750 word Reflection essay
Coronavirus Survey Interview Schedule
First, I would like to get some background information from you. I will not be asking you to provide
information that would identify who you are, such as your name, phone number, or home address. May I
begin?
1. Which one of the following best describes your race and/or ethnicity? (read options aloud)
White, White, African American, African American,
Non-Hispanic Hispanic Non-Hispanic Hispanic
Asian American Indian Native Hawaiian Other
or Alaskan Native or Pacific Islander
2. In what year were you born? _________ (enter year, e.g., 1995)
3. What is the highest level of schooling that either your mother or your father completed?
Less than H.S. H.S. Diploma Some College Associate’s Degree Bachelor’s Degree or Higher
4. Which one of the following best characterizes your political ideology? Are you:
Very Liberal Somewhat Liberal Neutral Somewhat Conservative Very Conservative
Thank you. Next, I want to ask you about some of your habits during November and December of 2020
related to the coronavirus, social distancing, and mask wearing. May I begin?
5. Out of every 10 times you were in a public space where mask wearing was recommended but not
required, how many times did you wear a mask over both your mouth and nose?
_______ Times (Enter response from 0-10)
6. Out of every 10 times you were in a public space, how many times did you use hand sanitizer or
wash your hands after touching door handles, shopping carts, and other surfaces?
_______ Times (Enter response from 0-10)
7. Out of every 10 times you were in a public space, how often did you work to maintain a minimum of
six feet of distance from other people?
_______ Times (Enter response from 0-10)
8. How many times did you attend social gatherings (e.g., Thanksgiving) of more than 5 people where
social distancing and mask wearing was not taking place? (read options aloud)
Never Once Twice 3 Times 4 Times 5 or More Times
Thank you. For the next two questions, I will be asking you about the behavior and attitudes of your
close friends about taking steps to reduce the transmission of the coronavirus. May I begin?
9. How many of your four closest friends consistently took steps during November and December of
2020 to reduce the transmission of the coronavirus (mask-wearing, hand washing, social distancing)?
None One Two Three All Four
10. How many of your four closest friends believed it was very important to practice social distancing
and mask-wearing during November and December 2020 to reduce the transmission of the
coronavirus?
None One Two Three All Four
Thank you for your answers. I want to end the interview by having you respond to a short series of statements
about some of your attitudes in general rather than specific to the coronavirus. For each statement, please
tell me how much you disagree or agree. May I begin? (read options to person until they understand the
options are the same for each statement):
11. You often do whatever brings you pleasure here and now at the cost of some distant goal.
Strongly Disagree Disagree Agree Strongly Agree
12. You are more concerned with what happens to you in the short run than in the long run.
Strongly Disagree Disagree Agree Strongly Agree
13. You don’t devote much thought and effort to preparing for the future.
Strongly Disagree Disagree Agree Strongly Agree
14. Sometimes you will take a risk just for the fun of it.
Strongly Disagree Disagree Agree Strongly Agree
15. You sometimes find it exciting to do things that could get you into trouble.
Strongly Disagree Disagree Agree Strongly Agree
16. Excitement and adventure are more important to you than security.
Strongly Disagree Disagree Agree Strongly Agree
17. You try to look out for yourself first, even if it means making things difficult for other people.
Strongly Disagree Disagree Agree Strongly Agree
18. If things you do upset people, it’s their problem, not yours.
Strongly Disagree Disagree Agree Strongly Agree
19. You are not very sympathetic to other people when they are having problems.
Strongly Disagree Disagree Agree Strongly Agree
Thank you so much for your time. That was the last item on the survey.
20. What is the sex of the participant? (do not ask out loud) Female Male