
2 |
3 |
4 |
Q.43h Are
there any other reasons why (he/she) doesn't ride in a child car seat?
Yes....................1
No............................2
Q.44 When
the (AGE) doesn't ride in the child car seat, when riding with you
does he/she usually sit on someone's lap, sit by him/herself in the
front seat or sit in the back seat?
Lap of passenger.....................1
Front seat................................2
Back seat............................3
Back of station wagon or truck (VOL)......4
(VOL) Don't know...................10
Q.45a When
the (AGE) doesn't ride in the child car seat, when riding with you,
how often is he/she buckled in a seat belt? (READ LIST)
ALL OF THE TIME........1
MOST OF THE TIME.............2
SOME OF THE TIME.......3
RARELY OR....................4
NEVER..................5
(VOL) Not sure.............6
(VOL) Refused........7
CONDITIONAL:
IF Q.44=1 AND Q.45a LE 4, ASK Q.45b ELSE GO TO Q.50b:
Q.45b
Is he/she buckled in a seatbelt when riding in someone's
lap?
Yes......................1
No............................2
(VOL) Don't
know.......3
(VOL) Refused...............4
IF Q22=NEVER
CONTINUE WITH Q46, ELSE GO TO Q50b
Q.46 Please
answer yes or no to each of the following statements to indicate if
this is a reason why the (AGE) does not ride in a child car seat.
My (AGE) doesn't ride in a child car seat because...
| |
|
YES |
NO |
[VOL]
NOT SURE |
[VOL]
REFUSED |
| a. |
HE/SHE DOESN'T HAVE ONE............... |
1 |
2 |
3 |
4 |
| b. |
HE/SHE IS TOO BIG..................... |
1 |
2 |
3 |
4 |
| c. |
HE/SHE DOESN'T LIKE IT................ |
1 |
2 |
3 |
4 |
| d. |
HE/SHE WON'T STAY IN IT............... |
1 |
2 |
3 |
4 |
| e. |
HE/SHE USES A SEAT BELT............... |
1 |
2 |
3 |
4 |
| f. |
THERE ISN'T ENOUGH ROOM IN THE CAR.... |
1 |
2 |
3 |
4 |
Q.46g Are
there any other reasons why he/she doesn't ride in a child car seat?
Yes......................1
No............................2
(VOL) Don't know.......3
(VOL) Refused...............4
IF YES, What other reasons? (Child doesn't ride in
a child car seat)
_____________________________________________________________________
IF Q.46a=1,
ASK Q.47, ELSE SKIP TO Q.48
Q.47 Is
there any particular reason why you don't have one?
Yes.......................1
No..............................2
(VOL) Don't know........3
(VOL) Refused.................4
IF YES, What is that reason?
__________________________________________________________________
Q.48
How often does he/she use a seat belt? (READ LIST)
ALL OF THE TIME............1
MOST OF THE TIME.................2
SOME OF THE TIME...........3
RARELY OR........................4
NEVER......................5
(VOL) Don't know...............6
N48b.
Where does (AGE)usually sit in the vehicle when you are driving --
the front seat or the back seat?
Front seat.............1
Back seat....................2
About equal............3
Other (SPECIFY)..............4 _____________
Q.49 Did
the (AGE) ever ride in a child car seat during the first year of life?
Yes.....................1
No..........................2 SKIP
TO Q.51
(VOL) Don't know......3
SKIP TO Q.51
(VOL) Refused.............4 SKIP TO
Q.51
Q.50a
How often did he/she use the child car seat during that first year?
Would you say...(READ LIST)
ALL OF THE
TIME................1
MOST OF THE TIME....................2
SOME OF THE TIME OR............3
RARELY..............................4
(VOL) Don't
know.............5
(VOL) Refused.....................6
Q.50b Before
today, had you ever seen or heard of a type of car seat called a booster
seat?
Yes.......................1
No..............................2 SKIP
TO Q.50e
(VOL) Don't know........3 SKIP
TO Q.50e
Q.50c Have
you ever used a booster seat when driving with your (child/children)?
Yes.......................1
No..............................2SKIP TO N50d1
(VOL) Don't
know........3 SKIP To N50d1
(VOL) Refused.................4 SKIP TO N50d1
Q.50d At
what age did you begin using a booster seat for your children?
_______ AGE AT FIRST USE OF BOOSTER SEAT
N50d1. Do
you have any concerns about the safety of boosters seats?
Yes.......................1
No..............................2 SKIP TO Q.50e
(VOL) Don't
know........3SKIP TO Q.50e
(VOL) Refused.................4 SKIP TO Q.50e
N50d2.
What are those concerns (about the safety of booster
seats)?
_________________________________________________
IF Q.22=5,
SKIP TO Q.51
Q.50e When
your (AGE) outgrows his/her current child car seat, do you expect
him/her to use a different type of car seat, a seat belt or something
else?
Different seat............1
Seat belts....................2
Other (SPECIFY)
____________________......3
(VOL) Nothing.............4
(VOL) Booster seat....5
Q.51 How
do you personally feel about the police enforcement of child car seat
laws? On a scale of 1 to 10, where 1 means police should hardly ever
give tickets and 10 means police should give a ticket at every opportunity
for violations of child car seat laws, how strict should police enforcement
be?
1=Police hardly
ever give a ticket for violations
2
3
4
5
6
7
8
9
10=Police give a ticket at every opportunity
11..........(VOL) Don't know
12..........(VOL) Refused
Q.52 What
do you think the minimum fine should be for violation of child car
seat laws?
$__________ (Range=1-1000)
No fine/warning...........0
Not sure..................1001
Q.53.
What about when children outgrow a child car seat? Do you agree or
disagree that they should be required by law to wear seat belts when
riding in a vehicle?
Agree..................1
Depends on age.............2
Disagree...............3
SKIP TO N55a
(VOL) Don't know.........4 SKIP TO
N55a
(VOL) Refused........5 SKIP
TO N55a
Q.54 How
old do you think children should be before they are not required by
law to wear seat belts or do you think all children should be required
to wear them?
__________ AGE (Range: 0-21) 0=SHOULD NOT BE REQUIRED AT ANY AGE
DELETED
Q.55
ASK N55a
IF Q13a LE 15, ELSE GO TO Q56a
N55a.
There are a few questions I would like to ask you about child injury
prevention in general. During the past two years, have you received
any training in CPR, specifically for infants and children? CPR is
how you press down on a child's chest to get their blood flowing while
you are also giving the child artificial respiration. (IF
TRAINING IN MOUTH-TO-MOUTH RESUSCITATION ONLY, CODE NO)
Yes.................1
No......................2
N55b.
During the past two years, have you received any other training in
first aid specifically for infants or children?
Yes.................1
No......................2
IF YES
IN EITHER N55a OR N55b ASK N55c, ELSE SKIP TO N55d
N55c. Who
provided the (CPR/and/first aid training)? MULTIPLE RECORD
Work.........................1
School...........................2
Doctor/health professional...3
Other (SPECIFY)..................4 _____________________
N55d.
Have you ever had a doctor or nurse talk to you about ways in which
you could prevent injuries from happening to your child(ren) -- either
over the phone, during an office visit, at a lecture, or anywhere
else?
Yes.................1
No......................2SKIP TO N55f
(VOL) Not sure....3SKIP
TO N55f
N55e. How
long ago did this happen (most recently)? Has it been within the
past month, within the past 12 months, within the past five years
or more than five years ago?
Past month..................1
Past 12 months..................2
Past five years.............3
More than five years ago........4
(VOL) Not sure..........5
N55f. Have
you ever had a doctor or nurse tell you what signs or symptoms to
look for to determine if your child is having a medical emergency,
a life-threatening situation, that needs immediate attention?
Yes.................1
No......................2 SKIP TO N55h
(VOL) Not sure....3
SKIP TO N55h
N55g.
How long ago did this happen (most recently)? Has it
been within the past month, within the past 12 months, within the
past five years or more than five years ago?
Past month..................1
Past 12 months..................2
Past five years.............3
More than five years ago........4
(VOL) Not sure..........5
N55h.
If your child was having a medical emergency, a life-threatening situation
that needed immediate attention, which of the following would you
do first? Would you.......
Call your doctor's
office.......................1
Take your child to the emergency room................2
Call 9-1-1 or another local emergency number....3
Do something else (SPECIFY)..........................4
(VOL) Not sure................................5
Now, I'd like
to ask you a few questions about airbags.
Q.56a Does
the (car/truck/van) you normally (drive/ride in) have an airbag?
Yes.................1
No......................2 SKIP
TO Q.56c
(VOL) Don't know..3
SKIP TO Q.56c
(VOL) Refused.........4 SKIP TO Q.56c
Q.56b Is
the airbag for the driver only, or is there also a passenger side
airbag?
Driver only.............1
Driver and passenger........2
(VOL) Don't
know......3
(VOL) Refused.............4
Q.56c
Based on what you know or have heard, how likely is it that an adult
sitting in the front seat would be injured by an airbag when it opens
normally? Are they ... (READ)?
Very likely to
be injured............1
Somewhat likely to be injured............2
Somewhat unlikely....................3
Very unlikely............................4
Q.56d
How likely is it that a small child sitting in the front seat would
be injured by an airbag when it opens normally? Are they... (READ
LIST)?
Very likely to
be injured............1
Somewhat likely to be injured............2
Somewhat unlikely....................3
Very unlikely............................4
DELETED
Q.56e AND Q.56f AND Q.56g AND Q.56h AND Q.56i
IF Q56a EQ 1 ASK N56e, ELSE SKIP TO Q57a.
N56e. Are
there any warning labels about airbags in the (car/truck/van) you
normally drive?
Yes................1
No.....................2 SKIP
TO Q57a
(VOL) Not sure...3
SKIP TO Q57a
N56f. Where
in the (car/van/truck) are the warning labels?
DO NOT READ LIST. MULTIPLE RECORD.
Sun visor.............1
Dashboard.................2
Other (SPECIFY).......3 __________________________
N56g.
As best as you can remember, what are the warnings listed on the
warning label? DO NOT READ LIST. MULTIPLE RECORD.
Airbags can
kill children under 12....................1
Back seat is safest for children...........................2
Never put rear facing child seat in front.............3
Sit as far back from airbag as possible....................4
Do not sit or lean unnecessarily close to airbag......5
Always use seatbelts and child restraints..................6
Do not place objects over the airbag or
between the airbag and yourself.....................7
See the owners manual......................................8
Other (SPECIFY: ___________________________)..........9
(VOL) Not sure...........................................10
Q.57a Now
I would like to ask you some questions about bicycle use. Have you
ridden a bicycle at all during the past 30 days? Do NOT include stationary
or exercise bikes.ude
Yes....................1
No..........................2 SKIP
TO Q.58
(VOL) Don't know.....3 SKIP
TO Q.58
(VOL) Refused.............4 SKIP TO
Q.58
Q.57b How
many days in the last 30 days did you ride a bicycle?
________ (Range:
0-30) DON'T KNOW=31 REFUSED=32
ALL ANSWERS IN Q57b SKIP TO Q.59
Q.58 Have
you ridden a bicycle at all during the past 12 months? Do not include
stationary or exercise bikes.
Yes....................1
No..........................2 SKIP TO Q.62
(VOL) Don't know.....3
SKIP TO Q.62
(VOL) Refused.............4 SKIP TO Q.62
Q.59 Do
you usually wear a bicycle helmet when you ride a bike?
Yes....................1
No..........................2
(VOL) Don't
know.....3
(VOL) Refused.............4
DELETE
Q.60 AND Q.61
IF Q.13=AT
LEAST 1 CHILD 4-12 ASK Q.62 FOR 1 RANDOMLY SELECTED CHILD
IF Q.13=NO CHILDREN 4-12 SKIP TO Q.65
Q.62 During
the past 12 months, has the (AGE) ridden a bicycle? Do NOT include
tricycles; DO include two-wheelers with training wheels.
Yes....................1
No..........................2
SKIP TO Q.65
(VOL) Don't know.....3
SKIP TO Q.65
(VOL) Refused.............4 SKIP TO
Q.65
Q.63 Does
he/she have a bicycle helmet?
Yes....................1
No..........................2
SKIP TO Q.65
(VOL) Don't know.....3
SKIP TO Q.65
Q.64a Does
he/she usually wear it?
Yes....................1
SKIP TO Q.65
No..........................2
(VOL) Don't know.....3
SKIP TO Q.65
Q.64b
Why not?(RECORD VERBATIM RESPONSES ON SAF NEXT TO
Q.64b, THEN ENTER "1" TO CONTINUE)
Gave response
to Q.64b....................1
No reason/don't know/not sure/refused.........2
Q.65 Do
you favor or oppose laws which require children to wear bicycle helmets?
(DO NOT READ LIST)
Favor.......................1
Oppose...........................2
Depends on age of child.....3
Depends on where they
ride/type of street............4
(VOL) Don't know...........5
(VOL) Refused..................6
DELETE
Q.66
Q.67a Now
I'd like to ask you some questions about a subject you may not know
much about. Can you tell me what the initials "EMS" stand for?
Yes, Emergency
Medical
Services/Systems..............1
Yes, wrong answer....................2
No............................3
(VOL) Don't know..................4
(VOL) Refused..............5
IF GAVE
WRONG ANSWER ON Q.67a READ THIS STATEMENT, ELSE GO TO Q.68a
Lots of people don't know it, but EMS stands for Emergency Medical
Services. This includes ambulance and rescue squads and hospital emergency
services
Q.68a
If someone was experiencing a medical emergency and you needed to
get help for that person, who would you call first? (NOTE:
MEDICAL EMERGENCY MEANS A LIFE-THREATENING SITUATION)
911................................1 SKIP
TO Q.71
Telephone operator.....................2
Police.............................3
Friend.................................4
Spouse/Relative....................5
Doctor.................................6
EMS (Emergency Medical Services)...7
Other (SPECIFY)........................8 ________________
(VOL) Don't know.................9
(VOL) Refused........................10
Q.69 Is
there a particular telephone number to call for medical emergencies
in your community?
Yes......................1
No.............................2 SKIP TO Q.71
(VOL) Don't know.......3SKIP
TO Q.71
(VOL) Refused................4 SKIP TO Q.71
Q.70 What
is that telephone number?
911..........................1
Other (SPECIFY)....................7
_____________________________
(VOL) Don't
know.........8
(VOL) Refused...................9
Q.71
If there was a medical emergency in your neighborhood and you called
an ambulance, how long do you think it would take for the ambulance
to arrive? (ENTER IN MINUTES)
___________ MINUTES
(Range: 1-60)
MORE THAN AN HOUR=61 DON'T KNOW=62 REFUSED=63
Q.72a. Regardless
of the type of medical emergency, how confident are you that the ambulance
or other emergency workers would know what to do? (READ LIST)
VERY CONFIDENT...............1
SOMEWHAT CONFIDENT OR.............2
NOT CONFIDENT................3
(VOL) Don't know................4
(VOL) Refused..............5
Q.72b Have
you, personally, ever called 911 or another emergency number for help?
Yes..........1
No...............2 SKIP TO Q.73
Q.72c
How long ago did that occur (the last time)?
Today................1
Within past week...........2
Within past month....3
Within past 12 months......4
A year or more ago...5
(VOL) Don't
know.........6
(VOL) Refused......7
Q.72d
Did you call for police, fire, an ambulance or something
else? MULTIPLE RECORD
Police.....................................1
Fire............................................2
Ambulance..................................3
Other (SPECIFY).................................4 _________________
(VOL) Whoever
911 thought was appropriate..5
(VOL) Not sure...............6
DELETED
Q.72e
IF YES TO N55a OR N55b, SKIP TO Q75
Q.73 In
the past 5 years, have you taken any kind of emergency or first aid
training?
Yes.......................1
No............................2 SKIP TO Q.75
(VOL) Don't know........3
SKIP TO Q.75
(VOL) Refused...............4 SKIP TO Q.75
Q.74 Who
provided the training? MULTIPLE RECORD
Work...........................1
School...............................2
Doctor/Health professional.....3
Other................................9
____________________________
(VOL) Don't
know.............10
(VOL) Refused......................11
Q.75
Assuming it was at low cost and in a convenient location, how interested
would you be in taking training on how to assist injured persons in
vehicle crashes? (READ LIST)
VERY INTERESTED.....................1
SOMEWHAT INTERESTED OR....................2
NOT INTERESTED......................3 SKIP
TO Q.77
(VOL) Already
have EMS training.........4 SKIP
TO Q.77
(VOL) Depends.....................5
(VOL) Don't know........................6
SKIP TO Q.77
(VOL) Refused.....................7 SKIP
TO Q.77
Q.76 If
the training took no more than two hours in a single class session,
how likely would you be to take such a class? (READ LIST)
VERY LIKELY............1
SOMEWHAT LIKELY.............2
SOMEWHAT UNLIKELY......3
VERY UNLIKELY...............4
(VOL) Not sure.......5
(VOL) Refused.............6
Q.77 Suppose
that you are driving, you see an accident happen and no one is there
at the scene to help. What concerns might you have about stopping
to help? Anything else? DO NOT READ LIST. MULTIPLE RECORD.
No concerns..............................1
Lawsuits/liability............................2
Not knowing what to do/how to help.......3
Trick to get you to stop......................4
Causing further injury to victim.........5
Personal safety...............................6
Other (SPECIFY)
_________________________________.......13
Q.78 How
likely would you be to stop? Do you think that you... (READ)?
Definitely would
stop.......1 SKIP TO Q.80
Probably would stop.............2
Probably would not stop.....3
Definitely would not stop.......4
(VOL) Depends...............5
Q.79
What would prevent you from stopping?
Nothing..........................................1
Fear of Lawsuits/liability............................2
Not knowing what to do/how to help...............3
Fear that it was trick to get you to stop.............4
Fear of causing further injury to victim.........5
Personal safety.......................................6
Other (SPECIFY)
_________________________________...........13
Q.80 Suppose
you are driving, you see an accident and think that someone might
be injured, but it is too dangerous to pull over and help at the scene.
How likely would you be to call for help from the nearest available
phone (if no one else was on the scene)? Do you think that you...(READ)?
Definitely would
call.......1 SKIP TO Q.82A
Probably would call.............2
Probably would not call.....3
Definitely would not call.......4
(VOL) Depends...............5
Q.81 What,
if anything, would prevent you from telephoning for help? _______________________________________________________________
Nothing........00
ASK IF
DRIVER ONLY, ELSE SKIP TO Q83a
Q.82a
Do you have a car phone or (ever) carry a cellular phone in the motor
vehicle you usually drive.....?
Yes..........1
No................2 SKIP
TO Q.83a
DELETE
Q.82b
N82b1.
Is it a hands free phone?
Yes..........1
No................2
N82b2.
Please answer yes or no to the following items about your car phone's
features. Does your car phone have... ?
| |
YES |
NO |
NOT
SURE |
| FAX....................... |
1 |
2 |
3 |
| E-mail ................... |
1 |
2 |
3 |
| Internet access........... |
1 |
2 |
3 |
| Paging ................... |
1 |
2 |
3 |
FOR
EACH YES IN N82b2, ASK:
N82b3.
Do you ever use the (FAX/e-mail/internet/paging) on your car phone
while driving?
| |
YES |
NO |
NOT
SURE |
| FAX....................... |
1 |
2 |
3 |
| E-mail ................... |
1 |
2 |
3 |
| Internet access........... |
1 |
2 |
3 |
| Paging ................... |
1 |
2 |
3 |
Q.82c How
often do you talk on your car phone when you are driving? Do you
talk on your car phone.....
On most trips
in your motor vehicle........1
On about half of your trips.....................2
On less than half of your trips............3
On very few trips, or...........................4
Never......................................5
Q.82d Have
you ever used a car phone or cellular phone to report an emergency
while you were driving or riding in a motor vehicle?
Yes............1
No..................2 SKIP TO Q.83A
Q.82e What
kind of emergency did you call about?
______________________________________________
Q.83a
Have YOU ever been injured in a vehicle accident? Only count injuries
that required medical attention.
Yes.......................1
SKIP TO Q.83b
No.............................2
(VOL) Don't know..........3
(VOL) Refused..................4,
N83a1. Have
you ever been injured in a motor vehicle accident when you were
a passenger, or have you ever been hit and injured by a motor vehicle
when you were walking or riding a bike? Only count injuries that
required medical attention.
Yes.......................1
No.............................2 SKIP
TO Q90
(VOL) Don't
know..........3 SKIP TO Q90
(VOL) Refused..................4 SKIP TO
Q90
Q.83b How
many times has this happened to you?
______________________________ DON'T KNOW=98 REFUSED=99
DELETE
Q.83c
Q.83d
How long ago did (that/your most recent) accident occur?
________________________
NUMBER OF YEARS AGO
WITHIN THE PAST 12 MONTHS=0 NOT SURE=98 REFUSED=99
DELETE
Q.83e
Q.83f Were
you a driver or a passenger in that accident?
Driver..............1
Passenger...............2
(VOL) Pedestrian....3
(VOL) Bicyclist.........4
Other (SPECIFY)
______________.......5
IF Q83f=3
OR 4, SKIP TO Q.85
Q.84 Were
you wearing your seat belt at the time of the accident?
Yes..................................1
No.......................................2
(VOL) Don't know...................3
(VOL) Motorcycle driver or rider.......4
Q.85 At
which of the following were you treated for your injuries? Were you
treated at ..(READ LIST. MULTIPLE RECORD)?
A hospital emergency
room........1
A doctor's office....................2
A clinic.........................3
The accident scene...................4
Somewhere else (SPECIFY).........5 ____________________________
Did not need treatment.........6 SKIP
TO Q.87b
Q.86 Were
you transported from the accident scene by ambulance or helicopter?
Yes, ambulance
(or other rescue vehicle)....1
Yes, helicopter..................................2
No, neither.................................3
(VOL) Don't know.................................4
Q.87a Were
you hospitalized?
Yes.......................1
No.............................2 SKIP
TO NQ87b
(VOL) Don't
know..........3 SKIP TO NQ87b
N87a1.
How long were you hospitalized?
______ DAYS
or ______ HOURS (1-23)
NQ87b.
Did you receive any continuing or follow-up treatment for your injuries?
Yes.......................1
No.............................2 SKIP
TO Q87b (VOL) Don't know..........3 SKIP TO Q87b
NQ87c. Where
did you receive this (follow-up) treatment? Was it at ... (READ
LIST AND MULTIPLE RECORD)?
A doctor's
office................1
A physical therapist.................2
A clinic.........................3
Somewhere else (SPECIFY).............4_____________________
Q.87b Did
your injuries from that accident prevent you from performing any
of your normal activities (work, school, household) for at least
a week?
Yes.......................1
No.............................2 SKIP
TO Q.88
(VOL) Don't
know..........3 SKIP TO Q.88
(VOL) Refused..................4 SKIP TO
Q.88
Q.87c Were
there any activities that you were unable to resume because of your
injuries even a year after the accident?
Yes.......................................1
No.............................................2
Happened less than 1 year ago.............3
(VOL) Not sure...............................4
IF YES
IN Q.87b or Q.83b=1 SKIP TO Q.90
Q.88 Have
you EVER received injuries from a vehicle accident that prevented
you from performing any of your normal activities (work, school, household)
for at least a week?
Yes.......................1
No.............................2 SKIP
TO Q.90
(VOL) Don't know..........3 SKIP
TO Q.90
(VOL) Refused..................4 SKIP
TO Q.90
Q.89
Were there any activities that you were unable to resume because of
your injuries even a year after the accident?
Yes.......................................1
No.............................................2
Happened less than 1 year ago.............3
(VOL) Not sure...............................4
(VOL) Refused...........................5
Q.90
Now I'm going to ask you a few questions about alcohol use. During
the past 30 days have you had at least one drink of any alcoholic
beverage, including liquor, beer, wine or wine coolers?
Yes......................1
SKIP TO Q.92
No............................2
Q.91 Did
you drink any alcoholic beverages at all during the past 12 months?
Yes.......................1
SKIP TO Q.93
No............................2 SKIP
TO Q.11
(VOL) Not sure..........3
SKIP TO Q.11
(VOL) Refused...............4 SKIP
TO Q.11
Q.92 How
many days out of the past 30 days did you drink alcoholic beverages?
_______________
(Range: 0-30) NOT SURE=31 REFUSED=32
Q.93 On
the average, how many drinks did you typically have on the days you
drank?
__________ (Range:
1-12) MORE THAN 12=13 NOT SURE=14
REFUSED=15
IF Q.1=NEVER
OR Q.90=NO, SKIP TO Q.11. ELSE ASK Q.94
Q.94 During
the past 30 days, have you driven a vehicle after you had been drinking
alcohol?
Yes....................1
No...........................2 SKIP
TO Q.11
(VOL) Not sure.......3 SKIP
TO Q.11
(VOL) Refused..............4 SKIP TO
Q.11
Q.95 How
many days out of the past 30 days did you drive after drinking alcoholic
beverages?
_____________(Range:
0-30) NOT SURE=31 REFUSED=32
Q.96 During
the past 30 days, have you driven a vehicle when you might have consumed
too much alcohol to drive safely?
Yes....................1
No...........................2
(VOL) Not sure.......3
(VOL) Refused..............4
Now I would like
to ask you just a few more questions about yourself and then we will
be done.
Q.11
What is your age?
__________ AGE
REFUSED=99
Q.12a
Including yourself, how many persons, AGE 16 OR OLDER, are living
in your household at least half of the time or consider it their primary
residence?
________ IF NO
OTHER ADULTS 16+, ENTER "0" REFUSED=99
Q.97 Do
you consider yourself to be Hispanic or Latino?
Yes....................1
No.........................2
(VOL) Not sure.......3
(VOL) Refused............4
Q.98 Which
of the following racial categories describes you? You may select more
than one. READ LIST AND MULTIPLE RECORD
American Indian
or Alaskan Native...........1
Asian...........................................2
Black or African-American...................3
Native Hawaiian or Other Pacific Islander.......4
White.......................................5
Other (SPECIFY).................................10 __________________________________________
(VOL) Refused................................11
Q.99 Are
you married, divorced, widowed, separated or have you never been married?
Married..............................1
Divorced....................................2
Widowed..............................3
Separated...................................4
Never been married...................5
A member of an unmarried couple.............6
(VOL) Refused.....................7
Q.100
What is the highest grade or year of school you completed?
8th grade or
less.............8
9th grade...........................9
10th grade....................10
11th grade..........................11
12th grade/GED................12
Some college........................13
College graduate or higher....14
(VOL) Refused.....................15
Q.101
Which of the following categories best describes your total household
income before taxes in 1997? (Include the income of all persons in
the household.) Was your total household income [READ LIST]
Less than $5,000.............1
$5,000 to $14,999..........2
$15,000 to $29,999...........3
$30,000 to $49,999.........4
$50,000 to $74,999...........5
$75,000 to $99,999.........6
$100,000 or more.............7
Not sure (VOL)..........8
Refused (VOL).............9
Q.102 Are
you currently employed for wages, self-employed, out of work, a homemaker,
a student, retired or unable to work? MULTIPLE RECORD
Employed for
wages.........1
Self-employed....................2
Out of work................3
Homemaker........................4
Student....................5
Retired..........................6
Unable to work.............7
(VOL) Refused..................8
Q103.
Not including beepers and pagers, do you have more than one telephone
number in your household at which you normally can receive in-coming
phone calls?
Yes...............1
No.....................2 SKIP
TO Q.105
(VOL) Refused...3
SKIP TO Q.105
Q.104 How
many different telephone numbers do you have at this residence at
which you can normally receive incoming phone calls?
___________
10 OR MORE=10 DON'T KNOW=11 REFUSED=12
Q.105
Finally, could you tell me the zip code where you live?
______________________
REFUSED=99999
Q.106 FROM
OBSERVATION, ENTER SEX OF RESPONDENT
Male.......1
Female............2
Q107. INTERVIEW
WAS CONDUCTED IN:
ENGLISH........1
SPANISH...........2
That
completes the survey.
Thank you very much for your time and cooperation.