Main Page of Report | Contents of Report
| Survey instruments | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Recom. Items |
Topic/Items | WES | NSAF | SPD | MO | NE | Alameda | Illinois | HCC | Iowa CI | CalWks | YFC Com |
| Demographics | ||||||||||||
| * | Age/DOB of SM | X | X | X | X | X | X | X | X | X | X | |
| * | Ethnicity (Hispanic or Latino descent) | X | X | X | X | |||||||
| * | Race | X | X | X | X | X | X | X | X | |||
| Born in US? | X | X | X | X | X | X | ||||||
| US citizen? | X | X | X | |||||||||
| * | current marital status | X | X | X | X | X | X | X | X | X | X | |
| how long married/living together | X | |||||||||||
| age / sex of spouse | X | X | ||||||||||
| * | currently living together as couple with someone | X | X | X | X | |||||||
| * | currently live with spouse? | X | X | |||||||||
| Educational Attainment/Low Educational Level | ||||||||||||
| * | Highest grade completed | X | X | X | X | X | X | X | X | X | ||
| * | types of degrees / diplomas / certificates | X | X | X | X | X | X | |||||
| age stopped attending school | X | |||||||||||
| Household Composition | ||||||||||||
| * | # people in HH | X | X | X | X | X | X | X | X | |||
| * | relationships of people to SM in HH | X | X | X | X | |||||||
| * | # kids age 5 or younger living in HH | X | X | |||||||||
| * | # kids age 6-17 living in HH | X | X | |||||||||
| ages / names of kids [under 18] in HH | X | X | X | X | X | X | ||||||
| * | Does SM have kids [under 18] not living with them? | X | X | X | X | |||||||
| # of kids under 18 living outside HH | X | X | X | |||||||||
| * | Where are they living? | X | X | |||||||||
| * | Why are they living there? | X | ||||||||||
| Pregnancies / Births | ||||||||||||
| sm had child last yr (part of list of life stress events) | X | |||||||||||
| Living Arrangements / Family and Child Moves | ||||||||||||
| type of living arrangement (own, rent, homeless, etc) | X | X | X | X | X | X | X | X | ||||
| * | Does SM live in public housing? | X | X | X | X | X | X | |||||
| Does SM receive vouchers for housing? | X | X | X | X | ||||||||
| SM's home owned / rented / occupied w/o cash payment | X | |||||||||||
| how long sm live in home | X | X | ||||||||||
| sm move from either from in-state or out of state | X | |||||||||||
| * | # bedrooms in home | X | X | X | ||||||||
| SM's rent / mortgage payments last month | X | X | X | |||||||||
| Total HH monthly rent / mortgage payments | X | |||||||||||
| what kind of place sm living in now (verbatim) | X | |||||||||||
| can stay where living next 30 days w/o being asked to leave | X | |||||||||||
| what other types of housing SM lived in past 12 mo's | X | |||||||||||
| how long sm lived in each type of place | X | |||||||||||
| where else [how long] has sm lived in past 12 mos | X | |||||||||||
| * | current housing situation interfere w/ wk or training | X | ||||||||||
| * | how many times did sm move (in past 12 mos) | X | X | X | ||||||||
| when was most recent move | X | |||||||||||
| * | primary reason sm moved? | X | ||||||||||
[Go to Contents ]
| Survey instruments | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Recom. Items |
Topic/Items | WES | NSAF | SPD | MO | NE | Alameda | Illinois | HCC | Iowa CI | CalWks | YFC Com |
| Employment History | ||||||||||||
| * | work in the last 12 months | X | X | X | X | X | X | |||||
| * | months/weeks employed during last 12 months | X | X | |||||||||
| how many hrs usually worked p/wk last yr | X | X | X | |||||||||
| * | # different jobs in last 12 months | X | ||||||||||
| Current Job / Main Job / Most recent Job | ||||||||||||
| sm (or spouse) currently working | X | X | X | X | X | X | ||||||
| * | no. of current jobs | X | X | X | ||||||||
| * | total hrs per week (all jobs) | X | X | X | X | X | X | X | ||||
| * | job start date/length of employment | X | X | X | X | X | X | X | ||||
| * | hrs per week - current, main or most recent job | X | X | X | X | X | X | X | ||||
| * | seasonal/temporary | X | X | X | X | |||||||
| * | shift information | X | X | X | ||||||||
| union membership | X | X | ||||||||||
| employed by self, gov., or private employer | X | X | X | X | X | |||||||
| * | industry/type of company | X | X | X | X | X | X | X | ||||
| * | occupation | X | X | X | X | X | X | X | ||||
| how long for new person to do your job? | X | |||||||||||
| no. of employees at company | X | X | ||||||||||
| * | hourly rate of pay | X | X | X | X | |||||||
| sm offered bonuses | X | X | ||||||||||
| * | weekly / monthly earnings | X | X | X | X | X | X | X | X | |||
| * | types of benefits offered | X | X | X | X | X | X | |||||
| expectations for working at job 6 mo/1 yr/2 yrs from now | X | |||||||||||
| * | opportunity for advancement | X | ||||||||||
| * | reasons SM left job | X | X | X | ||||||||
| Reasons Not Currently Working/Never worked | ||||||||||||
| * | Main Reasons (multiple) | X | X | X | ||||||||
| Main Reason (single) | X | X | X | |||||||||
| Has worked in exchange for goods/services (no $$) | X | |||||||||||
| * | lowest hourly wage acceptable for taking a job | X | ||||||||||
| List of reasons why sm can't find/keep a job (because | ||||||||||||
| it's discouraging to sm | X | |||||||||||
| someone makes sm feel guilty | X | X | ||||||||||
| someone refused to help sm | X | |||||||||||
| sm can't attend classes | X | |||||||||||
| sm harassed at work | X | |||||||||||
| someone caused sm to lose a job | X | |||||||||||
| list of job types/would sm take that job now if offered | X | |||||||||||
| * | perceived hiring discrimination (race, sex, welfare) | X | X | |||||||||
| Reasons not Working Prior Month | ||||||||||||
| couldn't afford / arrange child care | X | X | ||||||||||
| child was ill / disabled | X | |||||||||||
| sm currently ill / disabled | X | X | ||||||||||
| working does not pay sm enough $ | X | |||||||||||
| sm feels depressed / overwhelmed | X | |||||||||||
| sm getting financial support f/ husband / partner | X | |||||||||||
| sm in school / training | X | |||||||||||
| sm does not want to work | X | |||||||||||
| sm cannot find work | X | |||||||||||
| no jobs available in local area | X | |||||||||||
| sm not qualified for jobs | X | |||||||||||
| sm has transportation problems | X | |||||||||||
| sm has drinking problem | X | |||||||||||
| sm pregnant | X | |||||||||||
| sm retired | X | |||||||||||
| Participation in Work/Job Skills Training | ||||||||||||
| * | attend/received help find / pay for a GED Class last yr | X | X | X | X | X | ||||||
| * | attend/received help find / pay other ed. Training last yr | X | X | X | ||||||||
| sm receive help with resumes / applications last yr | X | |||||||||||
| sm receive help with proper dress, behavior last yr | X | |||||||||||
| sm receive help with on-the-job training last yr | X | X | ||||||||||
| sm participate in other ed / train programs last yr | X | X | X | X | X | |||||||
| sm participate in unpaid job | X | X | X | |||||||||
| sm participate in life skills / job readiness classes | X | X | ||||||||||
| sm take courses that trained for specific jobs | X | X | X | X | ||||||||
| sm receive training to improve job skills / learn new job | X | X | ||||||||||
| # different schools / training programs attended | X | X | ||||||||||
| why stopped attending program? | X | X | ||||||||||
| hours per week attending | X | X | X | X | X | |||||||
| describe skills you are learning | X | X | ||||||||||
| sm complete program? | X | |||||||||||
| sm find job as result of attending program? | X | X | ||||||||||
| type of school or training sm attended | X | X | X | |||||||||
| sm required to participate in activities | X | |||||||||||
| sm do community work / unpaid wk as part of job train | X | X | ||||||||||
| Utilization of Job Search/Basic Work Orientation Services | ||||||||||||
| sm currently in job search activity | X | |||||||||||
| * | attend job search in past 12 mos (sm and/or spouse) | X | X | X | ||||||||
| * | helped/did sm get job thru this source? | X | X | |||||||||
| receive any help from job search or placement | X | |||||||||||
| sm required to participate in job search | X | |||||||||||
| how helpful were programs in teaching skills, | X | |||||||||||
| feeling better about yourself | X | |||||||||||
| Were programs frustrating . | X | |||||||||||
| or make it difficult to get things done during day | X | |||||||||||
| sm looked for wk during past 30 days | X | X | ||||||||||
| when last looked for work / how long ago | X | |||||||||||
| no. of employers contacted | X | |||||||||||
| no. of applications filled out | X | |||||||||||
| no. of interviews sm had | X | |||||||||||
| how many wks sm looking for work | X | X | ||||||||||
| no. of hours p/week looking for work | X | |||||||||||
| was sm offered a job | X | |||||||||||
| why did sm turn down job offer | X | |||||||||||
| list of methods used by sm to find a job | X | |||||||||||
| Earnings | ||||||||||||
| * | SM's earnings (last month/week) | X | X | X | X | X | X | X | ||||
| Other HH members earnings, last month | X | X | X | X | X | |||||||
| Income | ||||||||||||
| * | SM's income last month/ year | X | X | X | X | X | X | |||||
| * | income from other adults, [last month / yr] | X | X | X | X | X | X | X | ||||
| * | total household income | X | X | X | X | X | X | X | X | |||
| receipt / amount of AFDC [last month / yr] | X | X | X | X | X | X | X | X | ||||
| receipt / amount of Food Stamps [last month / yr] | X | X | X | X | X | X | X | X | X | |||
| receipt / amount of WIC [last month / yr] | X | X | X | X | X | X | X | |||||
| receipt / amount of child support [last month / yr] | X | X | X | X | X | X | X | |||||
| receipt / amount of Unemployment Ins. [Last mon / yr] | X | X | X | X | X | X | X | |||||
| receipt / amount of SSI / SS [last month / yr] | X | X | X | X | X | X | X | X | X | |||
| receipt / amount of foster child payments last month | X | X | X | X | ||||||||
| receipt / amount of $ from other HH members last mon | X | X | X | X | ||||||||
| receipt / amount of $ from family friends [last mon / yr] | X | X | X | X | X | X | X | |||||
| receipt / amount from other sources [last mon / yr] | X | X | X | X | X | X | ||||||
| * | rating of difficulty living on HH income right now? | X | X | |||||||||
| list of activities to make money - did any in past 6mos | X | |||||||||||
| perceived hardship for HH in next 2 mos | X | |||||||||||
| Child Support Payments | ||||||||||||
| * | Did SM/other HH adults receive CS? Amount? | X | X | X | X | X | X | X | X | |||
| * | Did sm make CS payments to Non-HH kids under 18 | X | X | |||||||||
| were CS payments part of court order | X | X | X | X | ||||||||
| how much CS did SM contribute in past 12 mos | X | X | ||||||||||
[Go to Contents ]
| Survey instruments | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Recom. Items |
Topic/Items | WES | NSAF | SPD | MO | NE | Alameda | Illinois | HCC | Iowa CI | CalWks | YFC Com |
| Low Prior Labor Force Participation | ||||||||||||
| * | ever worked for pay | X | X | X | X | |||||||
| * | when did sm last work for pay | X | X | X | ||||||||
| * | how much time/years employed since age 18 | X | X | |||||||||
| Lack of Work Orientation Skills (Dress, attendance) | ||||||||||||
| * | list of failed work skills and perceived seriousness | X | ||||||||||
| whether received training in dress/job behavior, etc | X | |||||||||||
| Few Job Skills | ||||||||||||
| * | list of job skills that SM has ever done | X | X | |||||||||
| Perceived Discrimination on the Job | ||||||||||||
| * | discrim. because of gender or race/ethnicity (series) | X | X | |||||||||
| * | sexual harassment | X | ||||||||||
| Learning Problems | ||||||||||||
| * | screener for dyslexia; dyscalcula - scale | X | X | |||||||||
| sm was in special education program in school | X | X | ||||||||||
| sm has learning disability | X | |||||||||||
| * | sm mentally retarded | X | ||||||||||
| * | sm has ADD | X | ||||||||||
| list of different types of learning problems | X | X | ||||||||||
| Limited English Fluency | ||||||||||||
| * | difficulty speaking / reading / writing English | |||||||||||
| because not SM's native language | X | |||||||||||
| what is SM's native language (if o/than English) | ||||||||||||
| comfort level w/speaking, writing and reading English | X | |||||||||||
| Illiteracy | ||||||||||||
| does HH have a library card/ how often used | X | X | ||||||||||
| how many newspapers/magazines does HH get | X | X | ||||||||||
| does SM have trouble reading books/newspaper/mag | X | X | ||||||||||
| how often does SM read to him/herself | X | X | ||||||||||
| Physical Health Problems and Disabilities | ||||||||||||
| * | current health status | X | X | X | X | X | X | X | X | |||
| * | chronicity of condition | X | X | X | ||||||||
| * | physical disability | X | X | |||||||||
| functional limitations | X | X | X | X | X | |||||||
| * | sm has no health insurance | X | X | X | X | X | ||||||
| Mental Health Conditions | ||||||||||||
| * | Depression - scale | X | X | X | X | X | X | X | X | |||
| * | Generalized Anxiety Disorder - scale | X | X | X | X | |||||||
| * | Post Traumatic Stress Disorder - scale | X | X | |||||||||
| Phobias - scale | X | X | X | |||||||||
| Alcohol and Substance Abuse/Dependency | ||||||||||||
| * | Alcohol Use/Dependency - scale | X | X | X | X | X | X | |||||
| * | Drug Use/Dependency - scale | X | X | X | X | X | X | |||||
| Criminal Involvement | ||||||||||||
| * | SM has past criminal record (makes it hard to get job) | X | ||||||||||
| * | convicted of felony since age 18 | X | ||||||||||
[Go to Contents ]
| Survey instruments | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Recom. Items |
Topic/Items | WES | NSAF | SPD | MO | NE | Alameda | Illinois | HCC | Iowa CI | CalWks | YFC Com |
| Family Member with Disability/Health Problem | ||||||||||||
| * | SM has child w/ health/behavioral/other needs | X | X | X | X | X | ||||||
| * | SM has other fam mem w/ disability/other needs | X | ||||||||||
| * | children have no health insurance | X | X | X | X | X | ||||||
| Problem with Child Care | ||||||||||||
| SM concerned about | ||||||||||||
| provider being too far away | X | X | ||||||||||
| * | child care too costly | X | X | |||||||||
| can't find child care when needed/during work hrs | X | X | X | |||||||||
| * | quality of available childcare | X | ||||||||||
| * | childcare not dependable | X | ||||||||||
| no relatives who could help out w/childcare | X | |||||||||||
| * | afraid caretaker would harm child | X | ||||||||||
| sm skip wk / training b/c worried about childs safety | X | |||||||||||
| # days in past mon. sm missed wk to take care of child | X | |||||||||||
| Due to problem w/childcare: | ||||||||||||
| * | unable to look for work/training program | X | X | |||||||||
| * | unable to take job/participate in training | X | X | X | X | X | ||||||
| * | was late for work/school/training | X | ||||||||||
| * | was absent from work/school/training | X | ||||||||||
| * | had to quit job or training activity | X | X | X | X | X | ||||||
| X | ||||||||||||
| no. of different current childcare arrangements | X | X | ||||||||||
| satisfaction with current childcare arrangement | X | |||||||||||
| sm docked pay b/c she lacked child care | X | |||||||||||
| how difficult was it to arrange childcare | X | X | ||||||||||
| how much do you pay for childcare | X | X | X | X | ||||||||
| do you swap services w/others for childcare | X | |||||||||||
| what is the quality of child care you use | X | X | ||||||||||
| did child have an accident, injury, poisoning in ch care | X | X | ||||||||||
| was any child under 12 in self-care | X | |||||||||||
| how big of a problem are child care issues in terms of working or going to school/training | X | |||||||||||
| receive child care subsidy | X | |||||||||||
| ease or problems getting child care subsidy | X | |||||||||||
| need for child care | X | |||||||||||
| types of child care used | X | |||||||||||
| number of hours per week child care used | X | |||||||||||
| receive any child care that is unpaid | X | |||||||||||
| following cc situations prevent sm from looking for work: | ||||||||||||
| * | getting care for infants | X | ||||||||||
| * | getting care for sick kids | X | ||||||||||
| * | getting care for disabled kids | X | ||||||||||
| * | getting care for kids after school | X | ||||||||||
| * | getting care during breaks / summer | X | ||||||||||
| * | getting care for kids in early mornings | X | ||||||||||
| is childcare a barrier to getting a job? | X | |||||||||||
| Domestic Violence | ||||||||||||
| * | physical abuse | X | X | X | X | X | ||||||
| * | sexual abuse | X | X | X | X | X | ||||||
| * | serious threats | X | X | X | X | |||||||
| * | abusive control | X | X | X | ||||||||
| * | emotional abuse or verbal humiliation | X | X | X | ||||||||
| * | stalking | X | ||||||||||
| * | interference with work | X | ||||||||||
| * | who committed abuse (partner v. stranger) | X | X | X | X | |||||||
| Family Member w/ Criminal Involvement | ||||||||||||
| family member or close friend in jail in past 12 mos | X | |||||||||||
| someone close to sm died or was killed | X | |||||||||||
| sm lived with someone with an alcohol or drug problem | X | |||||||||||
| sm lived with people who she wished didn't live there | X | |||||||||||
[Go to Contents ]
| Survey instruments | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Recom. Items |
Topic/Items | WES | NSAF | SPD | MO | NE | Alameda | Illinois | HCC | Iowa CI | CalWks | YFC Com |
| Transportation Problems | ||||||||||||
| * | How SM gets to job, etc | X | X | X | X | X | ||||||
| * | Minutes to get to work, etc. (one way) | X | X | X | X | X | ||||||
| * | SM has valid drivers license | X | X | X | X | X | X | |||||
| * | SM owns / has access to car | X | X | X | X | X | X | |||||
| * | Did sm car break down last month | X | ||||||||||
| community offers shuttle / van service? | X | |||||||||||
| * | trans. Issues prevent sm from working? | X | X | X | ||||||||
| trans issues prevent sm from attending ed. activities? | X | X | ||||||||||
| sm docked pay b/c sm lacked transportation | X | |||||||||||
| sm lost / quit job b/c lack of transportation | X | X | ||||||||||
| public trans. A reasonable way to get to work? | X | |||||||||||
| public trans. A barrier to getting a job? | X | |||||||||||
| availability of public transportation | X | |||||||||||
| * | Could you get to work via public trans if needed? | |||||||||||
| * | How long would it take you (via public trans.) | |||||||||||
| agree/disagr: there is good pub. trans in neighborhood | X | X | ||||||||||
| High Crime Rates | ||||||||||||
| problems in neighborhood with | X | |||||||||||
| police not coming or taking a long time when called | X | X | ||||||||||
| groups of youth hanging out in public | X | X | ||||||||||
| vandalism | X | X | ||||||||||
| prostitution | X | |||||||||||
| sexual assaults/rapes | X | |||||||||||
| muggings | X | |||||||||||
| gangs | X | |||||||||||
| * | drug use or dealing in the open | X | X | X | ||||||||
| * | unemployment | X | X | X | ||||||||
| * | Run down buildings and yards | X | X | X | ||||||||
| * | crime, assaults,burgleries | X | X | |||||||||
| would sm move from neighborhood if could | X | |||||||||||
| perception of neighborhood safety | X | |||||||||||
| had any serious problems w/neighbors in past yr | X | |||||||||||
| * | sm afraid to walk alone in 8 block vicinity | X | X | |||||||||
| * | sm feel safe at home at night | X | X | |||||||||
| * | sm feel neighborhood is safe for kids to play in | X | X | |||||||||
| Housing Problems/Lack of Affordable Housing | ||||||||||||
| * | availability of affordable housing | X | ||||||||||
| * | been homeless during past year | X | ||||||||||
| no. of days/weeks sm was homeless | X | |||||||||||
| * | been evicted in past year | X | X | |||||||||
| had gas/electricity turned off b/c couldn't pay bill | X | X | ||||||||||
| had phone service turned off b/c couldn't pay bill | X | X | X | |||||||||
| sought/received help from community agencies past yr | X | |||||||||||
| food security question (one out of the scale) | X | X | X | X | X | |||||||
| received help paying rent | X | |||||||||||
| Inadequate Job Availability | ||||||||||||
| not working b/cause no jobs available in local area | X | |||||||||||
| People in neighborhood have to travel long way to work | X | |||||||||||
| High unemployment | X | X | ||||||||||
| Inadequate Availability of Services | ||||||||||||
| are services available/did you use them in past yr | ||||||||||||
| community family health service | X | X | ||||||||||
| bank or credit union | X | |||||||||||
| organized summer recreational program | X | X | ||||||||||
| community daycare or after-school program | X | |||||||||||
| literacy, GED, or tutoring program | X | X | ||||||||||
| an employment office | X | |||||||||||
| are services available in your community | ||||||||||||
| career or job counseling | X | |||||||||||
| couseling or treatment for alcohol or drug abuse | X | |||||||||||
| counseling to help w/other personal or family problems | X | |||||||||||
| health clinics/places for emergency health care | X | |||||||||||
| are services available in your community | ||||||||||||
| birth control / family planning services | X | |||||||||||
| referrals or help finding needed assistance | X | |||||||||||
| help preparing for a GED | X | |||||||||||
| place to improve reading, math or other subject skills | X | |||||||||||
| recreational activity place for teenagers/young adults | X | |||||||||||
| place like big brother/big sister program | X | |||||||||||
| have you needed any
did you know where to go for |
X | |||||||||||
| have you received
where did you get help for |
X | |||||||||||
| assistance with physical health | X | |||||||||||
| prenatal care | X | |||||||||||
| help w/emotional or mental health | X | |||||||||||
| help w/alcohol or drug problems | X | |||||||||||
| help w/physical violence in your home | X | |||||||||||
| assistance w/managing money | X | |||||||||||
| help getting and keeping a job | X | |||||||||||
| child care (sitters) for your children | X | X | ||||||||||
| assistance paying utility bills | X | |||||||||||
| help finding housing | X | |||||||||||
| assistance paying the rent | X | |||||||||||
| low-cost attorney services | X | |||||||||||
| help arranging transportation | X | |||||||||||
| free/inexpenvise clothing for your children | X | |||||||||||
| free/inexpenvise clothing for yourself | X | |||||||||||
| free/inexpensive cold weather clothing/raincoats for all | X | |||||||||||
| free or reduced price meals for kids at school/Head Start | X | X | ||||||||||
| free/inexpensive goods (pots, pans, cleaning devices) | X | |||||||||||
| other assistance | X | |||||||||||
[Go to Contents ]
Main Page of Report | Main Contents
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Human Services Policy (HSP)
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