Thank you for agreeing to participate in our ongoing survey which focuses on the impact of the novel coronavirus (COVID-19). Most of the questions in this survey were asked in previous surveys. Thank you for answering them accurately again, to ensure we always have the most up-to-date information.
First we’d like to ask you about any symptoms you may have experienced recently. Please pay attention to the list since it is different from the list you may have seen before.
Group of questions presented on the same screen
cr001_intro
Have you experienced any of the following symptoms in the past 7 days?
Subgroup of questions
Loop from 1 to 20
if cr001_order[cnt] = response then
Value of question 'cr001_questions[cr001_order[cnt]]' asked as question
End of if
End of loop
cr001v (experienced Other health problems)
Other health problems
1 Yes 2 No 3 Unsure
End of subgroup of questions
End of group of questions
cr002_modified (tested for the coronavirus--Yes/No/Unsure)
Have you been tested for coronavirus[ since ^FLDateEarlierSurvey (when you last took our coronavirus survey)]?
1 Yes 2 No 3 Unsure
if cr002_modified = 1 then
cr079 (how many times tested)
How many times have you been tested since [^FLDateEarlierSurvey/March 2020]?
1 I only tested positive (I had the coronavirus) 2 I only tested negative (I did not have the coronavirus) 3 I tested both negative and positive 4 I do not know the results
End of if
if cr080 in [1,3] then
Group of questions presented on the same screen
cr080a_month (month first positive covid)
On what date did you first test positive [ since ^FLDateEarlierSurvey]?
1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December
if cr080a_month = response and cr080a_year = response and cr080a_day = response then
if (strtotime(FLLastEndtime) > strtotime(cr080a_year . "-" . cr080a_month . "-" . cr080a_day)) then
cr080a_warning
The date you entered is BEFORE the date on which you answered our previous survey ([date of earlier survey[]]). Please go back and correct your response.
The date you entered is in the future. Please go back and correct your response.
End of if
elseif cr080a_month = response and cr080a_year = response then
if (date("Y", strtotime(FLLastEndtime)) = cr080a_year) AND (date("n", strtotime(FLLastEndtime)) > cr080a_month) then
cr080a_warning
The date you entered is BEFORE the date on which you answered our previous survey ([date of earlier survey[]]). Please go back and correct your response.
elseif (date("Y", time()) = cr080a_year) AND (date("n", time()) < cr080a_month) then
cr080a_warning2
The date you entered is in the future. Please go back and correct your response.
End of if
End of if
End of if
End of if
cr005 (diagnosed with the coronavirus)
Whether or not you have had a coronavirus test, has a doctor or another healthcare professional diagnosed you as having or probably having the coronavirus[ since ^FLDateEarlierSurvey]?
1 Yes 2 No 3 Unsure
cr005a (experienced cold or flu)
Have you experienced a cold or the flu in the last month (since [[]])?
1 Yes 2 No 3 Unsure
if cr080 != 1 AND cr080 != 3 AND cr005 !=1 then
cr007 (think infected with coronavirus)
Do you think you have been infected with the coronavirus[ since ^FLDateEarlierSurvey]?
if cr114a IN [1,3] or cr114b IN [1,3] or cr114c IN [1,3] or cr114d IN [1,3] or cr114e IN [1,3] or cr114f IN [1,3] or cr114g IN [1,3] or cr114h IN [1,3] or cr114i IN [1,3] or cr114j IN [1,3] then
if cr115a IN [1,3] or cr115b IN [1,3] or cr115c IN [1,3] or cr115d IN [1,3] or cr115e IN [1,3] or cr115f IN [1,3] or cr115g IN [1,3] or cr115h IN [1,3] or cr115i IN [1,3] or cr115j IN [1,3] then
Group of questions presented on the same screen
cr116_intro
Did these symptoms also occur before you were infected with COVID-19?
Subgroup of questions
Loop from 1 to 10
if cr115_answers[cr114_order[cnt]] IN [1,3] then
Value of question 'cr116_questions[cr114_order[cnt]]' asked as question
How much do/did these symptoms prevent you from going about your usual daily activities, such as going to work or school, socializing, or taking care of your personal needs?
1 A lot 2 A little 3 Not at all 4 Unsure
Group of questions presented on the same screen
cr120a (whether think experienced/experiencing long covid)
Some people experience a broad range of mental and physical symptoms that may last for a long time after a COVID-19 infection. This is commonly referred to as “long COVID”, “long-haul COVID”, or “post-COVID conditions”.
Do you think you have experienced or are experiencing long COVID?
1 Yes 2 No 3 Unsure
cr120b (whether been diagnosed with long covid by a doctor/medical care provider )
Has a doctor or other medical care provider ever diagnosed you with long COVID?
In the last seven days, have you done the following:
Subgroup of questions
Loop from 1 to 18
if cr015_questions[cr015_order[cnt]] = response then
Value of question 'cr015_questions[cr015_order[cnt]]' asked as question
End of if
End of loop
End of subgroup of questions
End of group of questions
if cr015a = 1 OR cr015b = 1 OR cr015c = 1 OR cr015d = 1 OR cr015e = 1 OR cr015f = 1 OR cr015k = 1 OR cr015l = 1 OR cr015m = 1 OR cr015n = 1 OR cr015r = 1 OR cr015s = 1 then
Group of questions presented on the same screen
cr069_intro
For each of the following activities, please indicate how often, if ever, you wore a mask or face covering.
Subgroup of questions
Loop from 1 to 16
if cr015_order[cnt] = 1 AND cr015a = 1 then
cr069a (face mask gone out to a bar, club, or other place where people gather )
When you went to a bar, club, or other place where people gather
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 2 AND cr015b = 1 then
cr069b (face mask gone to the grocery store or pharmacy )
When you went to the grocery store or pharmacy
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 3 AND cr015c = 1 then
cr069c (face mask friend, neighbor, or other relative’s residence)
When you went to a friend, neighbor, or other relative’s residence
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 4 AND cr015d = 1 then
cr069d (face mask visitors such as friends, neighbors, or relatives at residence)
When you had visitors such as friends, neighbors, or relatives at your residence
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 5 AND cr015e = 1 then
cr069e (face mask attended a gathering with more than 10 people)
When you attended a gathering with more than 10 people
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 6 AND cr015f = 1 then
cr069f (face mask sought care from a hospital or health care facility)
When you sought care from a hospital or health care facility
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 11 AND cr015k = 1 then
cr069k (face mask had close contact (within 6 feet) with people who do not live with you)
When you had close contact (within 6 feet) with people who do not live with you
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 12 AND cr015l = 1 then
cr069l (face mask gone outside to walk, hike, or exercise)
When you went outside to walk, hike or exercise
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 13 AND cr015m = 1 then
cr069m (face mask attended a political rally, protest, or demonstration)
When you attended a political rally, protest, or demonstration
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 14 AND cr015n = 1 then
cr069n (face mask attended an in-person religious service)
When you attended an in-person religious service
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 17 AND cr015r = 1 then
cr069r (face mask traveled by airplane)
When you traveled by airplane
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
elseif cr015_order[cnt] = 18 AND cr015s = 1 then
cr069s (face mask traveled by public transportation (bus, subway, commuter rail, etc.))
When you traveled by public transportation (bus, subway, commuter rail, etc.)
1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 6 Unsure
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
cr021 (how many family or close friends)
We'd like to ask about your family, as well as your close friends. How many family or close friends do you have? Only include people who are still alive, regardless of where they live.
RANGE 0..9223372036854775807
if cr021 > 999 then
cr021_warning (warning how many family or close friends)
Do you really have [how many family or close friends[]] family and close friends? If so, click "Next" to continue.
End of if
if cr021 > 0 then
cr022 (infected how many family or close friends)
How many family and close friends do you think have been infected with the coronavirus?
RANGE 0..9223372036854775807
if cr022 > cr021 then
cr022_warning
You said you know [how many family or close friends[]] people but that [infected how many family or close friends[]] people have been infected. Please go back and correct your answer(s).
elseif cr022 > 999 then
cr022_warning2
Do you really know [infected how many family or close friends[]] people who have been infected? If so, click "Next" to continue.
End of if
cr022a (hospitalized how many family or close friends)
How many family and close friends do you think have been hospitalized (spent at least one night in the hospital) from the coronavirus?
RANGE 0..9223372036854775807
if cr022a > cr021 then
cr022a_warning
You said you know [how many family or close friends[]] people but that [hospitalized how many family or close friends[]] people have been hospitalized. Please go back and correct your answer(s).
elseif cr022a > 999 then
cr022a_warning2
Do you really know [hospitalized how many family or close friends[]] people who have been hospitalized? If so, click "Next" to continue.
End of if
cr022b (died how many family or close friends)
How many family and close friends do you think have died from the coronavirus?
RANGE 0..9223372036854775807
if cr022b > cr021 then
cr022b_warning
You said you know [how many family or close friends[]] people but that [died how many family or close friends[]] people have died. Please go back and correct your answer(s).
elseif cr022b > 999 then
cr022b_warning2
Do you really know [died how many family or close friends[]] people who have died? If so, click "Next" to continue.
End of if
cr022c (received vaccine how many family or close friends)
How many family and close friends do you think have received at least one dose of the coronavirus vaccine?
RANGE 0..9223372036854775807
if cr022c > cr021 then
cr022c_warning
You said you know [how many family or close friends[]] people but that [received vaccine how many family or close friends[]] people have received at least one dose of the coronavirus vaccine. Please go back and correct your answer(s).
elseif cr022c > 999 then
cr022c_warning2
Do you really know [received vaccine how many family or close friends[]] people who have received at least one dose of the coronavirus vaccine? If so, click "Next" to continue.
End of if
End of if
Group of questions presented on the same screen
cr023 (chance get coronavirus in next 3 months)
On a scale of 0 to 100 percent, what is the chance that you will get the coronavirus in the next three months? If you’re not sure, please give your best guess.
If you do get the coronavirus, what is the percent chance you will be hospitalized (spend at least one night in the hospital) from it? If you’re not sure, please give your best guess.
You previously told us that you had received [^preload_cr076 doses/^preload_cr076 dose] of the coronavirus vaccine. Is this still correct? Or have you you received a different number of doses?
1 Yes, I have received this many doses 2 No, I have received a different number of doses 3 Unsure
if cr095 = 1 then
cr076 := preload_cr076
Else
cr076 (how many doses received)
How many doses of the coronavirus vaccine have you received, including any boosters?
0 0 1 1 2 2 3 3 4 4 or more
End of if
Else
cr076 (how many doses received)
How many doses of the coronavirus vaccine have you received, including any boosters?
0 0 1 1 2 2 3 3 4 4 or more
End of if
if cr076 = response and cr076 < 1 then
cr076_warning
You said you were vaccinated but received zero doses. Please go back and correct your answers
You previously told us that you received your first dose of the coronavirus vaccine on [previous survey month first dose[]] [previous survey day first dose[]], [preloaded year first dose[]]. Is this correct?
1 Yes 2 No 3 Unsure
End of if
if cr096 = 1 then
cr082_month := preload_cr082_month
cr082_day := preload_cr082_day
cr082_year := preload_cr082_year
Else
cr082_month := preload_cr082_month
cr082_day := preload_cr082_day
cr082_year := preload_cr082_year
Group of questions presented on the same screen
cr082_month (month first dose)
When did you receive your first dose of the coronavirus vaccine?
1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December
You previously told us that you received your second dose of the coronavirus vaccine on [previous survey month second dose[]] [previous survey day second dose[]], [preloaded year second dose[]]. Is this correct?
1 Yes 2 No 3 Unsure
End of if
if cr097 = 1 then
cr083_month := preload_cr083_month
cr083_day := preload_cr083_day
cr083_year := preload_cr083_year
Else
cr083_month := preload_cr083_month
cr083_day := preload_cr083_day
cr083_year := preload_cr083_year
Group of questions presented on the same screen
cr083_month (month second dose)
When did you receive your second dose of the coronavirus vaccine?
1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December
if cr126_month = response and cr126_year = response and cr126_day = response then
if (strtotime(cr126_year . "-" . cr126_month . "-" . cr126_day) > time()) then
cr_date_warning2
The date you entered is in the future. Please go back and correct your response.
End of if
elseif cr126_month = response and cr126_year = response then
if (date("Y", time()) = cr126_year) AND (date("n", time()) < cr126_month) then
cr_date_warning2
The date you entered is in the future. Please go back and correct your response.
End of if
End of if
Group of questions presented on the same screen
cr127 (which vaccine fourth dose)
Which coronavirus vaccine did you receive for your fourth dose?
1 Pfizer 2 Moderna 3 Johnson and Johnson 98 Other, please specify: 99 Unsure
cr127_other (other which vaccine--4th dose)
STRING
End of group of questions
End of if
if cr076 = 1 then
cr077 (how likely receive second dose of coronavirus vaccine )
How likely are you to receive the second dose of the coronavirus vaccine once enough time has passed since your first dose?
1 Very unlikely 2 Somewhat unlikely 3 Somewhat likely 4 Very likely 5 Unsure
elseif cr076 = 2 then
cr124 (how likely receive third dose of coronavirus vaccine )
How likely are you to receive the third dose of the coronavirus vaccine once enough time has passed since your second dose?
1 Very unlikely 2 Somewhat unlikely 3 Somewhat likely 4 Very likely 5 Unsure
elseif cr076 = 3 then
cr128 (how likely receive fourth dose of coronavirus vaccine )
How likely are you to receive the fourth dose (second booster) of the coronavirus vaccine once enough time has passed since your third dose?
1 Very unlikely 2 Somewhat unlikely 3 Somewhat likely 4 Very likely 5 Unsure
End of if
End of if
cr131 (how likely regular booster)
If periodic COVID-19 booster vaccines are recommended in the US for the next few years, how likely is it that you will get a booster as often as recommended? The recommended frequency is not known, but it may be once a year or every six months.
1 Very unlikely 2 Somewhat unlikely 3 Somewhat likely 4 Very likely 5 Unsure
cr132 (why not likely regular booster selected child)
Why are you unlikely to get a booster as often as recommended? Please mark all that apply.
1 It is not convenient 2 I don't have enough time 3 I won't get boosters if my doctor does not recommend them to me personally 4 I won't get boosters if my job and/or other places I frequently visit don’t require them 5 I don't feel a booster would add protection against COVID infection 6 I am concerned about the potential side effects of a booster 7 I am concerned the booster may not be safe 8 Other, please specify:
cr132_other (other why not likely regular booster)
STRING
End of group of questions
End of if
Group of questions presented on the same screen
md001_intro
Do you currently support or oppose requiring U.S. adults to be fully vaccinated against COVID-19 to do the following activities?
Subgroup of questions
md001a (vaccinated travel on an airplane)
Travel on an airplane
1 Support 2 Neither support nor oppose 3 Oppose
md001b (vaccinated attend an outdoor public event)
Attend a large outdoor event, like a concert or sporting event
1 Support 2 Neither support nor oppose 3 Oppose
md001h (vaccinated attend an indoor public event)
Attend a large indoor public event, like a concert or sporting event
1 Support 2 Neither support nor oppose 3 Oppose
md001c (vaccinated go to a bar or restaurant)
Go to a bar or restaurant
1 Support 2 Neither support nor oppose 3 Oppose
md001d (vaccinated go to a retail store, movie theater, or museum)
Go to a retail store, movie theater, or museum
1 Support 2 Neither support nor oppose 3 Oppose
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
md002_intro
For each of the following types of schools, should students who are eligible for the coronavirus vaccine be required to be fully vaccinated to attend school in person?
Subgroup of questions
md002a (vaccinated attend preschool)
Preschool
1 Yes 2 No 3 Unsure
md002b (vaccinated elementary school)
Elementary school
1 Yes 2 No 3 Unsure
md002c (vaccinated attend middle or high school)
Middle or high school
1 Yes 2 No 3 Unsure
md002d (vaccinated attend college)
College
1 Yes 2 No 3 Unsure
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
md003_intro
Do you currently support or oppose requiring the following categories of workers to be fully vaccinated against COVID-19?
Subgroup of questions
md003a (vaccinated hospital or other health care workers)
Hospital or other health care workers
1 Support 2 Neither support nor oppose 3 Oppose
md003b (vaccinated workers who interact with the public, such as restaurant or retail workers)
Workers who interact with the public, such as restaurant or retail workers
1 Support 2 Neither support nor oppose 3 Oppose
md003c (vaccinated members of the military)
Members of the military
1 Support 2 Neither support nor oppose 3 Oppose
md003d (vaccinated government workers, such as fire fighters or police officers)
Government workers, such as fire fighters or police officers
1 Support 2 Neither support nor oppose 3 Oppose
md003e (vaccinated teachers and school staff)
Teachers and school staff
1 Support 2 Neither support nor oppose 3 Oppose
md003f (vaccinated workers who do not interact with the public, such as office workers)
Workers who do not interact with the public, such as office workers
1 Support 2 Neither support nor oppose 3 Oppose
md003g (vaccinated taxi or rideshare (Lyft, Uber, etc.) drivers)
Taxi or rideshare (Lyft, Uber, etc.) drivers
1 Support 2 Neither support nor oppose 3 Oppose
End of subgroup of questions
End of group of questions
md011 (support existing school vaccinations)
Many states require children to receive vaccinations against diseases such as measles, mumps, rubella, diphtheria, pertussis, and tetanus before they can attend school. In general, do you support or oppose these requirements?
1 Support 2 Neither support nor oppose 3 Oppose 4 Unsure
Group of questions presented on the same screen
md004_intro
Do you currently support or oppose requiring U.S. adults to wear a mask to do the following activities:
Subgroup of questions
md004a (wear a mask travel on an airplane)
Travel on an airplane?
1 Support 2 Neither support nor oppose 3 Oppose
md004b (wear a mask attend a large outdoor public event, like a concert or sporting event)
Attend a large outdoor public event, like a concert or sporting event?
1 Support 2 Neither support nor oppose 3 Oppose
md004e (wear a mask attend a large indoor public event, like a concert or sporting event)
Attend a large indoor public event, like a concert or sporting event?
1 Support 2 Neither support nor oppose 3 Oppose
md004c (wear a mask go to a bar or restaurant)
Go to a bar or restaurant?
1 Support 2 Neither support nor oppose 3 Oppose
md004d (wear a mask go to a retail store, movie theater, or museum)
Go to a retail store, movie theater, or museum?
1 Support 2 Neither support nor oppose 3 Oppose
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
md005_intro
Do you currently support or oppose requiring students to wear a mask to attend each of the following types of schools?
Subgroup of questions
md005a (wear a mask attend preschool)
Preschool
1 Support 2 Neither support nor oppose 3 Oppose
md005b (wear a mask elementary school)
Elementary school
1 Support 2 Neither support nor oppose 3 Oppose
md005c (wear a mask attend middle or high school)
Middle or high school
1 Support 2 Neither support nor oppose 3 Oppose
md005d (wear a mask attend college)
College
1 Support 2 Neither support nor oppose 3 Oppose
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
md006_intro
Do you currently support or oppose requiring the following workers to wear a mask while they are at work?
Subgroup of questions
md006a (wear a mask hospital or other health care workers)
Hospital or other health care workers
1 Support 2 Neither support nor oppose 3 Oppose
md006b (wear a mask restaurant or retail workers)
Restaurant or retail workers
1 Support 2 Neither support nor oppose 3 Oppose
md006c (wear a mask members of the military)
Members of the military
1 Support 2 Neither support nor oppose 3 Oppose
md006d (wear a mask government workers, such as fire fighters or police officers)
Government workers, such as fire fighters or police officers
1 Support 2 Neither support nor oppose 3 Oppose
md006e (wear a mask teachers and school staff)
Teachers and school staff
1 Support 2 Neither support nor oppose 3 Oppose
md006f (wear a mask workers who do not interact with the public, such as office workers)
Workers who do not interact with the public, such as office workers
1 Support 2 Neither support nor oppose 3 Oppose
md006g (wear a mask taxi or rideshare (Lyft, Uber, etc.) drivers)
Taxi or rideshare (Lyft, Uber, etc.) drivers
1 Support 2 Neither support nor oppose 3 Oppose
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
md009_intro
Governments and other organizations may require people to wear a mask in order to participate in various activities. For each activity below, would you wear a mask if you were required to in order to participate?
Subgroup of questions
md009a (if required wear mask travel on an airplane)
Travel on an airplane
1 Yes, regardless of whether I was required 2 Yes, only if I was required 3 No 4 Unsure 5 Not applicable
md009b (if required wear mask attend large public events)
Attend large public events, like concerts or sporting events
1 Yes, regardless of whether I was required 2 Yes, only if I was required 3 No 4 Unsure 5 Not applicable
md009c (if required wear mask go to a retail store, movie theater, or museum)
Go to a retail store, movie theater, or museum
1 Yes, regardless of whether I was required 2 Yes, only if I was required 3 No 4 Unsure 5 Not applicable
md009d (if required wear mask go to a bar or restaurant)
Go to a bar or restaurant
1 Yes, regardless of whether I was required 2 Yes, only if I was required 3 No 4 Unsure 5 Not applicable
md009e (if required wear mask work in your current job)
Work in your current job
1 Yes, regardless of whether I was required 2 Yes, only if I was required 3 No 4 Unsure 5 Not applicable
md009f (if required wear mask attend college)
Attend college
1 Yes, regardless of whether I was required 2 Yes, only if I was required 3 No 4 Unsure 5 Not applicable
md009g (if required wear mask attend an event at child school)
Attend an event at your child's school
1 Yes, regardless of whether I was required 2 Yes, only if I was required 3 No 4 Unsure 5 Not applicable
if preload_cr053a = empty AND preload_cr053b = empty AND preload_cr053c = empty AND preload_cr053d = empty AND preload_cr053e = empty AND preload_cr053f = empty then
Have you ever been told by a doctor, nurse, or other health professional that you have any of the following medical conditions? (please select all that apply)
1 Diabetes 2 Cancer (other than skin cancer) 3 Heart disease 4 High blood pressure 5 Asthma 6 Chronic lung disease such as COPD or emphysema 7 Kidney disease 8 Autoimmune disorder such as rheumatoid arthritis or Crohn’s Disease 9 A mental health condition 10 Obesity 11 None of the above
Else
cr054 := preload_cr054
End of if
if preload_cr056a = empty AND preload_cr056b = empty AND preload_cr056c = empty AND preload_cr056d = empty AND preload_cr056e = empty AND preload_cr056f = empty AND preload_cr056g = empty AND preload_cr056h = empty AND preload_cr056i = empty then
Which of the following mental health conditions has a doctor or another health professional ever told you that you have?
Subgroup of questions
Loop from 1 to 9
Value of question 'cr056_questions[cr056_order[cnt]]' asked as question
End of loop
End of subgroup of questions
cr056i_other (specify other mental issue)
STRING
End of group of questions
Else
cr056a := preload_cr056a
cr056b := preload_cr056b
cr056c := preload_cr056c
cr056d := preload_cr056d
cr056e := preload_cr056e
cr056f := preload_cr056f
cr056g := preload_cr056g
cr056h := preload_cr056h
cr056i := preload_cr056i
cr056i_other := preload_cr056i_other
End of if
if preload_cr054 = empty then
if 1 in cr054 then
cr055a (since when diabetes)
Did the doctor or other health professional first say that you have diabetes before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 2 in cr054 then
cr055b (since when cancer (other than skin cancer))
Did the doctor or other health professional first say that you have cancer (other than skin cancer) before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 3 in cr054 then
cr055c (since when heart disease)
Did the doctor or other health professional first say that you have heart disease before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 4 in cr054 then
cr055d (since when high blood pressure)
Did the doctor or other health professional first say that you have high blood pressure before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 5 in cr054 then
cr055e (since when asthma)
Did the doctor or other health professional first say that you have asthma before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 6 in cr054 then
cr055f (since when chronic lung disease such as COPD or emphysema)
Did the doctor or other health professional first say that you have chronic lung disease such as COPD or emphysema before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 7 in cr054 then
cr055g (since when kidney disease)
Did the doctor or other health professional first say that you have kidney disease before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 8 in cr054 then
cr055h (since when an autoimmune disorder such as rheumatoid arthritis or Crohn’s disease)
Did the doctor or other health professional first say that you have an autoimmune disorder such as rheumatoid arthritis or Crohn’s disease before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 9 in cr054 then
cr055i (since when a mental health condition)
Did the doctor or other health professional first say that you have a mental health condition before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
if 10 in cr054 then
cr055j (since when obesity)
Did the doctor or other health professional first say that you have obesity before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
End of if
Else
cr055a := preload_cr055a
cr055b := preload_cr055b
cr055c := preload_cr055c
cr055d := preload_cr055d
cr055e := preload_cr055e
cr055f := preload_cr055f
cr055g := preload_cr055g
cr055h := preload_cr055h
cr055i := preload_cr055i
cr055j := preload_cr055j
End of if
if preload_cr056a = empty AND preload_cr056b = empty AND preload_cr056c = empty AND preload_cr056d = empty AND preload_cr056e = empty AND preload_cr056f = empty AND preload_cr056g = empty AND preload_cr056h = empty AND preload_cr056i = empty then
Loop from 1 to 10
if cr056_order[cnt] = 1 and cr056a = 1 then
cr057a (since when an anxiety disorder)
Did the doctor or other health professional first say that you have an anxiety disorder before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
elseif cr056_order[cnt] = 2 and cr056b = 1 then
cr057b (since when attention deficit hyperactivity disorder (ADHD))
Did the doctor or other health professional first say that you have attention deficit hyperactivity disorder (ADHD) before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
elseif cr056_order[cnt] = 3 and cr056c = 1 then
cr057c (since when bipolar disorder)
Did the doctor or other health professional first say that you have bipolar disorder before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
elseif cr056_order[cnt] = 4 and cr056d = 1 then
cr057d (since when an eating disorder)
Did the doctor or other health professional first say that you have an eating disorder before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
elseif cr056_order[cnt] = 5 and cr056e = 1 then
cr057e (since when depression or another depressive disorder)
Did the doctor or other health professional first say that you have depression or another depressive disorder before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
elseif cr056_order[cnt] = 6 and cr056f = 1 then
cr057f (since when obsessive-compulsive disorder (OCD))
Did the doctor or other health professional first say that you have obsessive-compulsive disorder (OCD) before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
elseif cr056_order[cnt] = 7 and cr056g = 1 then
cr057g (since when post-traumatic stress disorder (PTSD))
Did the doctor or other health professional first say that you have post-traumatic stress disorder (PTSD) before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
elseif cr056_order[cnt] = 8 and cr056h = 1 then
cr057h (since when schizophrenia or another psychotic disorder)
Did the doctor or other health professional first say that you have schizophrenia or another psychotic disorder before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
elseif cr056_order[cnt] = 9 and cr056i = 1 then
cr057i (since when other mental issue)
Did the doctor or other health professional first say that you have another mental health condition ([specify other mental issue[]]) before or after March 10, 2020?
1 Before March 10, 2020 2 After March 10, 2020 3 Unsure
IF corrected_hadjob != 1 AND preload_lr003 = 2 then
corrected_hadjob := 1
End of if
IF corrected_hadjob != 1 AND preload_lr003a = 1 then
corrected_hadjob := 1
End of if
IF corrected_hadjob != 1 AND preload_lr003aa in [1,5] then
corrected_hadjob := 1
End of if
IF corrected_hadjob != 1 AND preload_lr003bb in [1,5] then
corrected_hadjob := 1
End of if
IF corrected_hadjob != 1 AND preload_lr003cc = 2 then
corrected_hadjob := 1
End of if
IF corrected_hadjob != 1 AND preload_lr003dd = 2 then
corrected_hadjob := 1
End of if
IF corrected_hadjob != 1 AND preload_lr003ee = 1 then
corrected_hadjob := 1
End of if
IF corrected_hadjob != 1 AND preload_laborstatus_covid = 1 then
corrected_hadjob := 1
End of if
IF corrected_hadjob = 1 THEN
Group of questions presented on the same screen
lr001 (employment status)
The next set of questions are about your primary job. If you have multiple jobs, think of the job in which you work the most hours or receive the most pay.
You told us on [date of earlier survey[]] that you had a job. Which statement best reflects your current employment status:
1 I am still working in the same job 2 I lost my job and I am looking for work 3 I have been temporarily laid off from the same job 4 I am on sick leave or other leave from the same job 5 I am now working at a different job 7 I am now retired 6 None of these, please specify:
lr001_other (other employment status)
STRING
End of group of questions
IF lr001 = 2 OR lr001 = 3 OR lr001 = 4 THEN
lr002 (still receiving benefits)
Are you still receiving benefits such as health insurance through your former job?
1 Yes 2 No 3 Unsure
End of if
Else
if corrected_hadjob = response then
if preload_lr001 = 3 OR preload_lr003aa = 2 OR preload_lr003bb = 4 OR preload_lr003ee = 3 OR preload_laborstatus_covid = 3 then
Group of questions presented on the same screen
lr003aa (job status after laid off)
You told us on [ ^FLDateEarlierSurvey] that you were temporarily laid off from your job. Which statement best reflects your current employment status?
1 I have resumed working at the same job 2 I am still temporarily laid off from the same job 3 I have lost my job and I am looking for work 4 I am on sick leave or other leave from the same job 5 I am now working at a different job 6 None of these, please specify:
lr003aa_other (other job status after laid off)
STRING
End of group of questions
elseif preload_lr001 = 4 OR preload_lr003bb = 2 OR preload_lr003aa = 4 OR preload_lr003ee = 2 OR preload_laborstatus_covid = 2 then
Group of questions presented on the same screen
lr003bb (job status after sick leave)
You told us on [ ^FLDateEarlierSurvey] that you were on sick leave or other leave from your job. Which statement best reflects your current employment status?
1 I have resumed working at the same job 2 I am still on sick leave or other leave from the same job 3 I have lost my job and I am looking for work 4 I have been temporarily laid off from the same job 5 I am now working at a different job 6 None of these, please specify:
lr003bb_other (other job status after sick leave)
STRING
End of group of questions
Else
if preload_lr001 = 7 OR preload_lr003 = 4 OR preload_lr003cc = 1 OR preload_lr003dd = 4 OR preload_lr003ee = 5 OR preload_laborstatus_covid = 5 then
Group of questions presented on the same screen
lr003cc (job status after retired)
You told us on [ ^FLDateEarlierSurvey] that you were retired. Which statement best reflects your current employment status?
1 I am still retired 2 I now have a job 3 I am unemployed and looking for work 4 None of these, please specify:
lr003cc_other (other job status after retired)
STRING
End of group of questions
elseif preload_lr003 = 5 OR preload_lr003dd = 1 OR preload_lr003ee = 6 OR preload_laborstatus_covid = 6 then
Group of questions presented on the same screen
lr003dd (job status after not in labor force)
You told us on [ ^FLDateEarlierSurvey] that you were not in the labor force. Which statement best reflects your current employment status?
1 I am still not in the labor force (not currently working and not looking for work) 2 I now have a job 3 I am unemployed and looking for work 4 I am retired 5 None of these, please specify:
lr003dd_other (other job status after not in labor force)
STRING
End of group of questions
elseif preload_laborstatus_covid = 7 then
Group of questions presented on the same screen
lr003ee (job status unknown labor force status)
Which statement best reflects your current employment status?
1 I have a job 2 I am on sick or other leave 3 I am temporarily laid off from my job 4 I am unemployed and looking for work 5 I am retired 6 I am not in the labor force (not currently working and not looking for work) 7 None of these, please specify:
lr003ee_other (other job status unknown labor status)
STRING
End of group of questions
Else
Group of questions presented on the same screen
lr003 (employment status prev no job)
You told us on [date of earlier survey[]] that you did not have a job. Which statement best reflects your current employment status:
1 I still do not have a job 2 I now have a job 4 I am retired 5 I am not in the labor force (not currently working and not looking for work) 3 None of these, please specify:
lr003_other (other employment status prev no job)
STRING
End of group of questions
End of if
End of if
Else
Group of questions presented on the same screen
lr003ee (job status unknown labor force status)
Which statement best reflects your current employment status?
1 I have a job 2 I am on sick or other leave 3 I am temporarily laid off from my job 4 I am unemployed and looking for work 5 I am retired 6 I am not in the labor force (not currently working and not looking for work) 7 None of these, please specify:
lr003ee_other (other job status unknown labor status)
STRING
End of group of questions
End of if
End of if
lr004 := 2
IF (corrected_hadjob = 1 AND (lr001 = 1 OR lr001 = 5)) THEN
lr004 := 1
ELSEIF (corrected_hadjob = 2 and preload_lr001 = 3 and lr003aa in [1,5]) then
lr004 := 1
ELSEIF (corrected_hadjob = 2 and preload_lr001 = 4 and lr003bb in [1,5]) then
lr004 := 1
ELSEIF (corrected_hadjob = response and preload_lr001 != 3 and preload_lr001 != 4 and preload_lr003 = 4 AND lr003cc = 2) then
lr004 := 1
ELSEIF (corrected_hadjob = response and preload_lr001 != 3 and preload_lr001 != 4 and preload_lr003 = 5 AND lr003dd = 2) then
lr004 := 1
ELSEIF (corrected_hadjob = 2 and preload_lr001 != 3 and preload_lr001 != 4 and lr003 = 2) then
lr004 := 1
ELSEIF (corrected_hadjob = empty and lr003ee = 1) then
lr004 := 1
ELSEIF lr003 = 2 then
lr004 := 1
ELSEIF lr003aa in [1,5] then
lr004 := 1
ELSEIF lr003bb in [1,5] then
lr004 := 1
ELSEIF lr003cc = 2 then
lr004 := 1
ELSEIF lr003dd = 2 then
lr004 := 1
ELSEIF lr003ee = 1 then
lr004 := 1
ELSEIF lr001 in [1,5] THEN
lr004 := 1
End of if
IF lr004 = 1 THEN
Group of questions presented on the same screen
lr005 (self employed or work for employer)
In your primary job, are you self-employed or do you work for an employer?
1 Self-employed 2 Work for an employer 3 Other (specify)
lr005_other (self employed or work for employer other)
STRING
End of group of questions
lr019 (describe primary job)
Do any of the following describe your primary job? Please check all that apply.
1 Independent contractor (for example, freelance worker, Uber driver, Instacart worker, independent consultant) 2 On-call worker or day laborer 3 Temporary agency worker 4 Contract company worker 5 None of the above
lr006 (how many day work past seven days)
Out of the past seven days, how many days did you work at your job?
0 0 days 1 1 day 2 2 days 3 3 days 4 4 days 5 5 days 6 6 days 7 7 days
lr008 (home many hours work for pay past 7 days)
Think of every day you worked in the past seven days. How many total hours did you work for pay across all the days?
RANGE 0..150
lr007 (how many day work from home past seven days)
Out of the past seven days, how many days did you work from home?
0 0 days 1 1 day 2 2 days 3 3 days 4 4 days 5 5 days 6 6 days 7 7 days
if lr007 = 0 then
lb004 (able to work from home)
Consider your current job. Are you able to do that job from home at least partially?
[For example, a bartender is not able to do their job from home; an administrative assistant working in an office should be able to work from home, at least partially]
1 Yes 2 No
End of if
if lr007 > 0 OR (lr007 = 0 AND lb004 = 1) then
lb005 (how often like to work from home)
Looking ahead to the next three months, how often would you like to work from home, whether you think you will be able to or not?
1 5+ days per week 2 4 days per week 3 3 days per week 4 2 days per week 5 1 day per week 6 Less than 1 day per week 7 Never
if lr005 = 2 then
lb006 (how often employer planning to work from home next six months)
Looking ahead to the next three months, how often is your employer planning for you to work from home?
1 5+ days per week 2 4 days per week 3 3 days per week 4 2 days per week 5 1 day per week 6 Less than 1 day per week 7 Never 8 I don't know
End of if
End of if
Group of questions presented on the same screen
lr010 (how frequently paid)
How frequently are you paid for your job?
1 Monthly 6 Twice a month 2 Every two weeks 3 Every week 4 Every day 5 Other (specify)
lr010_other (how frequently paid other)
How frequently are you paid?
STRING
End of group of questions
Loop from 1 to 5
lr011 (amount most recent paycheck)
What was the amount on your most recent paycheck?
RANGE 0..10000000
IF lr011 > 50000 THEN
check_lr011 (amount over 50k)
You entered an amount over $50,000. Is this correct?
1 Yes 2 No
ELSEIF lr011 = response and lr011 < 30 then
lr011a (confirm paycheck amount)
You said your last paycheck was $[amount most recent paycheck[]]. Is this correct?
1 Yes, it is correct 2 No, I made a mistake 3 I did not receive a paycheck in the past fourteen days 4 I do not recall the amount of my last paycheck 5 I prefer not to answer
if lr011a != 2 then
End of if
Else
End of if
End of loop
lr012_ask := 2
if lr011 > 29 OR (lr011 < 30 and lr011a = 1) then
lr012_ask := 1
End of if
if lr011 = empty OR (lr011 = response and lr011 < 30 AND lr011a = 4) then
if lr010 = 1 then
lr011b_i (paycheck monthly)
For the most recent paycheck for your job, would you say the amount was
1 Lower than $1,500 2 Between $1,500 and $3,000 3 Between $3,000 and $4,500 4 Between $4,500 and $6,000 5 Higher than $6,000 6 Prefer not to answer 7 Don't know
if lr011b_i in [1,2,3,4,5] then
lr012_ask := 1
End of if
elseif lr010 in [2,6] then
lr011b_ii (paycheck twice a month or every two weeks)
For the most recent paycheck for your job, would you say the amount was
1 Lower than $750 2 Between $750 and $1,500 3 Between $1,500 and $2,250 4 Between $2,250 and $3,000 5 Higher than $3,000 6 Prefer not to answer 7 Don't know
if lr011b_ii in [1,2,3,4,5] then
lr012_ask := 1
End of if
elseif lr010 = 3 then
lr011b_iii (paycheck every week)
For the most recent paycheck for your job, would you say the amount was
1 Lower than $375 2 Between $375 and $750 3 Between $750 and $1,125 4 Between $1,125 and $1,500 5 Higher than $1,500 6 Prefer not to answer 7 Don't know
if lr011b_iii in [1,2,3,4,5] then
lr012_ask := 1
End of if
elseif lr010 = 4 then
lr011b_iv (paycheck every day)
For the most recent paycheck for your job, would you say the amount was
1 Lower than $75 2 Between $75 and $150 3 Between $150 and $300 4 Between $300 and $600 5 Higher than $600 6 Prefer not to answer 7 Don't know
if lr011b_iv in [1,2,3,4,5] then
lr012_ask := 1
End of if
elseif lr010 = 5 then
lr011b_v (paycheck other frequency)
For the most recent paycheck for your job, would you say the amount was
1 Lower than $375 2 Between $375 and $750 3 Between $750 and $1,500 4 Between $1,500 and $3,000 5 Higher than $3,000 6 Prefer not to answer 7 Don't know
if lr011b_v in [1,2,3,4,5] then
lr012_ask := 1
End of if
End of if
End of if
if lr010 = 4 OR lr010 = 5 OR lr005 = 1 then
lr011c (takeaway amount last month)
Overall, taking into account all sources of income related to your job(s) and/or business, what was your income or “take home pay” in the past month?
RANGE 0..10000000
if lr011c > 50000 then
check_lr011c (takeaway amount over 50k)
You entered an amount over $50,000. Is this correct?
1 Yes 2 No
elseif lr011c = empty then
lr011c_i (followup takeaway amount past month)
Would you say that your income or "take home pay" in the past month was:
1 Lower than $1,500, 2 Between $1,500 and $3,000 3 Between $3,000 and $4,500 4 Between $4,500 and $6,000 5 Higher than $6,000 6 Prefer not to answer 7 Don't know
End of if
End of if
lr026 (currently interaction within six feet)
How often does your job currently require you to come within six feet of other people (such as customers, clients, patients, or coworkers)?
1 Never 2 Less than once per week 3 1-2 times per week 4 Several times per week 5 Nearly every day 6 Every day
End of if
Group of questions presented on the same screen
ei001 (chance run out of money)
The coronavirus may cause economic challenges for some people regardless of whether they are actually infected.
What is the percent chance you will run out of money because of the coronavirus in the next three months?
cr_error
Please enter a number between 0% and 100%.
End of group of questions
if preload_UAS468_ei002 = response then
ei002 := preload_UAS468_ei002
Else
ei002 (worried you would run out of food)
In the past seven days, were you worried you would run out of food because of a lack of money or other resources?
1 Yes 2 No 3 Unsure
End of if
if preload_UAS468_ei003 = response then
ei003 := preload_UAS468_ei003
Else
ei003 (did you eat less)
In the past seven days, did you eat less than you thought you should because of a lack of money or other resources?
1 Yes 2 No 3 Unsure
End of if
if preload_UAS468_ei004 = response then
ei004 := preload_UAS468_ei004
Else
ei004 (did you go without eating)
In the past seven days, did you go without eating for a whole day because of a lack of money or other resources?
1 Yes 2 No 3 Unsure
End of if
if preload_UAS468_ei011 = response then
ei011 := preload_UAS468_ei011
Else
ei011 (do you have a mortgage)
Do you have a mortgage?
1 Yes 2 No
End of if
IF ei011 = 1 THEN
ei012 (permission to delay mortgage payment)
Have you received permission from your lender to delay or reduce payment on your mortgage?
1 Yes 2 No
if preload_UAS468_ei013 > 0 then
ei013 := 1
elseif preload_UAS468_ei013 = 0 then
ei013 := 2
Else
ei013 (past month delay payment on mortgage)
In the past month, did you miss or delay payment on your mortgage, or did you pay less than the full amount?
1 Yes 2 No
End of if
End of if
if preload_UAS468_ei014 = 1 then
ei014 := 1
elseif preload_UAS468_ei014 > 1 then
ei014 := 2
Else
ei014 (rent primary residence)
Do you rent your primary residence?
1 Yes 2 No
End of if
IF ei014 = 1 THEN
ei015 (permission to delay or reduce rent payment)
Have you received permission from your landlord to delay or reduce payment of your rent?
1 Yes 2 No
if preload_UAS468_ei013 > 0 then
ei016 := 1
elseif preload_UAS468_ei013 = 0 then
ei016 := 2
Else
ei016 (past month missed or delay rent payment)
In the past month, did you miss or delay payment of your rent, or did you pay less than the full amount?
1 Yes 2 No
End of if
End of if
ei030 (have you been evicted or foreclosed, received an eviction or foreclosure notice)
[Since ^FLDateEarlierSurvey/Since April 1, 2020], have you been evicted or foreclosed, received an eviction or foreclosure notice, or been told by a landlord to move from your residence?
1 Yes, I have been, or am currently being, evicted or foreclosed from my residence 2 Yes, I have received an eviction or foreclosure notice, but have not yet been evicted or foreclosed from my residence 3 Yes, I have been told by a landlord to leave my residence, but have not yet received a written eviction notice 4 No, I have not been evicted or foreclosed, received an eviction or foreclosure notice, or been told by a landlord to leave my residence
if ei030 in [2,3,4] then
Group of questions presented on the same screen
ei031 (chance will be evicted)
What is the percent chance that you will be evicted, go into foreclosure, or be forced by a landlord to move from your current residence in the next thirty days? If you are not sure, please give your best guess.
ei031_na (does not apply chance will be evicted)
OR
1 Does not apply to my housing situation
ei_error
Please select a value or check the box.
End of group of questions
End of if
ei017 (how confident you could come up with 2000)
How confident are you that you could come up with $2,000 if an unexpected need arose within the next month?
1 I am certain I could come up with the full $2,000 2 I could probably come up with $2,000 3 I could probably not come up with $2,000 4 I am certain I could not come up with $2,000 5 Don’t know 6 Prefer not to say
ei019 (something been stolen in last 7 days)
In the past seven days, has anything belonging to you been stolen, such as a wallet or purse, clothing, jewelry, things in your home, or things in your vehicle?
1 Yes 2 No 3 Unsure
Group of questions presented on the same screen
ei020_intro (My neighborhood is clean)
Do you agree or disagree with each of the following statements?
sl090 (confirmation selected child when gotten third dose)
In our last survey a few months ago you answered questions about [previous survey k-12 selected names[]]'s experiences. Is [previous survey k-12 selected names[]] still under the age of 18 and still living in your household?
1 Yes, [previous survey k-12 selected names[]] is under age 18 and still living in my household 2 Yes, but their name is incorrect or misspelled 3 No, they are not living in my household or are at least 18 years old
if sl090 = 2 then
sl091 (new name selected child)
What is [previous survey k-12 selected names[]]'s correct first name or nickname?
STRING
selectedchild := preload_selectedchild
selectednames := preload_selectednames
selectednames[selectedchild] := sl091
haveselectedchild := 1
elseif sl090 = 3 then
haveselectedchild := 2
selectedchild := empty
sl092_text
Since [previous survey k-12 selected names[]] is no longer under the age of 18, we will select a new child from your household.
Else
selectedchild := preload_selectedchild
selectednames := preload_selectednames
haveselectedchild := 1
End of if
End of if
if selectedchild = empty then
Group of questions presented on the same screen
sl015b_intro
You said that there is/are [number of hh members 5-17 years old[]] household members aged 5-17 in your household. What are their first names or nicknames? We are asking so that we can select a specific child for the following questions.
Loop from 1 to SL082
sl015b (name student)
STRING
End of loop
End of group of questions
Loop from 1 to SL082
if sl015b[checkcnt] = empty then
if sl082 > 1 then
checkcntwarning
You said that [number of hh members 5-17 years old[]] household members are currently 5-17 years old. Please go back and give all of their names or nicknames OR click "Next" to continue.
Else
checkcntwarning_single
You said that [number of hh members 5-17 years old[]] household member is currently 5-17 years old. Please go back and give their name or nickname OR click "Next" to continue.
1 Parent 2 Grandparent 3 Sibling 4 Other family member (e.g., aunt, uncle, cousin) 5 Non-family member (e.g., friend, child-care provider) 6 Other, please specify:
sc026_other (other relationship to selected child)
STRING
End of group of questions
sc027 (parent guardian to selected child)
Are you the parent or a legal guardian of [[]]?
1 Yes 2 No
if sc026 != 1 and sc027 != 1 then
sc029 (willing to answer child if not parent or guardian)
Would you be willing to answer some questions about [[]]'s vaccination-related experiences over the past 6 months? You will have the option to skip any questions you don’t want to answer.
1 (YES) Yes 2 (NO) No
End of if
if sc026 = 1 OR sc027 = 1 OR (sc026 != 1 and sc027 != 1 and sc029 = 1) then
sc028 (gender selected child)
What is [[]]'s gender?
1 Male 2 Female 3 Non-binary 4 Other
sv009 (been tested covid selected child)
Has [[]] been tested for the coronavirus[ since ^FLDateEarlierSurvey (when you last took our coronavirus survey)]?
1 Yes 2 No 3 Unsure
if sv009 in [1,3] then
sv017 (how often tested for covid selected child)
How many times has [[]] been tested[ since ^FLDateEarlierSurvey (when you last took our coronavirus survey)]?
1 [[]] only tested positive ([[]] had the coronavirus) 2 [[]] only tested negative ([[]] did not have the coronavirus) 3 [[]] tested both negative and positive 4 We do not know the results
if sv018 in [1,3] then
Group of questions presented on the same screen
sv010_month (month selected child first positive covid)
On what date did [[]] first test positive[ since ^FLDateEarlierSurvey (when you last took our coronavirus survey)]?
1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December
sv010_day (day selected child first positive covid)
if preload_sv003 = response AND haveselectedchild = 1 then
Fill code of question 'FL_sv013' executed
sv013 (confirmation selected child gotten number of doses)
You previously told us that [[]] had received [^preload_sv003 doses/^preload_sv003 dose] of the coronavirus vaccine. Is this still correct, or has [[]] received any additional doses or boosters since then?
1 Yes, [[]] has received this many doses 2 No, [[]] has received additional doses/boosters since then 3 Unsure
if sv013 = 1 then
sv003 := preload_sv003
Else
sv003 (how many doses vaccinated selected child)
How many doses of the vaccine has [[]] received?
0 0 1 1 2 2 3 3 4 4 or more
End of if
Else
sv003 (how many doses vaccinated selected child)
How many doses of the vaccine has [[]] received?
0 0 1 1 2 2 3 3 4 4 or more
End of if
if sv003 = 0 then
sv003_warning (how many doses vaccinated selected child)
You said [[]] was vaccinated but that he or she received zero vaccine doses. Please go back and correct your answers.
if preload_sv004_year = response and preload_sv004_month = response and preload_sv004_day = response AND haveselectedchild = 1 then
sv014 (confirmation selected child when gotten first dose)
You previously told us that [[]] received their first dose of the coronavirus vaccine on [preloaded month first dose selected child[]] [preloaded day first dose selected child[]], [preloaded year first dose selected child[]]. Is this correct?
1 Yes 2 No 3 Unsure
if sv014 = 1 then
sv004_month := preload_sv004_month
sv004_day := preload_sv004_day
sv004_year := preload_sv004_year
Else
sv004_month := preload_sv004_month
sv004_day := preload_sv004_day
sv004_year := preload_sv004_year
Group of questions presented on the same screen
sv004_month (month first dose selected child)
When did [[]] receive his or her first dose?
1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December
if preload_sv005_year = response and preload_sv005_month = response and preload_sv005_day = response AND haveselectedchild = 1 then
sv015 (confirmation selected child when gotten second dose)
You previously told us that [[]] received their second dose of the coronavirus vaccine on [preloaded month second dose selected child[]] [preloaded day second dose selected child[]], [preloaded year second dose selected child[]]. Is this correct?
1 Yes 2 No 3 Unsure
if sv015 = 1 then
sv005_month := preload_sv005_month
sv005_day := preload_sv005_day
sv005_year := preload_sv005_year
Else
sv005_month := preload_sv005_month
sv005_day := preload_sv005_day
sv005_year := preload_sv005_year
Group of questions presented on the same screen
sv005_month (month second dose selected child)
When did [[]] receive his or her second dose?
1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December
if preload_sv006_year = response and preload_sv006_month = response and preload_sv006_day = response AND haveselectedchild = 1 then
sv016 (confirmation selected child when gotten third dose)
You previously told us that [[]] received their third dose of the coronavirus vaccine on [preloaded month third dose selected child[]] [preloaded day third dose selected child[]], [preloaded year third dose selected child[]]. Is this correct?
1 Yes 2 No 3 Unsure
if sv016 = 1 then
sv006_month := preload_sv006_month
sv006_day := preload_sv006_day
sv006_year := preload_sv006_year
Else
sv006_month := preload_sv006_month
sv006_day := preload_sv006_day
sv006_year := preload_sv006_year
Group of questions presented on the same screen
sv006_month (month third dose selected child)
When did [[]] receive his or her third dose?
1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December
Why hasn't [[]] been vaccinated for the coronavirus yet? Please mark all that apply.
1 [[]] doesn't want to get vaccinated. 2 I don't want [[]] to get vaccinated. 3 Another family member doesn't want [[]] to get vaccinated. 4 We don't know how to schedule an appointment. 5 We don't know where to go for the vaccine. 6 We are waiting for a vaccine provider to contact us. 7 The vaccine providers are too far away. 8 There is a vaccine shortage in my community. 9 We don't have access to transportation. 10 We don't have access to a phone or computer. 11 We don't have time. 12 We are physically unable to travel. 13 We believe the vaccine is not effective. 14 We believe the vaccine is unsafe. 15 [[]] doesn't need the vaccine. 16 The vaccine is not available in my community for people like [[]]. 17 [[]] is not required to get vaccinated. 18 Other, please specify:
sv008_other (other why not vaccinated selected child)
STRING
End of group of questions
End of if
sv022 (how likely regular booster selected child)
If periodic COVID-19 boosters are recommended in the US for the next few years for children, how likely is it that [[]] will get a booster as often as recommended? The recommended frequency is not known, but it may be once a year or every six months.
1 Very unlikely 2 Somewhat unlikely 3 Somewhat likely 4 Very likely 5 Unsure
sv023 (why not likely regular booster selected child)
Why is [[]] unlikely to get a booster as often as recommended? Please mark all that apply.
1 It is not convenient 2 We don't have enough time 3 [[]] won't get boosters if [[]]'s doctor does not recommend them to [[]] personally 4 [[]] won't get boosters if [[]]'s school or other places [[]] frequently visits don't require them 5 I don't feel a booster would add protection against COVID infection 6 I am concerned about the potential side effects of a booster for [[]] 7 I am concerned boosters may not be safe for [[]] 8 Other, please specify:
sv023_other (other why not likely regular booster selected child)
pv001 (number of hh members at least 6 months old but not yet 5 years old)
How many members of your household are at least 6 months old but not yet 5 years old?
0 0 1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 10 10
if pv001 > 0 then
Group of questions presented on the same screen
pv002_intro
Please list the first names or nicknames of the [number of hh members at least 6 months old but not yet 5 years old[]] children in your household who are at least 6 months old but not yet 5 years old.
Loop from 1 to PV001
pv002 (name 0-5 child)
STRING
End of loop
End of group of questions
Loop from 1 to PV001
if pv002[checkcnt] = empty then
if pv001 > 1 then
checkcntwarning_pv
You said that [number of hh members at least 6 months old but not yet 5 years old[]] household members are currently at least 6 months old but not yet 5 years old. Please go back and give all of their names or nicknames OR click "Next" to continue.
Else
checkcntwarning_single_pv
You said that [number of hh members at least 6 months old but not yet 5 years old[]] household member is currently at least 6 months old but not yet 5 years old. Please go back and give their name or nickname OR click "Next" to continue.
if pv_selectednames[pv_selectedchild] = response then
End of if
End of loop
End of if
if pv_selectedchild = response and pv_selectednames[pv_selectedchild] = response then
pv003 (how old selected 0-5 child)
How old is [[]]?
1 6-11 months 2 1 year 3 2 years 4 3 years 5 4 years
Group of questions presented on the same screen
pv017 (relationship to selected child)
What is your relationship to [[]]?
1 Parent 2 Grandparent 3 Sibling 4 Other family member (e.g., aunt, uncle, cousin) 5 Non-family member (e.g., friend, child-care provider) 6 Other, please specify:
pv017_other (other relationship to selected child)
STRING
End of group of questions
pv018 (parent guardian to 0-5 selected child)
Are you the parent or a legal guardian of [[]]?
1 Yes 2 No
if pv017 != 1 and pv018 != 1 then
pv020 (willing to answer 0-5 child if not parent or guardian)
Would you be willing to answer some questions about [[]]'s vaccination-related experiences over the past 6 months? You will have the option to skip any questions you don’t want to answer.
1 (YES) Yes 2 (NO) No
End of if
if pv017 = 1 OR pv018 = 1 OR (pv017 != 1 and pv018 != 1 and pv020 = 1) then
pv004 (gender 0-5 selected child)
What is [[]]'s gender?
1 Male 2 Female 3 Non-binary 4 Other
pv005 (vaccinated 0-5 selected child)
Has [[]] gotten vaccinated for the coronavirus?
1 Yes 2 No 3 Unsure
if pv005 = 1 then
pv006 (how many doses vaccinated 0-5 selected child)
How many doses of the vaccine has [[]] received?
0 0 1 1 2 2 3 3 or more
if pv006 = 0 then
pv006_warning (how many doses vaccinated selected child)
You said [[]] was vaccinated but that he or she received zero vaccine doses. Please go back and correct your answers.
End of if
if pv006 > 0 then
Group of questions presented on the same screen
pv007_month (month first dose 0-5 selected child)
When did [[]] receive his or her first dose?
1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December
If periodic COVID-19 boosters are recommended in the US for the next few years for children, how likely is it that [[]] will get a booster as often as recommended? The recommended frequency is not known, but it may be once a year or every six months.
1 Very unlikely 2 Somewhat unlikely 3 Somewhat likely 4 Very likely 5 Unsure
pv022 (why not likely regular booster 0-5 selected child)
Why is [[]] unlikely to get a booster as often as recommended? Please mark all that apply.
1 It is not convenient 2 We don't have enough time 3 [[]] won't get boosters if [[]]'s doctor does not recommend them to [[]] personally 4 [[]] won't get boosters if [[]]'s school or other places [[]] frequently visits don't require them 5 I don't feel a booster would add protection against COVID infection 6 I am concerned about the potential side effects of a booster for [[]] 7 I am concerned boosters may not be safe for [[]] 8 Other, please specify:
pv022_other (other why not likely regular booster 0-5 selected child)
STRING
End of group of questions
End of if
Group of questions presented on the same screen
pv019_intro
Do you agree or disagree with the following statements?
Subgroup of questions
pv019a (feel responsible is vaccinated for the coronavirus and becomes sick)
I would feel responsible if [[]] were vaccinated for the coronavirus and became sick
Next, we would like to ask a few questions about your religious affiliation, if any.
Group of questions presented on the same screen
rl001 (present religion)
What is your present religion, if any?
1 Protestant 2 Roman Catholic 3 The Church of Jesus Christ of Latter Day Saints (Mormon) 4 Orthodox such as Greek or Russian Orthodox 5 Jewish 6 Muslim 7 Buddhist 8 Hindu 9 Atheist 10 Agnostic 11 Something else, please specify: 12 Nothing in particular
rl001_other (other present religion)
STRING
End of group of questions
rl005 (how long ago first identify with present religion)
How long ago did you first identify with your present religion, if any?
1 Less than 6 months ago 2 6-12 months ago 3 1-5 years ago 4 5 years ago or more 5 Unsure
if rl001 in [1,2,3,4,11] then
rl002 ( born-again or evangelical Christian)
Would you describe yourself as a born-again or evangelical Christian, or not?
1 Yes 2 No 3 Unsure
if rl002 = 1 then
rl006a (how long ago first describe as born-again or evangelical Christian)
How long ago did you first describe yourself as a born-again or evangelical Christian?
1 Less than 6 months ago 2 6-12 months ago 3 1-5 years ago 4 5 years ago or more 5 Unsure
elseif rl002 = 2 then
rl006b (how long ago first describe as not born-again or evangelical Christian)
How long ago did you first describe yourself as not born-again or evangelical Christian?
1 Less than 6 months ago 2 6-12 months ago 3 1-5 years ago 4 5 years ago or more 5 Unsure
End of if
End of if
if rl001 in [1,11] then
Group of questions presented on the same screen
rl003 (denomination or church identify most with)
As far as your present religion, what denomination or church, if any, do you identify with most closely?
1 Baptist 2 Methodist 3 Lutheran 4 Presbyterian 5 Pentecostal 6 Episcopalian or Anglican 7 Church of Christ or Disciples of Christ 8 Congregational or United Church of Christ 9 Holiness 10 Reformed 11 Church of God 12 Nondenominational or independent church 13 Something else, please specify: 14 None in particular
rl003_other (other denomination or church identify most with)
STRING
End of group of questions
if rl003 = 1 then
Group of questions presented on the same screen
rl004 (baptist identify most with)
Which of the following Baptist churches, if any, do you identify with most closely?
1 The Southern Baptist Convention 2 The American Baptist Churches in the USA 3 National Baptist Convention 4 Progressive Baptist Convention 5 An independent Baptist church 6 Some other Baptist church, please specify:
rl004_other (other baptist identify most with)
STRING
End of group of questions
End of if
rl007 (how long ago first identify with current denomination or church)
How long ago did you first identify with your current denomination or church?
1 Less than 6 months ago 2 6-12 months ago 3 1-5 years ago 4 5 years ago or more 5 Unsure
End of if
tn001 (anyone in HH ages 13-17)
Are there any children between the ages of 13-17 who live in your household? Include any children who live in your household full time or part time.
1 Yes 2 No 3 Unsure
if tn001 = 1 or tn001 = 3 then
tn001a (legal guardian of teen)
Are you the parent or a legal guardian of any of the children in your household who are between the ages of 13 and 17?
1 (YES) Yes 2 (NO) No
if tn001a = 1 then
tn000_info1
We are considering a new survey project and would like your feedback. We are interested in inviting 13- to 17-year-olds living in households with UAS members to participate in surveys like you do. Asking questions directly to teens will help us understand their experiences and allow us to ask them directly about their well-being.
Right now we are only trying to estimate how many teens might be allowed to participate. We do not need a firm “yes” or “no” right now, but would like a general sense of if you might allow your teen to participate.
if tn000_random = empty then
tn000_random := mt_rand(0,1)
End of if
Fill code of question 'FLtn000_info2' executed
tn000_info2
Here’s how this would work:
Teens would be invited (via text or email) to complete short surveys a few times a year.
We would ask for their first name or a nickname, and the best way to contact them. This information would only be used to invite them to do surveys – it would not be used in any other way.
The questions would ask about their school experiences and general well-being. For example: how they feel about their teachers, how well they are doing in school, whether or not they are planning to go to college, and more generally how they feel day to day.
Teens would be asked only about their own experiences and opinions, not about you or your household.
[
You would be able to review questions in advance.
]
We would protect the teens’ privacy in the same way we protect yours. This means we would never share their answers with anyone in a way in which they could be identified. Their names would never be connected to their answers.
Just like you, each teen could decide whether or not to complete any specific survey, and they could choose whether or not to answer each question in the survey.
We would pay each teen a similar amount to what you earn for doing UAS surveys.
Doing UAS surveys is completely voluntary. You or your teen could always opt out later.
tn002 (whether would allow teen to participate)
Based on this description would you allow your teen(s) to participate? Note: This is not a commitment. If this project goes forward, we will explain it again, answer any of your questions, and seek consent to enroll your teen.
1 Definitely yes 2 Probably yes 3 Probably no 4 Definitely no 5 I need more information before deciding
if tn002 = 3 or tn002 = 4 then
tn003 (why it is unlikely teen will be allowed to participate)
Could you tell us briefly why you are unlikely to allow your teen(s) to participate in the project?
STRING
elseif tn002 = 1 or tn002 = 2 then
tn004 (how likely teen would agree to join project)
How likely do you think it is that your teen (or one of them, if you have more than one) would agree to join the project? Just your best guess is helpful – we are trying to figure out how many teens might participate.
1 Definitely yes 2 Probably yes 3 Probably no 4 Definitely no 5 Not sure
tn005 (how likely teen would complete the surveys when invited)
And, if they agreed to participate, how likely do you think it is that your teen would complete the surveys when invited?
1 Definitely would 2 Probably would 3 Probably would not 4 Definitely would not 5 Not sure
elseif tn002 = 5 then
tn006 (more information about project--FAQ)
You indicated that you would need more information before deciding. Here are some answers to common questions about the proposed project:
tn007 (would allow teen to participate after reading more about project)
After having read more about this possible project, would you allow your teen(s) to participate? Remember that you will be provided with more information if this project goes forward, and you will have the chance to answer yes or no at that time.
1 Definitely yes 2 Probably yes 3 Probably no 4 Definitely no
End of if
tn_closing
Thank you for helping us gauge the feasibility of this potential project!
End of if
End of if
CS_001 (HOW PLEASANT INTERVIEW)
Could you tell us how interesting or uninteresting you found the questions in this interview?
1 Very interesting 2 Interesting 3 Neither interesting nor uninteresting 4 Uninteresting 5 Very uninteresting
CS_003 (comments)
Do you have any other comments on the interview? Please type these in the box below. (If you have no comments, please click next to complete this survey.)