SRD- ASS 1B
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04549-0003-Questionnaire.pdf
The 500 Family Study [1998-2000: United States]
ICPSR 4549
Barbara Schneider University of Chicago. National Organization for Research and Computing (NORC). Alfred P. Sloan Center on Parents, Children and Work
Linda J. Waite University of Chicago. National Organization for Research and Computing (NORC). Alfred P. Sloan Center on Parents, Children and Work
Parent Data Questionnaires
P.O. Box 1248 Ann Arbor, Michigan 48106
www.icpsr.umich.edu
About Research Connections
These data are made available by the Child Care and Early Education Research Connections project. Research Connections promotes high quality research in child care and early education and the use of that research in policymaking.
Research Connections is operated by the National Center for Children in Poverty at the Mailman School of Public Health, Columbia University and the Inter-university Consortium for Political and Social Research at the Institute for Social Research, University of Michigan, through a cooperative agreement with the Child Care Bureau, Office of Family Assistance and the Office of Planning, Research, and Evaluation, Administration for Children and Families in the U.S. Department of Health and Human Services.
Terms of Use The terms of use for this study can be found at:
http://www.icpsr.umich.edu/cocoon/ICPSR/TERMS/4549.xml
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Part I. Your Family's Background 1. What is your relationship and that of your spouse/partner to the teenager participating in this study? Source: Modified from 1990 U.S. Census
(CIRCLE ONE IN EACH COLUMN)
You Your Spouse/ Partner
Biological Mother ............................ 1 ...................................... 1
Adoptive Mother .............................. 2....................................... 2
Biological Father .............................. 3 ...................................... 3
Adoptive Father ................................ 4 ...................................... 4
Stepmother ....................................... 5 .......................................5
Stepfather ......................................... 6 .......................................6
Grandmother .....................................7 ......................................7
Grandfather ...................................... 8 .......................................8
Other female relative ........................ 9 .......................................9
Other male relative .......................... 10 .................................... 10
Other adult female ........................... 11 .................................... 11 (such as e.g. foster mother or guardian)
Other adult male ............................... 12 ................................... 12 (such as e.g. foster father or guardian) Does not apply, no .....................................................................13 other parent/guardian 2. How much of the time does the teenager participating in this study live with you? Source: Modified from 1990 U.S. Census
(CIRCLE ONE)
All of the time ............................................................................ 1 --> SKIP TO QUESTION 4
Most of the time ............................................ ............................ 2
Half of the time ............................................. ............................ 3
Less than half of the time .............................. ............................ 4
3. With whom does the teenager participating in this study live most of the time when he/she does not live with you? Source: Modified from 1990 U.S. Census
(CIRCLE ONE)
By himself/herself ...................................................................... 1
With his or her other parent ....................................................... 2
With another adult relative ........................................................ 3
He/she lives at boarding school ................................................. 4
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He/she lives at college ............................................................... 5
4. Does your teenager have another parent (biological or adoptive) who lives outside of your home? Source: Modified from 1990 U.S. Census
(CIRCLE ONE) No .......................................................................................................................... 0 --> SKIP TO QUESTION 7 Yes ......................................................................................................................... 1
5. How often does this non-resident parent visit your teenager? Source: Modified from 1990 U.S. Census
(CIRCLE ONE) Never .................................................................................................................... 0
Once or twice a year ............................................................................................. 1
Less than once a month ......................................................................................... 2
Twice a month ....................................................................................................... 3
Once a week .......................................................................................................... 4
Everyday ............................................................................................................... 5
6. How much help does your teen's non-resident parent give you regarding...
Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE ON EACH LINE)
None A little Some A Good Amount A lot a. Financial or material support of your teen? ........................... 0 ............ 1 ............... 2 ................ 3 ...................... 4 b. Emotional support of your teen ?.......... 0 .............1 ................2 ................. 3 .................... 4 c. Decisions about your teen's education (e.g., where teen attends school)?...................................... 0 .............1 ............... 2 ..................3 .....................4
7. What is your current marital status? Source: Modified from 1990 U.S. Census
(CIRCLE ONE)
Single, never married ............................................................................... 1 --> SKIP TO QUESTION 10
Married .................................................................................................. 2
Not married but living in a marriage-like relationship ................................................................. 3 Divorced ................................................................................................. 4 --> SKIP TO QUESTION 9
Separated ................................................................................................ 5 --> SKIP TO QUESTION 9
Widowed ................................................................................................ 6 --> SKIP TO QUESTION 9
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8. When did you and your current spouse/partner start living together? Please tell us the month/year or your
best guess: Source: Modified from 1990 U.S. Census
__________ 19________ Month Year
9. How many times have you been married? Source: Modified from 1990 U.S. Census
(CIRCLE ONE)
Never married ......................................................................................... 0
Once ........................................................................................................ 1
Twice ..................................................................................................... 2
More than two times ............................................................................... 3
10. Which best describes you?
Source: National Educational Longitudinal Study (NELS: 88/92)
(CIRCLE ALL THAT APPLY)
Asian or Pacific Islander ......................................................................... 1
Hispanic, regardless of race .................................................................... 2
Black, not of Hispanic origin .................................................................. 3
White, not of Hispanic origin .................................................................. 4
American Indian or Alaskan Native ........................................................ 5
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11. Please complete the following chart for all people in your household. Include all of the children in your family, even if they are not living at home. Source: Modified from 1990 U.S. Census
Instructions: Please fill in a word or number code for each question
a. What is this person=s name? (Last, First)
b. Gender Male = 0 Female = 1
c. Date of Birth
Mo/Yr
d. Does this person currently live in the home? No = 0 Yes = 1
e. Relationship to child Enter number from list below
1
2
3
4
5
6
7
8
12. What is this person=s relationship to your teen? Write a number from the list below into column "e" of the chart. 0. This person is the teen in the study Teen=s Relative: 1. Birth Parent 6. Paternal Grandparent 11. Step Sibling 2. Adoptive Parent 7. Aunt/Uncle 12. Adoptive Sibling 3. Step Parent 8. Cousin 13. Foster Sibling 4. Foster Parent 9. Full Sibling 14. Other Relative 5. Maternal Grandparent 10. Half Sibling
Not Teen=s Relative: 15. Your Boyfriend/Girlfriend/Partner 18. Housekeeper 16. Nanny 19. Other Nonrelative ________ _____
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17. Roomer/Boarder in Your Home (Please write in relationship) 13. Do you or your teen often speak a language other than English at home? Source: Modified from 1990 U.S. Census
(CIRCLE ONE FOR EACH PERSON) No Yes a. You ..................................................................................... 0 .................... 1 --> If yes, Which language? (CIRCLE ONE) 1. Spanish 2. Other language b. Your Teen .......................................................................... 0 ..................... 1 --> If yes, Which language? (CIRCLE ONE) 1. Spanish 2. Other language 14. In what country were you, your spouse/partner, and your teen born? Source: Modified from 1990 U.S. Census
(CIRCLE ONE FOR EACH PERSON) United States Other Country a. You ......................................... 1 ........................... 2 -->> please specify ____________________ ___________ (country) Yr. Came to U.S. b. Your Spouse/Partner ............... 1 ........................... 2 -->> please specify ____________________ __________ (country) Yr. Came to U.S. c. Teen ....................................... 1 ............................. 2 -->> please specify ____________________ __________ (country) Yr. Came to U.S. 15. What is your religious background? Source: NELS: 88/92
(CIRCLE ONE)
Baptist .............................................................................................................. 1
Methodist ......................................................................................................... 2
Lutheran ........................................................................................................... 3
Presbyterian........................................................................................................4
Episcopalian.......................................................................................................5
Pentecostal.........................................................................................................6
Other Protestant.................................................................................................7
Roman Catholic................................................................................................ 8
Eastern Orthodox...............................................................................................9
Mormon............................................................................................................ 10
Other Christian................................................................................................. 11
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Jewish............................................................................................................... 12
Muslim............................................................................................................. 13
Eastern Religion (Buddhist, Hindu, Tao)......................................................... 14
Other Religion.................................................................................................. 15
None................................................................................................................. 16
16. In the past year, about how often have you attended religious services? Source: NELS: 88/92
(CIRCLE ONE)
Not at all .......................................................................................................... 0
Several times a year or less .............................................................................. 1
About once a month ..........................................................................................2
Two or three times a month ..............................................................................3
About once a week ........................................................................................... 4
More than once a week .................................................................................... 5
17. Do you think of yourself as a religious person? Source: NELS: 88/92
(CIRCLE ONE)
No, not at all ................................................................................................... 0
Yes, somewhat ................................................................................................ 1
Yes, very ......................................................................................................... 2
18a. Does any person in your household have a severe physical disability, chronic illness, learning disability or mental illness that requires treatment or care? Source: Alfred P. Sloan Working Families Center, 1999 No 0 --> SKIP TO QUESTION 19 Yes 1 18b. If yes, please indicate the person's name, the nature of their disability/illness, and the type of treatment or medication they receive in the table below. Source: Alfred P. Sloan Working Families Center, 1999 Person's Name Type of Disability/Illness Treatment/Medication
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Part II. Your Education, Income, and Work Life 19. What is the highest degree or level of school you and your spouse have completed? If currently enrolled,
mark the previous grade or highest degree received. Source: Modified from NELS: 88/92
(CIRCLE ONE IN EACH COLUMN, WHERE APPLICABLE)
YOU YOUR SPOUSE/ PARTNER
a. Did not finish high school ................................................................. 1 ........................................... 1
b. Graduated from high school or equivalent (GED) ............................ 2 ........................................... 2
c. After graduating high school, attended a vocational school, junior college, or another type of two- year school, but did not complete a degree ....................................... 3 ........................................... 3
d. After graduating high school, completed a vocational school, junior college, or another type of two-year school ............................................................................. 4 ...........................................4 e. After graduating high school, went to college but did not complete a four-year degree ................................................... 5 .......................................... 5 f. Graduated from a four-year college ................................................... 6 ........................................... 6
g. Completed a Master's degree or equivalent ...................................... 7 ............................................ 7
h. Completed a Ph.D., M.D., J.D., or other equivalent professional degree ........................................................................... 8 ............................................ 8 20a. Are you currently taking courses or pursuing a degree or certificate? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
No ......................................................................................................... 0 --> SKIP TO QUESTION 21a
Yes..........................................................................................................1
20b. What kind of courses/program are you taking? Source: Modified from NELS: 88/92
(CIRCLE ONE)
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Individual courses B no degree or certificate .................... 1 Courses or degree at a High school diploma (GED) ............................................. 2 four-year college or university .................5 Certificate (e.g., real estate or actuarial license) ............... 3 Master's degree or equivalent .................. 6
Courses or a degree at a Ph.D., M.D., JD, or other equivalent vocational school, junior professional degree .................................. 7 college, community college, or other type of two-year school ....................................... 4
20c. When do you currently attend classes? Source: Alfred P. Sloan Working Families Center, 1999 (CIRCLE ALL THAT APPLY)
I don't currently attend classes................................................................0
On weekdays when my children are at school........................................1
On weekday evenings.............................................................................2
On weekends...........................................................................................3
20d. When do you currently do schoolwork/homework? Do not include time spent in class. Source: Alfred P. Sloan Working Families Center, 1999 (CIRCLE ALL THAT APPLY)
I don't do work outside of my classes.....................................................0
On weekdays when my children are at school........................................1
On weekday evenings.............................................................................2
On weekends...........................................................................................3
20e. How much time per week do you spend on your schoolwork? Include time spent in classes and time spent doing homework. Source: Alfred P. Sloan Working Families Center, 1999 (CIRCLE ONE) Less than 2 hours per week......................................................................1
2-4 hours per week...................................................................................2
4-6 hours per week...................................................................................3
6-10 hours per week.................................................................................4
Over 10 hours per week...........................................................................5
21a. While you were in high school, did your mother work for pay? Source: A version of a Traditional Intergenerational Mobility Question
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(CIRCLE ONE)
No .......................................................................................................... 0 --> SKIP TO QUESTION 22a
Yes ......................................................................................................... 1
Not Applicable ....................................................................................... 2 --> SKIP TO QUESTION 22a
21b. When you were in high school, what was your mother's paid work status? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE ON EACH LINE) None of Some of Most of All of Not Applicable the time the time the time the time a. Full Time ........................... 0 ........................ 1 .......................... 2 ........................ 3 ..................... 4
b. Part Time ........................... 0 ........................ 1 .......................... 2 ........................ 3 ..................... 4
21c. What was the main kind of work your mother did? ______________________________ Source: A version of a Traditional Intergenerational Mobility Question
21d. If your mom worked, did she ...... Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Work for pay at home? ......................................................................... 1
Have her own business? ....................................................................... 2
Work for pay at home and have her own business? ............................. 3
None of the above apply ...................................................................... 4
22a. While you were in high school, did your father work for pay? Source: A version of a Traditional Intergenerational Mobility Question
(CIRCLE ONE)
No ........................................................................................................ 0 --> SKIP TO QUESTION 23
Yes ....................................................................................................... 1
Not Applicable .................................................................................... 2 --> SKIP TO QUESTION 23
22b. When you were in high school, what was your father's paid work status? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE ON EACH LINE)
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None of Some of Most of All of Not Applicable the time the time the time the time a. Full Time ........................... 0 ........................ 1 .......................... 2 ........................ 3 .................. 4
b. Part Time ........................... 0 ........................ 1 .......................... 2 ........................ 3 .................. 4
22c. What was the main kind of work your father did? _ Source: A version of a Traditional Intergenerational Question
23. Do you own your place of residence (your own home, condo, townhouse, etc)? Source: Modified from 1990 U.S. Census
(CIRCLE ONE)
No ..................................................................................................... 0
Yes .................................................................................................... 1
24. In studies like this, households are sometimes grouped according to income. Which group best matches the total income of all persons in your household in the last calendar year, including salaries and all other sources of income for all household members? Source: Question – Modified from 1990 U.S. Census; Scale – Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
0-25,000 ............................................................................................. 1
25,001-50,000 .................................................................................... 2
50,001-80,000 .................................................................................... 3
80,001-100,000 .................................................................................. 4
100,001-150,000 ................................................................................ 5
Over 150,000 ..................................................................................... 6
25. How much is your and your spouse's current annual salary? If you regularly receive commissions, bonuses, or tips, please include those amounts in the total. Source: Modified from 1990 U.S. Census
(CIRCLE ONE IN EACH COLUMN)
YOU YOUR SPOUSE/ PARTNER
0-20,000 ....................................................................................................... 1 ........................................... 1
20,001-35,000 ...............................................................................................2............................................ 2
35,001-50,000 ...............................................................................................3............................................ 3
50,001-75,000 .............................................................................................. 4 ........................................... 4
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75,001-100,000 ............................................................................................ 5 ........................................... 5
More than 100,000 ....................................................................................... 6 ........................................... 6
Not Applicable ............................................................................................. 7 ........................................... 7
26. Who do you feel should provide the majority of the income in your family? Source: Modified from the “Breadwinner Status in Family” Scale, (Maureen Perry-Jenkins)
(CIRCLE ONE)
Your spouse/partner entirely .............................................................. 1
Your spouse/partner more than you ................................................... 2
You and your spouse/partner equally ................................................. 3
You more than your spouse/partner ................................................... 4
You entirely ....................................................................................... 5
Other, specify:________________________..................................... 6
27. Please estimate how much your family= s monthly income from all sources has changed during the past year: Source: Modified from the Iowa Youth and Families Project’s Technical Paper #102-2 and Study Questionnaires (Rand Conger)
(CIRCLE ONE)
Not changed at all .................................................................... 0
Increased 1-5% ........................................................................ 1
Increased 5-10% ...................................................................... 2
Increased 11-25% .................................................................... 3
Increased more than 25% ......................................................... 4
Decreased 1-5% ....................................................................... 5
Decreased 5-10% ..................................................................... 6
Decreased 11-25% ................................................................... 7
Decreased more than 25% ....................................................... 8
28. Do you currently volunteer or work somewhere without pay (other than in your own family business, or doing housework)?
Source: Modified from 1990 U.S. Census (CIRCLE ONE)
No ........................................................................................... 0 --> SKIP TO QUESTION 30a
Yes, at one organization/place................................................. 1
Yes, at more than one organization/place................................ 2
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29a. What kind of volunteer work are you doing? If you have multiple volunteer jobs, please identify them all, starting with the one you do the most: Source: 1990 U.S. Census
(For example: kindergarten aide, hospital worker, charity fundraiser, etc.)
29b. How often do you do this volunteer work? If you have multiple volunteer jobs, please indicate how often overall you are involved in all of them. Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
A few times a year .................................................................. 1
A few times a month ............................................................... 2
About once a week .................................................................. 3
More than once a week ........................................................... 4
30a. What is your current work status? Source: Modified from NELS: 88/92
(CIRCLE ONE)
Currently working (includes unpaid work at a family business)... 1
Unemployed - looking for work .................................................. 2 --> SKIP TO QUESTION 30c
Unemployed - not looking for work ............................................ 3 --> SKIP TO QUESTION 30c
Retired ......................................................................................... 4 --> SKIP TO QUESTION 30c
Disabled ...................................................................................... 5 --> SKIP TO QUESTION 30c
30b. How many jobs do you currently have? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
One ............................................................................................ 1 --> SKIP TO QUESTION 30d
Two or More ............................................................................. 2 --> SKIP TO QUESTION 30d
30c. When was the last time you were employed? ____________ 19___________ Month Year
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Source: Modified from 1990 U.S. Census
Please answer the following parts of question 30 for your current main job. If you are not currently working, please answer the following questions for the last job you had. 30d. In this main job are you: Source: 1990 U.S. Census
(CIRCLE ONE) An employee of a private for-profit company? ................................................................................... 1 An employee of a private not-for-profit, tax-exempt, or charitable organization? ..................................... 2 A local government employee (city, county, etc.)? ..................................................................... 3 A state government employee? ................................................... 4 A federal government employee? ............................................... 5 Self-employed in own not-incorporated business, or professional practice? ............................................. 6 Self-employed in own incorporated business, or professional practice? ............................................. 7 Working without pay in family business? .................................. 8 30e. How long have you worked in your current job?__________________ ____________________ Source: 1990 U.S. Census (Years) (Months) 30f. What kind of work are you doing? If you have multiple titles, please identify them all, starting with the one you occupy the most: Source: 1990 U.S. Census
(For example: kindergarten teacher, banker, registered nurse, personnel manager, supervisor of order department, electrical engineer, etc.)
30g. What are your most important activities or duties? If you have multiple responsibilities, please identify them all, starting with those you do the most: Source: 1990 U.S. Census
(For example: patient care, directing hiring policies, supervising order clerks, dealing with customer complaints, etc.)
30h. What kind of business or industry is this? Describe the activity at the location where you are employed. Source: 1990 U.S. Census
____________________________________________________________________________ ____________________________________________________________________________
(e.g. hospital, newspaper publishing, mail order house, auto engine manufacturing, retail bakery).
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30i. How is your job described by your employer? If you are self-employed, the following questions may not seem to apply to you. Please answer as best you can. Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
a. Part time .................................................................................................... 1
b. Full time .................................................................................................... 2
c. Not working/ not applicable ...................................................................... 3
30j. Is your job permanent or temporary? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
One permanent full position filled by you alone ................................................... 1 One permanent full position split with another employee ......................................2 Multiple positions that make up one full-time position in the same organization............................................................................3 Temporary job arranged through a temporary employment agency ..............................................................4 Seasonal job (what months is this job available?: ______________) ..............................................................5 Other temporary (e.g., specific project; please tell us about it: _________________________) .......................................6 30k. Regardless of what type of work you are doing now, if you could choose between different kinds of jobs, which of the following would you personally choose? I would choose to be... Source: Modified from General Social Survey (GSS), 1989
(CIRCLE ONE)
An employee ........................................................................................ 1
Self-employed ...................................................................................... 2
30l. Is your spouse/partner currently working, unemployed, retired, or disabled? Source: Modified from NELS: 88/92
(CIRCLE ONE)
Currently working ................................................................................. 1
Unemployed - looking for work ........................................................... 2
Unemployed - not looking for work ..................................................... 3
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Retired .................................................................................................. 4
Disabled ............................................................................................... 5
Deceased .............................................................................................. 6 --> SKIP TO QUESTION 30q
Not applicable (do not have spouse/partner)......................................... 7 --> SKIP TO QUESTION 30q
30m. If your spouse/partner is not currently working, when was the last time he/she was employed? Source: Modified from 1990 U.S. Census _____________ 19_______ month year 30n. If your spouse/partner is not currently working, please answer the following questions for his/her most recent job. What kind of work is your spouse/partner doing? If he/she has multiple titles, please identify them all, starting with the one he/she occupy the most: Source: 1990 U.S. Census
(For example: kindergarten teacher, banker, registered nurse, personnel manager, supervisor of order department, electrical engineer, etc.)
30o. What kind of business or industry is this? Describe the activity at the location where he/she is employed. Source: 1990 U.S. Census
____________________________________________________________________________ ____________________________________________________________________________
(For example: hospital, newspaper publishing, mail order house, auto engine manufacturing, retail bakery). 30p. How is your spouse's/partner's job described by his/her employers? If he/she is self-employed, the following questions may not seem to apply. Please answer as best you can. Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
a. Part time .................................................................................................... 1
b. Full time .................................................................................................... 2
c. Not working/ not applicable ...................................................................... 3
30q. Describe whether the following benefits are available on your job. Then indicate whether you use these benefits. Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE ON EACH LINE FOR EACH CATEGORY) Category 1
This is available at my
job
Category 2
I use this from my job or my spouse's job
No Yes No Yes
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a. Health insurance.................................................................. 0 1 0 1 b. Personal days...................................................................... 0 1 0 1 c. Compensation based on your performance or merit (like cash or stock bonuses or commissions)......................
0
1
0
1
d. Unpaid leaves of absence (e.g., for maternity, paternity, or family needs)...................
0
1
0
1
e. Paid leaves of absence (e.g., for maternity, paternity, or family needs)..................
0
1
0
1
f. Dependent Care Assistance Program (pretax dollars that can be used for child care, afterschool, or summer programs).............................................................................
0
1
0
1
g. Company-run or subsidized child care or after school programs.............................................................................
0
1
0
1
h. Flexible work hours............................................................. 0 1 0 1 i. Option to work at home (some or all of the time)................ 0 1 0 1 j. Education funding for employee's children.......................... 0 1 0 1 k. Pension or retirement plan.................................................. 0 1 0 1 l. Profit sharing or stock option program............................... 0 1 0 1 m. Car allowance or company car.......................................... 0 1 0 1 n. Expense account for meals................................................. 0 1 0 1 Now we would like to understand your work schedule at your main job. 31a. Which of the following best describes the hours you usually work at your main job or business? Source: Modified Traditional Fixed Shift Question
(CIRCLE ONE)
A regular day time schedule (anytime between 6am and 6pm).............................. 1
A regular evening shift (anytime between 2pm to midnight) ................................ 2
A regular night shift (anytime between 9pm to 8am) ............................................ 3
A rotating shift - one that changes periodically from days to evenings or nights.......................................................... 4
A split shift - one consisting of two distinct periods each day................................ 5
An irregular shift arranged by employer ................................................................ 6
Other (please specify) _______________________________ ............................ 7
31b. What is the main reason why you work this type of shift? Source: CPS, May 1987
(CIRCLE ONE)
Better child care arrangements .............................................................................. 1
Better pay .............................................................................................................. 2
Better arrangements for care of other family members ......................................... 3
Allows time for school .......................................................................................... 4
Easier commute, less traffic .................................................................................. 5
Could not get any other job ................................................................................... 6
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Job requires it ........................................................................................................ 7
Other (please specify) _________________________ ........................................ 8
31c. Approximately, how many hours do you spend working for your main job in a typical week? Please include hours worked on weekends and at home. Source: Alfred P. Sloan Working Families Center, 1999 (CIRCLE ONE)
1-15 ....................................................................................................................... 1
16-25...................................................................................................................... 2
26-37...................................................................................................................... 3
38-45...................................................................................................................... 4
46-50...................................................................................................................... 5
51-60...................................................................................................................... 6
More than 60 ......................................................................................................... 7
32. In a typical work week, How much time outside of your regular work day do you spend working for your
job in the following places? Please answer in hours per week. Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE ON EACH LINE)
Never < 2hrs 3-5hrs 6-10hrs 11-15hrs 16-20hrs More than 20 hrs
a. While commuting to work ................0 .............1 .............2 .............3 ................4 ...............5 ......................6
b. Staying late at your job......................0 .............1 .............2 .............3 ................4 ...............5 ......................6
c. Coming early to your job ..................0 .............1 .............2 .............3 ................4 ...............5 ......................6
d. In the evenings at home ....................0 .............1 .............2 .............3 ................4 ...............5 ......................6
e. In the mornings at home ...................0 .............1 .............2 .............3 ................4 ...............5 ......................6
f. On the weekends at home ..................0 .............1 .............2 .............3 ................4 ...............5 ......................6
g. On the weekends at work ..................0 .............1 .............2 .............3 ................4 ...............5 ......................6
33. When you work at home after your regular work hours, is it usually because you want to, because you have to in order to keep up with your job, or because you don't have to but are asked to by others you work with? Source: Quality of Employment Survey, 1973, 1977
(CIRCLE ONE)
I want to .................................................................................................. 1
I have to in order to keep up with the job ............................................... 2
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I am asked to ........................................................................................... 3
I never work at home .............................................................................. 4 34. How often do you have to do work on short notice for your job or business, at times when you had not
expected to work or weren=t scheduled to work? Source: Modified Slightly from NSFH-SecondWave, MP47, MP49
(CIRCLE ONE)
Never ...................................................................................................... 0
Once or twice a year ............................................................................... 1
Once or twice a month ............................................................................ 2
Once or twice a week .............................................................................. 3
Almost daily ............................................................................................ 4
35. Currently, do you and your spouse/partner's times of work overlap, or do you work different days or
hours? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Never overlap .......................................................................................... 0
Overlap hardly at all ................................................................................ 1
Overlap somewhat ................................................................................... 2
Overlap quite a bit ................................................................................... 3
Overlap nearly completely ...................................................................... 4
36a. How many of your children (including teenagers) currently receive supervised care by someone other than yourself and/or your spouse? (This includes participation in afterschool programs) Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
None ....................................................................................................... 0 --> SKIP TO QUESTION 38
One ......................................................................................................... 1
Two ........................................................................................................ 2
Three ...................................................................................................... 3
More than three ...................................................................................... 4
36b. What type of childcare or supervisory arrangements do you currently have for your children (including teenagers)? Source: Alfred P. Sloan Working Families Center, 1999 (CIRCLE ALL THAT APPLY)
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Informal care/supervision by relative ..................................................... 1
Informal care/supervision by a friend, neighbor, or regular sitter........................................................................ 2 Family day care (based in provider's home) ........................................... 3
Center-based day care ............................................................................ 4
Before- and/or after-school program at a school or in a center ............................................................................ 5 Other (please specify____________________) .................................... 6
36c. About how much do you currently spend on childcare and after school programs including teen supervision arrangements each week? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
$0 ......................................................................................................... 0
Less than $50 a week............................................................................. 1
$50-$100 a week .................................................................................. 2
$101-$150 a week ................................................................................ 3
$151-$200 a week ................................................................................ 4
over $200 a week ................................................................................. 5
37. Does any of your current childcare or after school arrangements ever cause problems with your work
schedule? Source: Modified from Quality of Employment Survey, V1832, V1830
(CIRCLE ONE)
Never ..................................................................................................... 0
Rarely .................................................................................................... 1
Sometimes ............................................................................................. 2
Often ..................................................................................................... 3
Always ................................................................................................... 4
Not applicable.........................................................................................5
Part III. Your Place of Work
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38. When you are doing your main job, do you usually do it in one place (in the same work location) or in
several different places (like at a client=s place of business or home)? Source: Modified from GSS, 1989
(CIRCLE ONE)
Always same place .................................................................................. 1
Mostly the same place.................... ......................................................... 2
Mostly different places ............................................................................ 3
Always different places ........................................................................... 4
39. Do you ever work at home for your main job?
No 0 --> SKIP TO QUESTION 42a
Yes 1
40. Please indicate the extent to which you agree or disagree with the following statements about working at home. Source: Alfred P. Sloan Working Families Center, 1999 When you work at home, you feel . . .
(CIRCLE ONE ON EACH LINE) Never Rarely Sometimes Often
a. Guilty about ignoring your spouse 0 1 2 3 b. Guilty about ignoring your children 0 1 2 3 c. You are available for your children 0 1 2 3 d. You are able to do both family chores
and work tasks 0 1 2 3 e. The quality of your work suffers 0 1 2 3
f. You do not have the right materials to complete your work 0 1 2 3
41. If you primarily work at home, skip to question 43. Source: Alfred P. Sloan Working Families Center, 1999
When you work at home, how often do you feel the following?
(CIRCLE ONE ON EACH LINE)
Never Rarely Sometimes Often a. You have fewer interruptions than you do
at your workplace 0 1 2 3 b. You feel more productive than you do
when you are at your workplace 0 1 2 3
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42a. How do you typically get to and from work? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Walk ........................................................................................................ 1
Own car/carpool ...................................................................................... 2
Bus/train/subway ..................................................................................... 3
Other, specify:_________________________........................................ 4
42b. Typically, how long does it take for you to get to work? Source: Modified from 1990 U.S. Census
(CIRCLE ONE)
0-5 min...................................................................................................... 1
6-10 min.................................................................................................... 2
11-19 min.................................................................................................. 3
20-29 min.................................................................................................. 4
30-60 min.................................................................................................. 5
More than an hour .................................................................................... 6
43. When you are at work, are you able to: Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE ON EACH LINE) No Yes a. Make or receive non-emergency family related calls?......................................................................................... 0 ............................. 1 b. Feel free from anxiety/guilt when making or receiving family related calls? ............................................ 0 ............................. 1 c. Make or receive calls when there is an emergency at home? ............................................................................ 0 .............................. 1 d. Bring your children to work once in a while? .................................................................................... 0 ............................. 1 e. Bring your children to work regularly? ................................................ 0 ............................. 1 f. Send and/or receive personal faxes? .................................................... 0 ............................. 1 g. Send and/or receive personal e-mails? .................................................. 0 ............................ 1
-22-
44a. How often do you communicate with your family when you are at work? Source: Alfred P. Sloan Working Families Center, 1999 never or
almost never once or twice a
week about once a
week 2-3 times a week daily or
almost daily not applicable
a. spouse/partner 1 2 3 4 5 6
b. children 1 2 3 4 5
44b. Which of the following does your family use to keep in touch when you are at work? Source: Alfred P. Sloan Working Families Center, 1999
No Yes
Cellular or mobile phone 0 1
"Regular" phone 0 1
Pager 0 1
E-mail 0 1
FAX 0 1
Personal Visits 0 1
Other
(Specify______________)
0 1
45. Over the last 12 months, about how many nights per month, on the average, were you out of town and away from your family because of work-related travel?
Source: Alfred P. Sloan Working Families Center, 1999 Average number of nights per month____________
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I am self-employed in my main job --> SKIP TO QUESTION 47
46a. How many promotions have you gotten since working for your present employer? Source: Modified from Question 418, GSS, 1989
(CIRCLE ONE)
None .............................................................................................. 0
One ................................................................................................ 1
Two or more .................................................................................. 2
Not applicable ................................................................................ 3
46b. How important to you is the opportunity to be promoted? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Very important ............................................................................... 1
Important ....................................................................................... 2
Somewhat important ...................................................................... 3
Not at all important ........................................................................ 4
Not applicable ................................................................................ 5
47. How well does each of the statements below fit your views? Source: Parts Modified from GSS, 1989 Alfred P. Sloan Working Families Center
(CIRCLE ONE ON EACH LINE)
I am currently working in my main job....
Very True
True
Somewhat
True
Not True
At All a. for the money ............................................
1............
2.................
3...............
........4
b. for the benefits ..........................................
1............
2.................
3...............
........4
c. for the job security it provides ................ 1............ 2................. 3............... ........4
d. to become well known in my profession..................................................
1............
2.................
3...............
........4
e. because I enjoy the tasks involved in my job ..................................................... 1............ 2................. 3............... ........4 f. to contribute to knowledge in my field......
1............
2.................
3...............
........4
g. because I like being challenged at work.....
1............
2.................
3...............
........4
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h. to help people........................................... 1............ 2................. 3............... .......4 i. to be geographically closer to my children during the day.................................................. 1........... 2.............. 3.............. .........4
48. How true are the following statements about your job? Source: Gordon & Heinrich, Jobs for Youth Evaluation
(CIRCLE ONE ON EACH LINE)
Very True
True
Somewhat
True
Not True At
All a. I have a lot of opportunity to make my own decisions ...............................................................
1.................
2.................
3.................
.........4
b. I have a lot of say over what happens on my job........................................................................
1.................
2.................
3.................
.........4
c. I can design or plan most of my daily work........
1.................
2.................
3.................
.........4
49. How often... Source: Gordon & Heinrich, Jobs for Youth Evaluation
(CIRCLE ONE ON EACH LINE)
Never
Hardly Ever
Some- times
Often
Always
a. do you finish your workday feeling physically exhausted?............................................ 0............ 1............ 2............ 3............ ......4 b. do you come home from work feeling angry or hostile?.................................................................. 0............ 1............ 2............ 3............
......4
c. do you come home from work feeling drained of energy?............................................................ 0............ 1............ 2............ 3............ ......4 d. do you find your work stressful?......................... 0............ 1............ 2............ 3............ ......4 e. are you bored at work?....................................... 0............ 1............ 2............ 3............ ......4 f. do you work in dangerous conditions?................ 0............ 1............ 2............ 3............ ......4
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g. do you work in unhealthy conditions?................ 0............ 1............ 2............ 3............ ......4 h. do you work in physically unpleasant conditions?......................................................... 0............ 1............ 2............ 3............ ......4 i. do you feel discriminated against at work........... 0............ 1............ 2............ 3............ ......4 h. do you receive unwanted sexual attention.......... 0............ 1............ 2............ 3............ ......4
50. How often do you socialize with people from your work? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Rarely or Never ................................................................................... 0
Several times a year ............................................................................ 1
Several times a month ......................................................................... 2
Several times a week ........................................................................... 3
I work alone or only with family members .......................................... 4
Please answer questions 51-52 only if you do any other work for pay, in addition to your main job. OTHERWISE, SKIP TO QUESTION 53a. 51. In your second job are you: Source: 1990 U.S. Census
(CIRCLE ONE) An employee of a private for profit company or business, or of an individual, for wages, salary, or commissions? ................................................................................... 1 An employee of a private not -for-profit, tax-exempt, or charitable organization? ....................................................................... 2 A local government employee (city, county, etc.)? ............................................................................... 3 A state government employee? ............................................................ 4 A federal government employee? ......................................................... 5 Self-employed in own not incorporated business, or professional practice? ........................................................................... 6 Self-employed in own incorporated
-26-
business, or professional practice? ....................................................... 7 Working without pay in family business? ............................................. 8 52a. What kind of work do you do at your second job? If you have multiple job titles, please identify them all, starting with the one you occupy the most. Source: 1990 U.S. Census
____________ ____________ (For example: kindergarten teacher, banker, registered nurse, personnel manager, supervisor of order department, electrical engineer, etc.)
52b. What are your most important activities or duties? If you have multiple responsibilities, please identify them all, starting with those you do the most: Source: 1990 U.S. Census
____________
____________ (For example: patient care, directing hiring policies, supervising order clerks, dealing with customer complaints, etc.)
52c. What kind of business or industry is this? Describe the activity at location where you=re employed at your second job Source: 1990 U.S. Census
________________________________________________________________________________________
(e.g. hospital, newspaper publishing, mail order house, auto engine manufacturing, retail bakery).
52d. Is your second job permanent, temporary or seasonal? Source: Alfred P. Sloan Working Families Center, 1999 Permanent 1 Temporary 2 Seasonal 3 52e. Approximately how many hours per week do you spend working for your second job? Source: Alfred P. Sloan Working Families Center, 1999 0 hr
1-5 hrs 5-10 hrs 11-15 hrs 16-20 hrs 20 or more
Weekdays (before 6 pm) 0 1 2 3 4 5 Weeknights (after 6 pm) 0 1 2 3 4 5 Weekends 0 1 2 3 4 5 52f. Which of the following reasons, if any, best explain why you have a second job?
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Source: Modified from CPS. May 1997 (CIRCLE ONE ON EACH LINE) NO YES
To meet regular household expenses 0 1
Can not find a full-time position 0 1
To save for my child(ren)=s college education 0 1
To pay off debts 0 1
My second job is more of a hobby or for fun 0 1
To save for the extras 0 1
To get experience in a different occupation or to build a business 0 1 Would rather be doing this job full-time but do not want to lose my benefits from my primary job 0 1 Other (specify)___________________ 0 1 The next set of questions are about advantages and disadvantages of being self-employed. Even if you=re not currently self-employed, please tell us what you think might be the advantages and disadvantages of working for yourself. 53a. Which of these advantages do you feel exist for being self-employed? Source: Quality of Employment Survey, v. 1164
(CIRCLE ONE IN EACH LINE)
NO YES a. Pays well .............................................................................................................. 0 .............. 1 b. The fruits of my labor go to me, not someone else ....................................................................................... 0 ............... 1 c. Independence, autonomy .......................................................................................0 ............... 1 d. Control over vacations or number of days worked ........................................................................................ 0 ............... 1 e. Control over hours .................................................................................................0 ............... 1 f. Security (no layoffs, can not be fired) ..................................................................................................... 0 ............... 1 g. Feelings of personal gratification, self-esteem that comes from the job ...................................................................... 0 ............... 1 h. Other, specify______________________ ............................................................ 0 ............... 1
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53b. Which of these disadvantages do you feel exist for being self-employed? Source: Quality of Employment Survey, v. 1168
(CIRCLE ONE ON EACH LINE) NO YES a. Economic insecurity ................................................................................................................. 0 .............. 1 b. Paperwork, red tape (bookkeeping, complying with government regulations) ................................................................................... 0 ............... 1 c. Getting money to start or maintain a business ........................................................................... 0 ............... 1 d. Problems with expenditures (taxes, meeting payrolls) ............................................................................................................ 0 .............. 1 e. Lack of fringe benefits ................................................................................................................ 0 ............... 1 f. Problems with personnel employed by you ................................................................................ 0 ............... 1 g. Excessive hours .......................................................................................................................... 0 .............. 1 NO YES h. Responsibilities (can=t walk away from a problem; making all decisions) .................................................................................................. 0 .............. 1 i. Other, specify__________________________ ......................................................................... 0 ............... 1
If you are not self-employed, skip to question 55.
54. How long have you been self-employed ___________ ____________ (Years) (Months) Source: CPS, 1995 Part IV. History and Perceptions of Family Life
55. Have you ever taken an extended period of time off from work to care for one or more of your children?
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Source: Alfred P. Sloan Working Families Center, 1999 (CIRCLE ALL THAT APPLY)
No, I never took time off..................................................................... 0
Yes, for a pregnancy ........................................................................... 1
Yes, for official paid maternal/paternal leave...................................... 2
Yes, for official unpaid maternal/paternal leave.................................. 3
Yes, leave for child illness................................................................... 4
Yes, I quit my job to raise my child(ren)............................................. 5
Yes, for other reasons ......................................................................... 6 (Please explain):________________________________________________________
56. Do you feel you have had a choice to stay home and not work for pay in order to raise your children? Source: Modified from Roper
(CIRCLE ONE)
No ...................................................................................................... 0
Yes ..................................................................................................... 1
57. If you were free to do any of the following, would you prefer to... Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Stay home and not work for pay......................................................... 1
Have a part-time job .......................................................................... 2
Have a full-time job ........................................................................... 3
58. For the following series of questions we would like to know how strongly you agree or disagree with the
following statements: Source: GSS, 1989; Modified from Roper
(CIRCLE ONE ON EACH LINE)
Strongly Agree
Agree Neither Agree or Disagree
Disagree
Strongly Disagree
a. It should not bother the husband if a wife=s job sometimes requires her to be away from him overnight..........................
1..............
2.........
3............
4............
......5
b. If his wife works full-time, a husband should share equally in household chores such as cooking, cleaning, and washing..................................................................................
1..............
2.........
3............
4............
......5
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Strongly Agree
Agree Neither Agree or Disagree
Disagree
Strongly Disagree
c. It is more important for a wife to help her husband=s career than to have a career herself...................................................
1..............
2.........
3............
4............
.......5
d. Parents should encourage just as much independence in their daughters as in their sons...............................................
1..............
2.........
3............
4............
.......5
e. Boys are more likely than girls to be encouraged to excel in school..................................................................................
1..............
2.........
3............
4............
.......5
f. Teachers don't expect girls to do as well as boys in math or science courses.......................................................................
1.............
2........
3...........
4...........
.......5
59. Regardless of how you feel about mothers and fathers working outside the home, which of these things, if
any, do you think is true of most children whose parents both work full-time, compared with children who have at least one parent who stays home most of the time?
Source: Roper Children who have parents working...
(CIRCLE ONE ON EACH LINE)
Strongly Disagree
Disagree
Neither
Disagree or Agree
Agree
Strongly Agree
a. Are more independent................................
1...............
2...............
3............... 4............... .......5
b. Have more problems in school...................
1...............
2...............
3.............. 4............... .......5
c. Don't learn important values from parents..
1...............
2...............
3............... 4............... .......5
d. Watch too much television.........................
1...............
2...............
3............... 4............... .......5
e. Are more responsible..................................
1...............
2...............
3............... 4............... .......5
f. Are more involved in afterschool activities.
1...............
2...............
3.............. 4............... .......5
g. Get into more trouble.................................
1...............
2...............
3...............
4...............
.......5
h. Are higher achievers...................................
1...............
2...............
3............... 4............... .......5
i. Miss out on time spent as a family unit.......
1...............
2...............
3............... 4............... .......5
4............... .......5
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Strongly Disagree
Disagree
Neither
Disagree or Agree
Agree
Strongly Agree
j. Have a lot of close friends........................... 1............... 2............... 3............... k. Are more often alone..................................
1...............
2...............
3............... 4............... .......5
l. Are more open-minded about the roles of women........................................................ 1............... 2............... 3............... 4............... .......5 m. Have more opportunities as a result of their parents' financial strength..................
1..............
2...............
3...............
4...............
.......5
60. All things considered, do you think the benefits of women working while raising children outweigh the
drawbacks, or do you think the drawbacks outweigh the benefits? Source: Roper
(CIRCLE ONE)
Benefits outweigh the drawbacks ................................................................................ 1
About equal ................................................................................................................. 2
Drawbacks outweigh the benefits ................................................................................ 3
61. Working couples sometimes find it difficult to devote time and energy to the satisfactory performance of both their family roles and work roles. How often do you feel that work roles and family roles conflict? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Never ...................................................................................................................... 0 -->SKIP TO QUESTION 64
Rarely ..................................................................................................................... 1
Sometimes .............................................................................................................. 2
Often ...................................................................................................................... 3
Almost always ........................................................................................................ 4
62. When this happens, which of the following do you think gets slighted the most? Source: Modified from Roper
(CIRCLE ONE)
Job or business ...................................................................................................... 1
Marriage only......................................................................................................... 2
Children only.......................................................................................................... 3
Both marriage and children.................................................................................... 4
All get slighted....................................................................................................... 5
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None get slighted ................................................................................................... 6 --> SKIP TO QUESTION 64
63. Which of these things, in particular, would need to change in order for working parents to balance evenly
their job or business, their marriage, and their children? Source: Modified from Roper
(CIRCLE ONE ON EACH LINE)
No Yes a. Men helping more with household and child care responsibilities .................................................... 0............................. 1 b. Employers being more understanding of employees' dual roles as employees and parents .................................................................................. 0 ............................ 1 c. More flexible work hours/schedules ............................................................ 0.............................. 1 d. Women putting less pressure on themselves to be Asuperwomen" ................................................................... 0 ............................ 1 e. Men putting less pressure on women to be Asuperwomen" ......................................................................... 0 ............................ 1 f. Children helping more with household responsibilities ............................................................................. 0 ............................. 1 g. Improved day-care and after-school care arrangements ......................................................................................... 0 ............................ 1
64. Below are some statements which people have made about their work and family lives. How well do they describe how you feel? Source: Modified from Roper, Question 44
(CIRCLE ONE ON EACH LINE)
Never
Rarely
Sometimes
Often
a. I feel bad about leaving my kids in the morning when I go to
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work ........................................ 1 .................
2 .................
3 ................
4 .................
b. I feel guilty that I don't spend more time with my family.........
1 .................
2 .................
3 ................
4 .................
c. My family is understanding about the demands of my job.....
1 .................
2 .................
3 ...............
4 .................
65. How often do you take time out of your schedule "for yourself"? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Never or rarely..............................................................................................0
Once a month................................................................................................1
Once a week..................................................................................................2
Several times a week.....................................................................................3
66. Would you like your spouse/partner to spend more time working in order to have more money, even if it meant spending less time with you and your child(ren)? Source: Quality of Employment Survey, v. 1858
(CIRCLE ONE)
No ............................................................................................................. 0
Yes ............................................................................................................ 1
67. Would you like to spend less time working so that you could spend more time with your (spouse/partner) and child(ren), even if it meant having less money? Source: Quality of Employment Survey
(CIRCLE ONE)
No ............................................................................................................. 0
Yes ............................................................................................................ 1
68. The following questions relate to what you think about during the day.
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Source: Alfred P. Sloan Working Families Center, 1999 (CIRCLE ONE ON EACH LINE)
None/ Rarely
A little/ Sometimes
Some/ Often
A lot/ Always
a. About how much time are you able to devote to personal business while at your job? .......................................................
1 ...............
2 ........................
3 ..................
.........4
b. About how often do you think about your spouse/partner while at your job? .............
1 ...............
2 ........................
3 ..................
.........4
c. About how often do you think about your children while at your job? ........................
1 ...............
2 ........................
3 ..................
.........4
d. When you are with your family, about how often do you think about work? ........
1 ...............
2 .......................
3 ..................
.........4
Part V. Household Activities 69. Now we'd like to find out about how much time the people in your family spend doing various tasks. We
understand that it may be difficult to estimate the amount of time spent on these tasks, but please make your best guess.
Source: Alfred P. Sloan Working Families Center, 1999 How many hours per week do you personally spend on the following tasks?
Task
0 hours
1-2 hours
3-5 hours
6-10 hours
11-15 hours
16-20 hours
20+ hours
a. Shopping for household
0
1
2
3
4
5
6
b. Taking the kids to and from activities
0
1
2
3
4
5
6
c. Cooking
0 1 2 3 4 5 6
d. Washing the dishes
0 1 2 3 4 5 6
e. Cleaning the house
0 1 2 3 4 5 6
Task
0 hours
1-2 hours
3-5 hours
6-10 hours
11-15 hours
16-20 hours
20+ hours
f. Laundry
0 1 2 3 4 5 6
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g. Yard and home maintenance
0 1 2 3 4 5 6
h. Family paperwork, like paying bills and balancing the checkbook
0
1
2
3
4
5
6
i. Helping the kids with their homework
0
1
2
3
4
5
6
70. How many hours per week does your spouse/partner personally spend on the following tasks? Source: Alfred P. Sloan Working Families Center, 1999
Task
0 hours
1-2 hours
3-5 hours
6-10 hours
11-15 hours
16-20 hours
20+ hours
a. Shopping for household
0
1
2
3
4
5
6
b. Taking the kids to and from activities
0
1
2
3
4
5
6
c. Cooking
0 1 2 3 4 5 6
d. Washing the dishes
0 1 2 3 4 5 6
e. Cleaning the house
0 1 2 3 4 5 6
f. Laundry
0 1 2 3 4 5 6
g. Yard and home maintenance
0 1 2 3 4 5 6
h. Family paperwork, like paying bills and balancing the checkbook
0
1
2
3
4
5
6
i. Helping the kids with their homework
0
1
2
3
4
5
6
71. How many hours per week does the teen in the study personally spend on the following tasks? Source: Alfred P. Sloan Working Families Center, 1999
Task
0 hours
1-2 hours
3-5 hours
6-10 hours
11-15 hours
16-20 hours
20+ hours
a. Shopping for household
0
1
2
3
4
5
6
b. Babysitting younger siblings
0
1
2
3
4
5
6
c. Driving siblings to and from activities
0 1 2 3 4 5 6
Task
0 hours
1-2 hours
3-5 hours
6-10 hours
11-15 hours
16-20 hours
20+ hours
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d. Cooking
0 1 2 3 4 5 6
e. Washing the dishes
0 1 2 3 4 5 6
f. Cleaning his/her room
0 1 2 3 4 5 6
g. Cleaning other parts of the house
0 1 2 3 4 5 6
h. Doing laundry 0 1 2 3 4 5 6
i. Yard and home maintenance
0 1 2 3 4 5 6
72. How often do you typically pay for the following services? Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
About once 2-3 times Once Several times Never a month a month a week a week
a. Cleaning the home .................................... 0 1 2 3 4
b. Yard work ................................................. 0 1 2 3 4
c. Laundry ...................................... 0 1 2 3 4
d. Order out/Take out food for dinner............ 0 1 2 3 4
e. Tutoring for my child(ren) ......................... 0 1 2 3 4
f. Grocery Shopping ...................................... 0 1 2 3 4
g. Other Maintenance Tasks .......................... 0 1 2 3 4
73. When your family last decided to make a major purchase such as a car, a home, or a major appliance...... Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE ON EACH LINE)
Not at all A little Some A Lot
a. To what extent were you involved in making the decision? ............................................ 0 ......................... 1 ......................... 2 ......................... 3
b. To what extent was your spouse involved in making the decision? ............................. 0 ........................ 1 ........................ 2 ......................... 3 c. To what extent were your children involved in making the decision? ............................. 0 ........................ 1 ........................ 2 ......................... 3
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Part VI. You and Your Spouse/Partner I am not currently living with a spouse/partner --> SKIP TO QUESTION 76 74. Many people have disagreements in their relationships. Please indicate below the approximate extent of
agreement and disagreement between you and your spouse/partner for each item on the following list. Source: Enrich Marital Satisfaction Scale (Fowers & Olson, 1993)
(CIRCLE ONE ON EACH LINE)
Strongly Disagree
Moderately Disagree
Neither
Agree or Disagree
Moderately
Agree
Strongly Agree
a. My partner and I understand each other perfectly..............................................
1..................
2................
3..............
4................
...........5
b. I am not pleased with the personality characteristics and personal habits of my partner............................................
1..................
2................
3..............
4................
...........5
c. I am very happy with how we handle role responsibilities in our relationship...........................................
1..................
2................
3..............
4................
...........5
d. My partner completely understands and sympathizes with my every mood.....................................................
1..................
2................
3..............
4...............
............5
e. I am not happy about communication and feel my partner does not understand me.......................................
1..................
2................
3..............
4................
...........5
f. Our relationship is a perfect success................................................
1..................
2................
3..............
4................
...........5
g. I am very happy about how we make decisions and resolve conflicts.............. 1.................. 2................ 3.............. 4................ ...........5 h. I am unhappy about our financial position and the way we make financial decisions...............................................
1..................
2................
3................
4................
............5
i. I have some needs that are not being met by our relationship .........................
1..................
2................
3..............
4................
............5
j. I am very happy with how we manage our leisure activities and the time we spend together........................................
1..................
2................
3..............
4................
............5
k. I am very pleased about how we
1..................
2................
3..............
4................
............5
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Strongly Disagree
Moderately Disagree
Neither
Agree or Disagree
Moderately
Agree
Strongly Agree
express affection and relate sexually l. I am not satisfied with the way we each handle our responsibilities as parents....................................................
1..................
2................
3..............
4................
...........5
m. I have never regretted my relationship with my partner, not even for a moment................................................
1..................
2................
3..............
4................
...........5
n. I am dissatisfied about our relationship with my parents, in-laws, and/or friends....................................................
1..................
2................
3..............
4................
...........5
o. I feel very good about how we each practice our religious beliefs and values....................................................
1..................
2................
3..............
4................
...........5
p. Overall, I am satisfied with my relationship with my spouse/partner...... 1................... 2................ 3................. 4.................. ............5 75. There are various ways that couples deal with serious disagreements. When you have a serious disagreement with your spouse/partner, how often do you:
(CIRCLE ONE ON EACH LINE)
Never Rarely
Sometimes
Often
Very often
a. Just keep your opinions to yourself...................
0............
1...........
2..............
3.......
.........4
b. Discuss your disagreements calmly...................
0............
1...........
2..............
3.......
.........4
c. Argue heatedly or shout at each other...............
0............
1...........
2..............
3.......
.........4
d. End up hitting or throwing things at each other.
0............
1...........
2..............
3.......
.........4
76. Now we'd like to find out about the amount of social, material and emotional support you have outside
of your nuclear family unit. Please mark whether each statement is NEVER true for you, SOMETIMES true for you, or ALWAYS true for you.
Source: Modified from NELS: 88/92
Never
Sometimes
Always
a. If I need to work late, I can easily find someone to watch my children...........
0...........
1................
......2
b. If I=m unavailable to get my child to the doctor, friends or family will help me.....................................................................................................................
0...........
1...............
.......2
c. If I have an emergency and need cash, family or friends will loan it to me......
0...........
1...............
.......2
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Never
Sometimes
Always
d. If I have troubles or need advice, I have someone I can talk to........................ 0........... 1............... .......2
Part VII. You and Your Teenager
All of the questions in this section pertain to the teenager participating in the study. Please answer the questions
with this child in mind.
77. Do you think your teen=s opportunities to succeed will be better than, or not as good as those you have? Source: NELS: 88/92
(CIRCLE ONE)
Much Better ................................................................................... 1
Better ............................................................................................. 2
Same .............................................................................................. 3
Not as good ................................................................................... 4
Not comparable ............................................................................. 5
78. How far in school do you want the teen participating in the study to go? Source: Modified from FIC Study
(CIRCLE ONE) a. Less than high school graduation ......................................................
............1
b. Graduate from high school, but not go any further ............................
............2
c. Go to vocational, trade, or business school after high school ............
............3
d. Attend a two-year college ..................................................................
............4
e. Attend a four-year college but not graduate.......................................
............5
f. Graduate from college .......................................................................
............6
g. Attend a higher level of school after graduating from college ...........
............7
h Don't know .........................................................................................
............8
79. What do you think the chances are that the teenager participating in the study will: Source: Modified from NELS: 88/92
(CIRCLE ONE ON EACH LINE)
Very Low 50/50 High Very low high
a. Graduate from high school .......................................1......... 2.............3............4.............5
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b. Graduate from college ..............................................1......... 2..............3...........4.............5
c. Get married .......................................................... ... 1......... 2..............3...........4.............5
d. Have children ............................................................1......... 2............. 3...........4.............5
e. Own his/her own home .............................................1.......... 2..............3.......... 4.............5
Very Low 50/50 High Very low high f. Enjoy his/her work life...............................................1......... 2..............3...........4.............5
g. Enjoy his/her home life .............................................1......... 2..............3...........4.............5
h. Have a stable marriage .............................................1.......... 2..............3...........4.............5
80. How often do you and the teen in the study participate in the following activities together: Source: Modified from NELS: 88/92; Sloan Study of Youth and Social Development
(CIRCLE ONE ON EACH LINE)
Rarely or Less than Once or Every day or never once a week twice a week almost every day
a. Talking about everyday events in our lives............................................. 1 2 3 4 b. Talking about important life issues.... 1 2 3 4 c. Talking about news/politics/world events................................................ 1 2 3 4 d. Preparing meals together................... 1 2 3 4 e. Working on household chores together............................................... 1 2 3 4 f. Eating meals together........................... 1 2 3 4 g. Watching TV or videos together.......... 1 2 3 4 h. Shopping together................................. 1 2 3 4 i. Doing sports/athletic activities............... 1 2 3 4 j. Listening to or playing music together.... 1 2 3 4 k. Doing art or craft activities together....... 1 2 3 4 l. Doing volunteer/charity work.................. 1 2 3 4 m. Attending religious services................... 1 2 3 4 n. Doing other shared hobbies together...... 1 2 3 4 specify: __________________________
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81. How often do you do each of the following activities with the teen participating in the study? Source: Modified from NELS: 88/92; Sloan Study of Youth and Social Development
(CIRCLE ONE ON EACH LINE)
Less than
once a year or never
Once a
year
Several times
a year
Once a
month or more
a. Go to the theater, symphony, or similar musical/cultural events ........................................
0....................
1...............
2....................
.........3
b. Go out to the movies............................................
0....................
1...............
2....................
.........3
c. Visit museums......................................................
0....................
1...............
2....................
.........3
d. Go out to watch sports events...............................
0....................
1...............
2....................
.........3
e. Going out to eat dinner (sit down dinner, not take out) .......................................................
0....................
1...............
2....................
.........3
f. Visiting nearby relatives and/or family friends...................................................................
0...................
1...............
2....................
.........3
g. Visiting relatives that live far away ...................
0....................
1...............
2....................
.........3
h. Traveling together for fun ...................................
0....................
1...............
2....................
.........3
i. Visiting my workplace........................................ 0................ 1.............. 2.................... .........3
82. Which of the following best describes the grades your teen received on his or her last report card? Source: NELS: 88/92
(CIRCLE ONE)
Mostly A's.............................................................1 About half C's and half D's................................6
About half A's and half B's...................................2 Mostly D's.........................................................7
Mostly B's...........................................................3 Mostly below D.................................................8
About half B's and half C's .................................4 His/her class is not graded.................................9
Mostly C's............................................................5
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83. To the best of your knowledge, how many times did the following things happen to your teenager since the beginning of the school year?
(CIRCLE ONE ON EACH LINE)
Never
1-2
times
several
times
Often
a. Cheated on a class test? ..................................................
0...........
1.........
2.........
3.........
b. Skipped a full day of school/work without an excuse?....
0...........
1.........
2.........
3.........
c. Drunk beer, wine, or liquor without your permission......
0...........
1.........
2.........
3.........
d. Gotten into a physical fight at school or work.................
0...........
1.........
2.........
3.........
e. Taken something from a store without paying for it........
0..........
1.........
2..........
3........
f. My teen was transferred to another school for disciplinary reasons .....................................................
0...........
1.........
2.........
3.........
84. Since the beginning of the school year, has any of the following things happened to your teen in
in the study? (CIRCLE ONE ON EACH LINE) NO YES a. My teen received an award for his/her academic performance................................................................ 0............ 1........ b. My teen received an award for his/her athletic performance................................................................. 0............ 1.......... c. My teen was elected to student council........................ 0........... 1......... d. My teen received an award for community service ....................... 0........... 1.........
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85. In your family, who makes most of the decisions on each of the following topics?
Source: Modified from NELS: 88/92 (CIRCLE ONE ON EACH LINE)
Parent(s)
decide
Parent(s) decide after
discussing with teen
Parent(s) and teen decide
together after
discussing it
Teen
decides after discussing it
with parent(s)
Teen
decides
a. How late at night your teen can stay out ..
1..............
2................
3..................
4..................
.......5
b. Which friends teen can spend time with ..
1..............
2................
3..................
4..................
.......5
c. What classes your teen takes in school ....
1..............
2................
3..................
4..................
.......5
d. Whether your teen has a job ....................
1..............
2................
3..................
4..................
.......5
e. How your teen spends his/her money.......
1..............
2................
3..................
4..................
.......5
f. Whether your teen can date ....................
1..............
2................
3..................
4..................
.......5
g. Whether your teen should go to college....................................................
1..............
2................
3..................
4..................
.......5
h. Where your teen can go to college........ 1.............. 2................ 3.................. 4................... ......5
86. How often do you or your spouse talk with your teen about... Source: Modified from NELS: 88/92
(CIRCLE ONE ON EACH LINE)
Never
A few times a year
About once a month
A few times a
week
How Teen Spends Time: a. The amount of time your child spends watching TV ...............................
0....................... 1.....................................
2.....................................
...............3
b. Where your teen is most afternoons after school...
0.......................
1.....................................
2.....................................
..............3
c. Where your teen goes at night ..............................
0....................... 1..................................... 2.....................................
..............3
d. What your teen does with his/her free time .... 0.......................
1.....................................
2.....................................
..............3
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Educational and Career Plans:
Never
A few times a year
About once a month
A few times a week
e. Which courses or programs to take at school ................................
0.......................
1.....................................
2..................................... ..............3
f. School activities or events of particular interest to your teen ...........
0....................... 1.....................................
2..................................... ..............3
g. Things your teen has studied in class .............. 0....................... 1..................................... 2..................................... ..............3 h. Your teen=s grades ......... 0....................... 1..................................... 2..................................... ..............3 i. Your teen=s plans and preparations for the ACT or SAT 0....................... 1.....................................
2..................................... ..............3
j. Your teen going to college ............................... 0....................... 1..................................... 2..................................... ..............3 k. Your teen=s career plans................................... 0....................... 1..................................... 2................................... ..............3
Rules and Decision Making:
l. How late your teen stays out .................................. 0....................... 1..................................... 2..................................... ..............3 m.Your teen breaking rules 0....................... 1.....................................
2..................................... ..............3
n. How your teen spends his/her money ............................... 0....................... 1.....................................
2..................................... ..............3
Friendships and Peer Pressure:
o. Who your teen=s friends are ......................... 0....................... 1..................................... 2..................................... .............3
p. Dating ........................... 0....................... 1..................................... 2..................................... .............3
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q. Sexual relations ............. 0....................... 1..................................... 2..................................... .............3 r. Alcohol .......................... 0....................... 1..................................... 2..................................... .............3 s. Drugs ............................. 0....................... 1..................................... 2..................................... .............3 Moral/Ethical/ Religious
Issues: Never A few times a year About once a month A few times a
week t. Religion/faith/spirituality 0....................... 1..................................... 2..................................... .............3 u. How to express love or caring to people......... 0....................... 1..................................... 2..................................... .............3 v. How to stand up for oneself .......................... 0....................... 1.....................................
2..................................... .............3
w. Becoming independent .................. 0.......................
1.....................................
2..................................... .............3
87. How often do you and/or your spouse/partner do the following? Source: Modified from NELS: 88/92
(CIRCLE ONE FOR EACH PERSON)
YOU YOUR SPOUSE/PARTNER
Never
Rarely
Sometimes
Often Never Rarely Sometimes Often
a. Check on whether your teen has done his/her homework....................................
0.........
1...........
2..............
3
0.........
1.........
2..............
....3
b. Call to check on your teen when he/she is out .................................
0.........
1...........
2..............
3
0.........
1.........
2..............
....3
c. Ask your teen to call and check in with you when he/she is out ........
0.........
1...........
2..............
3
0.........
1.........
2..............
....3
d. Limit the amount of time your teen can spend watching TV or playing video or computer games
0.........
1...........
2..............
3
0.........
1.........
2..............
....3
e. Limit the amount of time your teen can go out with friends on school nights .............................
0.........
1...........
2..............
3
0.........
1.........
2..............
....3
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88. In a typical week, what is the latest the teen is allowed to stay out on SCHOOL NIGHTS (Sunday-
Thursday) and on weekend nights (Friday and Saturday)? Source: Modified from NELS: 88/92
(CIRCLE ONE IN EACH COLUMN)
SCHOOL NIGHTS WEEKEND NIGHTS
a. Not allowed out..................................................................1..................................................1
b. Before 9:00pm...................................................................2..................................................2
c. 9:00pm to 9:59pm..............................................................3..................................................3
d. 10:00pm to 10:59pm..........................................................4..................................................4
e. 11:00pm to 11:59pm..........................................................5..................................................5
f. 12:00 to 12:59am................................................................6..................................................6
g. 1:00am to 1:59am...............................................................7.................................................7
h. A fixed hour after 2:00am..................................................8..................................................8
i. As late as he/she wants .......................................................9..................................................9
VIII. Personal Well-Being and Health 89. Lots of things happen in families that may affect their lives. In the last 2 years, have any of the following happened to your family? Source: Modified from NELS: 88/92
(CIRCLE ONE ON EACH LINE) No Yes
a. You started to work .............................................................................. 0 ................................. 1 b. Your spouse/partner started to work ...................................................................................... 0 ................................. 1 c. You lost your job ................................................................................... 0 ................................ 1 d. Your spouse/partner lost his/her job .......................................................................................0 ................................ 1 e. You changed jobs ................................................................................... 0 ............................... 1
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f. Your spouse/partner changed jobs ........................................................................................... 0 ............................... 1 g. You or your spouse/partner worked more to raise your income ................................................................................... 0 ............................... 1 No Yes h. You took on more responsibility around the house so your spouse could work more ..................................................................................... 0 ............................... 1 i. Your family went on welfare....................................................................0.................................1 j. You got (re)married ................................................................................0 ............................... 1 k. Your family moved to a new home in the same city...................................................................... 0................................ 1 l. Your family moved to a new home in a new city......................................................................... 0................................. 1 m. You had a baby ...................................................................................... 0 ................................ 1 n. You adopted a child ............................................................................... 0 ................................ 1 o. An unmarried family member got pregnant............................................................................................ 0 ................................ 1 p. A child in your family dropped out of school ............................................................................. 0 .................................1 q. Your spouse/partner died ........................................................................0..................................1 r. A close relative died ...............................................................................0...................................1 s. A family member was a victim of a crime ..................................................................................0...................................1 t. A family member was sent to jail .......................................................... 0 ..................................1 u. You became responsible for the care of an elderly family member ..........................................................0...................................1 v. A family member became seriously ill or disabled ...........................................................................0...................................1 w. You and spouse/partner began counseling ............................................................................................... 0 ................................. 1 x. Your teen began counseling .................................................................... 0 ................................. 1
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y.Your family -- including spouse/partner and child(ren) -- began counseling ...........................................................0 ................................. 1 z. Other major stressful event......................................................................0....................................1 specify:_______________________
90. Now we're going to present a few more statements about parenting. How true do you feel each of the following
statements is in your life?
(CIRCLE ONE ON EACH LINE)
Always
True
Mostly
true
Sometimes
true
Rarely
true
Never true
a. Being a parent is harder than I thought it would be .........................................................................
1..................
2 ..........
3..............
4.......
....5
b. My child does things that really bother me..........
1..................
2..........
3..............
4.......
....5
c. I find myself giving up more of my life to meet my child=s needs than I ever expected..................
1..................
2..........
3..............
4.......
....5
d. I feel trapped by my responsibilities as a parent...
1..................
2...........
3..............
4.......
....5
91. In general, I am a parent who...
(CIRCLE ONE ON EACH LINE)
Always
True
Mostly
true
Sometimes
true
Rarely
true
Never true
a. Makes my children feel better when they talk over their worries with me................................
1..................
2 ..........
3..............
4.......
....5
b. Likes to talk with my children and be with them much of the time.............................................
1..................
2..........
3..............
4.......
....5
c. Enjoys talking things over with my children...... 1.................. 2.......... 3.............. 4....... ....5 d. Enjoys doing things with my children................ 1.................. 2........... 3.............. 4....... ....5 e. Cheers my children up when they are sad .......... 1.................. 2........... 3.............. 4....... ....5 f. Has a good time at home with my children........ 1.................. 2........... 3.............. 4....... ....5
92. When you and your children have had a disagreement, how often have you...
(CIRCLE ONE ON EACH LINE)
Never
Rarely
Sometimes
Often
Very often
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Never
Rarely
Sometimes
Often
Very often
a. Just kept your opinion to yourself...............................
0.........
1.........
2................
3.......
.........4
b. Discussed your disagreement calmly with him/her.....
0.........
1.........
2................
3.......
.........4
c. Argued heatedly with or shouted at him/her..............
0.........
1.........
2................
3.......
.........4
d. Pushed, grabbed, or hit him/her.................................
0.........
1.........
2................
3.......
.........4
93. Compared to other people your age, would you say your general health is Source: Alfred P. Sloan Working Families Center, 1999
(CIRCLE ONE)
Poor .................................................................................................................. 0
Fair .................................................................................................................... 1
Good ................................................................................................................. 2
Very good ......................................................................................................... 3
Excellent ........................................................................................................... 4
94. Now we're going to list some statements that deal with ways that you may perceive yourself. Indicate how often these statements apply to you. Source: Modified from NELS: 88/92, Taylor's Anxiety Inventory, and Cohen's Perceived Stressed Scale
(CIRCLE ONE ON EACH LINE)
Never
Rarely
Sometimes
Often
Very often
a. I feel good about myself.................................................
0...........
1.........
2................
3.......
.....4
b. I feel I do not have much to be proud of.......................
0...........
1.........
2................
3.......
.....4
c. I feel on edge, like something awful is about to happen............................................................................
0...........
1.........
2................
3.......
.....4
d. I forget things readily.....................................................
0...........
1.........
2................
3.......
.....4
e. I feel nervous for reasons I can=t put my finger on.........
0...........
1.........
2................
3.......
.....4
f. I have trouble concentrating...........................................
0...........
1.........
2................
3.......
.....4
g. My anger is unpredictable...............................................
0...........
1.........
2................
3.......
.....4
h. I get more angry than I should......................................
0...........
1.........
2................
3.......
.....4
i. I express my anger easily...............................................
0...........
1.........
2................
3.......
.....4
-50-
Never
Rarely
Sometimes
Often
Very often
j. I feel on top of things..................................................... 0........... 1......... 2................ 3....... .....4 k. I feel stressed.................................................................
0...........
1.........
2................
3.......
.....4
l. I feel I can=t cope with everything I have to do..............
0...........
1.........
2................
3.......
.....4
m. I feel confident about my ability to handle personal or family matters...............................................................
0...........
1.........
2................
3.......
.....4
n. I feel confident about my ability to handle work- related matters...........................................................................
0...........
1.........
2................
3.......
.....4
95. Next, we're going to present some statements that may relate to how you have felt about yourself and your life
during the past week. How often in the past week did the following statements apply to you? Source: CESD Depression Scale. Available: Radloff, L. The CESD Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1977,1, 385-401
(CIRCLE ONE ON EACH LINE)
Rarely or none
of the time (less than 1 day)
Some or a little
of the time (1-2 days)
A moderate
amount of the time (3-4 days)
Most or all of
the time (5-7 days)
a. I was bothered by things that don't usually bother me ..........
0.........................
1.........................
2.........................
........3
b. I did not feel like eating; my appetite was poor....................
0.........................
1.........................
2.........................
........3
c. I felt hopeful about the future...
0.........................
1.........................
2.........................
........3
d. I felt that I could not shake off the blues even with help from my family or friends.................
0.........................
1.........................
2.........................
.........3
e. I had trouble keeping my mind on what I was doing..................
0.........................
1.........................
2.........................
.........3
f. I was happy..............................
0.........................
1.........................
2.........................
.........3
g. I felt depressed..........................
0.........................
1.........................
2.........................
.........3
h. I felt that everything I did was an effort ..................................
0.........................
1.........................
2.........................
.........3
i. I felt fearful...............................
0.........................
1.........................
2.........................
.........3
-51-
Rarely or none
of the time (less than 1 day)
Some or a little
of the time (1-2 days)
A moderate
amount of the time (3-4 days)
Most or all of
the time (5-7 days)
j. I felt that people disliked me.... 0......................... 1......................... 2......................... .........3 k. My sleep was restless................
0.........................
1.........................
2.........................
.........3
l. I talked less than usual............
0.........................
1.........................
2.........................
.........3
m. I felt lonely...............................
0.........................
1.........................
2.........................
.........3
n. I enjoyed life.............................
0.........................
1.........................
2.........................
.........3
o. I felt sad....................................
0.........................
1.........................
2.........................
.........3
p. I could not get going................
0.........................
1.........................
2.........................
.........3
q. I felt that I was at least as good as other people..........................
0.........................
1.........................
2.........................
.........3
r. I thought my life had been a failure.......................................
0.........................
1.........................
2.........................
.........3
s. People were unfriendly............
0.........................
1.........................
2.........................
.........3
t. I had crying spells....................
0.........................
1.........................
2.........................
.........3
96a. Use the following scale to rate how well each of the following statements describes you. Source: Modified from Hazant & Shaver, 1987
(CIRCLE ONE ON EACH LINE)
Not at all
like me
Exactly like me
a. I find it relatively easy to get close to others and am comfortable depending on them. I don't often worry about being abandoned or about someone getting close to me.
1
2
3
4
5
6
7
b. I am somewhat uncomfortable being close to others. I find it difficult to trust them completely, difficult to allow myself to depend on them. I am nervous when anyone gets too close, and often, people want me to be more intimate than I feel comfortable being.
1
2
3
4
5
6
7
c. I find that others are reluctant to get as close as I would like. I often worry that people don't really love me or won=t want to stay with me. I want to get very close to people, and this sometimes scares people away.
1
2
3
4
5
6
7
96b. Which of the three statements above is most like you? Source: Modified from Hazant & Shaver, 1987
(CIRCLE ONE)
Statement A ......................................................................................................... 1
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Statement B ........................................................................................................ 2
Statement C ......................................................................................................... 3
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THESE FOLLOW-UP INFORMATION PAGES WILL BE SEPARATED FROM THE OTHER INFORMATION YOU PROVIDE BEFORE ANY DATA ARE ENTERED INTO OUR COMPUTERS. YOUR NAME WILL NOT BE CONNECTED WITH YOUR ANSWERS TO THE MAIN PORTION OF THE QUESTIONNAIRE. 1. What is your name, and address? NAME: _______________________________________________________________________________________________ Last First Middle ADDRESS: _________________________________________________________________________________ Number Street ADDRESS CONTINUED: _________________________________________________________________________________ _______________________________________________________________________________________________ City State ZIP Code 2a. Do you have a telephone? No .............................. 0 --> SKIP TO QUESTION 3 Yes ............................. 1 2b. What is your telephone number? TELEPHONE: (___________)______________________________________________ Area Code Number 3. What is the name, address, and telephone number of a close relative or friend who does not live with you? Choose someone who is likely to know how to locate you if you move. NAME: _______________________________________________________________________________________________ Last First Middle ADDRESS: ____________________________________________________________________________________ Number Street ADDRESS CONTINUED:_________________________________________________________________________ _______________________________________________________________________________________________ City State ZIP Code
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4a. Does this relative/friend have a telephone? No ...................................... 0 --> SKIP TO 4c Yes ..................................... 1 4b. What is the telephone number of this relative/friend? TELEPHONE: (____________)______________________________ Area Code Number 4c. What is this person's relationship to you? _______________________________________________________ 5a. What is the name, address, and telephone number of another close relative or friend who does not live with you? Choose someone who is likely to know how to locate you if you move. NAME: _______________________________________________________________________________________________ Last First Middle ADDRESS: ____________________________________________________________________________________ Number Street ADDRESS CONTINUED:_________________________________________________________________________ _______________________________________________________________________________________________ City State ZIP Code 6a. Does this relative/friend have a telephone? No ...................................... 0 --> SKIP TO 4c Yes ..................................... 1 6b. What is the telephone number of this relative/friend? TELEPHONE: (____________)______________________________ Area Code Number 6c. What is this person's relationship to you? _______________________________________________________ We want to thank you very much for completing the Sloan Parent Survey. You have made an extremely valuable contribution to this important study about the relationship between family and work.
- ICPSR 4549
- About Research Connections
- Terms of Use
- Survey for Moms of Young Children
- I. Your Family's Background
- II. Your Education, Income and Work Life
- III. Your Place of Work
- IV. History and Perceptions of Family LIfe
- V. Household Activities
- VI. You and Your Spouse/Partner
- VII. You and Your Child
- VIII. Personal Well-Being and Health
- Survey for Dads of Young Children
- I. Your Family's Background
- II. Your Education, Income and Work Life
- III. Your Place of Work
- IV. History and Perceptions of Family Life
- V. Household Activities
- VI. You and Your Spouse/Partner
- VII. You and Your Child
- VIII. Personal Well-Being and Health
- Survey for Moms of Adolescents
- I. Your Family's Background
- II. Your Education, Income and Work Life
- III. Your Place of Work
- IV. History and Perceptions of Family Life
- V. Household Activities
- VI. You and Your Spouse/Partner
- VII. You and Your Teenager
- VIII. Personal Well-Being and Health
- Question Sources for Survey for Moms of Adolescents
- Survey for Dads of Adolescents
- I. Your Family's Background
- II. Your Education, Income and Work Life
- III. Your Place of Work
- IV. History and Perceptions of Family Life
- V. Household Activities
- VI. You and Your Spouse/Partner
- VII. You and Your Teenager
- VIII. Personal Well-Being and Health
