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Telephone (CATI) SurveySection C Disability Information & Travel Outside The Home

Telephone (CATI) Survey
Section C
Disability Information & Travel Outside The Home

PROGRAMMER NOTE:

OPTION (6) SHOULD NOT DISPLAY FOR SELECTED RESPONDENTS WHO DO NOT HAVE DISABILITIES (ENUM.DISABLED IS NOT 1) AND WHO ARE AGE 18 AND OVER. IF PROXY IS NEEDED FOR THESE RESPONDENTS, INTERVIEWER WILL NEED TO CODE AS PROBLEM.

FOR CHILDREN AGE 17 AND YOUNGER, DISPLAY OPTION 6 AS "(NEW) MKA NEEDED."

FOR SELECTED RESPONDENTS WHO HAVE DISABILITIES (ENUM.DISABLED=1), AND WHO ARE AGE 18 AND OLDER, DISPLAY OPTION 6 AS " (NEW) PROXY NEEDED."

INTRO2 Hello, may I speak to {SELECTED HHM NAME/PROXY NAME}?

[This is {INTERVIEWER'S NAME} and I'm calling for the U.S. Department of Transportation about a survey on transportation use.]
(HELLO)

R SPEAKING/COMING TO THE PHONE - 1 GO TO NEXT PROG. NOTE
R LIVES HERE - NEEDS APPOINTMENT - 2
R KNOWN LIVES AT ANOTHER NUMBER - 3
NEVER HEARD OF R - 4
TELEPHONE COMPANY RECORDING - 5
(NEW) PROXY NEEDED - 6
ANSWERING MACHINE - AM
RETRY DIALING - RT
GO TO RESULT - GT

PROGRAMMER NOTE:

IF THE SCREENER RESPONDENT IS THE SELECTED HHM, GO TO THE 1ST DISPLAY IN C1.

IF THE SCREENER RESPONDENT IS THE PROXY FOR A HHM GO TO THE 2ND DISPLAY IN C1.

IF THE RESPONDENT IS NOT THE SCREENER RESPONDENT AND IS A PROXY FOR A HHM, GO TO THE 3RD DISPLAY IN C1. USE ENUM.PROX HHM TO DETERMINE WHETHER THE WORDS "We recently spoke with your household about U.S. Department of Transportation Study" SHOULD BE DISPLAYED.

IF THE SELECTED HHM IS NOT THE SCREENER RESPONDENT AND IS RESPONDING FOR HIMSELF/HERSELF, GO TO THE 4TH DISPLAY IN C1.

C1. {Next, I'm going to ask some questions about your transportation use.}

{Next, I'm going to ask about { HHM'S NAME/AGE/SEX} transportation use.}

[This is {INTERVIEWER'S NAME} and I'm calling for the U.S. Department of Transportation about a survey on transportation use.]

We recently spoke with your household about a U.S. Department of Transportation Survey. We were informed that you are the best person to provide information about {NAME/AGE/SEX OF HHM THAT NEEDS A PROXY}. We are calling to ask you some questions about {his/her} transportation use.

{[This is {INTERVIEWER'S NAME} and I'm calling for the U.S. Department of Transportation about a survey on transportation use.]

{We recently spoke with your household about a U.S. Department of Transportation Survey. We are calling to ask you some questions about your transportation use. }

[PRESS ENTER TO CONTINUE.]

PROGRAMMER NOTE:

WHERE APPLICABLE THROUGHOUT THE QUESTIONNAIRE, FOR DISPLAYS WITHIN A QUESTION, USE 1ST DISPLAY IF TALKING TO THE SUBJECT. ELSE, USE THE 2ND DISPLAY.

RANGE FOR C2 IS 0 TO 7.

C2. On average, about how many days per week {do you/does NAME/AGE/SEX OF HHM} leave the home for any reason?
(NUMDAYS)

[ENTER 0, IF R NEVER LEAVES THE HOME.]

NUMBER OF DAYS/WEEK LEAVE HOME - |__|
REFUSED  -7
DON'T KNOW  -8

PROGRAMMER NOTE:

1. IF THE SELECTED HHM IS UNDER AGE 16:

IF B3 IS 1 AND ENUM.DISABLED FOR THE SUBJECT IS 1, AUTOCODE INFORMATION FROM B2C THROUGH B2E IN C3 THROUGH C5. THEN GO TO PROGRAMMER NOTE BEFORE C5A.

IF B3 IS GREATER THAN 1 OR -7 OR -8, GO TO PROGRAMMER NOTE BEFORE C3. ELSE, GO TO PROGRAMMER NOTE BEFORE C6 .

2. IF SELECTED HHM IS 16 AND ABOVE OR IF AGE IS MISSING:

IF B1 IS 1 AND ENUM.DISABLED IS 1, AUTOCODE INFORMATION FROM B2C THROUGH B2E IN C3 THROUGH C5. THEN GO TO THE PROGRAMMER NOTE BEFORE C5A.

IF B1 IS 1 AND ENUM.DISABLED IS NOT 1, GO TO PROGRAMMER NOTE BEFORE C6.

IF B1 IS GREATER THAN 1 AND B3 IS 1 AND YOU ARE SPEAKING TO THE SCREENER RESPONDENT AND ENUM.DISABLED FOR HIM/HER IS 1, GO TO PROGRAMMER NOTE BEFORE C5A. AUTOCODE B2C THROUGH B2E IN C3 THROUGH C5.

IF A SCREENER RESPONDENT IS SELECTED FOR A NON-DISABLED INTERVIEW, DO NOT RE-ASK THE DISABILITY QUESTIONS. CIA, COB, CIA, COB, COCA, COD, AND C5 SHOULD BE AUTO CODED AS 2, NO.

ELSE, GO TO BOX BEFORE C3.

 

PROGRAMMER NOTE:

IF TALKING TO THE SCREENER RESPONDENT, DISPLAY THE FOLLOWING INTRODUCTION BEFORE GOING TO THE 2ND SENTENCE IN C3. Earlier, you answered some questions about disabilities for members of your household. Now, I need to ask these questions specifically for {you/NAME/AGE/SEX OF HHM}. ELSE, GO DIRECTLY TO C3.

C3. A focus of this survey is on transportation needs of persons with disabilities. {Do you/Does NAME/AGE/SEX OF HHM} have any of the following long lasting conditions:

[INTERVIEWER NOTE: EXCLUDES HEALTHY INFANTS AND CHILDREN YES NO REF DK
a. Blindness, deafness, or a severe vision or hearing impairment?
(SEEHEAR)
1 2 -7 -8
b. A condition that substantially limits one or more basic physical activities such as walking, climbing stairs, reaching, lifting, or carrying?
(BASICACT)
1 2 -7 -8

 

PROGRAMMER NOTE:

IN C4, IF SUBJECT IS UNDER 16 YEARS OF AGE, DO NOT ASK C4C AND C4D.

[INTERVIEWER NOTE: EXCLUDES HEALTHY INFANTS AND CHILDREN

C4. Because of a physical, mental or emotional condition lasting six months or more, {do you/does NAME/AGE/SEX OF HHM} have any difficulty in doing any of the following activities:

YES NO REF DK
a. Learning, remembering or concentrating?
(MEMORY)
1 2 -7 -8
b. Dressing, bathing, or getting around inside the home?
[INTERVIEWER NOTE: DOES NOT INCLUDE HEALTHY INFANTS AND CHILDREN
(MOBILE)
1 2 -7 -8
c. Going outside the home alone to shop or visit a doctor's office?
(GOOUT)
1 2 -7 -8
d. Working at a job or business?
(DIFFJOB)
1 2 -7 -8

 

PROGRAMMER NOTE:

IF SUBJECT IS 22 AND OVER, GO TO PROGRAMMER NOTE BEFORE C5A. ELSE, CONTINUE.

C5. {Do you/Does NAME/AGE/SEX OF HHM} receive special education services?
(SPECEDU)

YES 1
NO 2
REFUSED  -7
DON'T KNOW  -8

Programmer Note:

IF C3A, B OR C4 A, B, C , D OR C5 = 1, ASK C5A.

DISPLAY RESPONSES FROM ABOVE QUESTIONS THAT ARE 1.

If ONE PERSON HH OR SCREENER RESPONDENT AND C3, C4, AND C5 WERE AUTOCODED (ENUM.DISABLED IS 1 FOR SCREENER RESPONDENT), Before asking C5a, add introduction, {You told me you have certain conditions or difficulties. }

IF C3, C4, AND C5 WERE AUTOCODED AND YOU ARE SPEAKING WITH AN MKA/PROXY, Before asking C5a, add introduction, {We have that {NAME/AGE/SEX OF HHM} has certain conditions or difficulties. }

IF SUBJECT IS AGE 15 OR YOUNGER, USE 1st DISPLAY IN C5A.

ELSE SKIP TO PROGRAMMER NOTE BEFORE C6.

C5A. Overall, {do you/does/NAME AGE SEX OF HHM} consider these conditions or difficulties to be mild, moderate, or severe?

(DIFFSEV)

MILD 1
MODERATE 2
SEVERE 3
REFUSED  -7
DON'T KNOW  -8

PROGRAMMER NOTE:

IF C3A IS 1, ASK C5B. ELSE SKIP TO PROGRAMMER NOTE BEFORE C6.

C5B. I have recorded that {you have/NAME/AGE/SEX OF HHM has} a vision or hearing impairment. Does the condition affect {your/his/her} vision, hearing or both?

(WHICHIS)

VISION 1
HEARING 2
BOTH 3
REFUSED  -7
DON'T KNOW  -8

PROGRAMMER NOTE:

USE 1ST DISPLAY (1ST SENTENCE) IF C2 IS 0. ELSE, USE 2ND DISPLAY.

IF B1 IS GREATER THAN ONE AND ENUM.DISABLED IS NOT 1 OR 2, ADD INTRODUCTION TO C6 {The focus of this survey is on transportation use by both persons with and without disabilities.}

C6. {You indicated that {you do/NAME/AGE/SEX OF HHM does} not leave the home. Is this because {you need/s(he) needs} specialized assistance or equipment to travel outside the home?} {{Do you/does NAME/AGE/SEX OF HHM} need any specialized assistance or equipment to travel outside the home?}
(NEEDHELP)

YES  1
NO  2  GO TO PROG. NOTE BEFORE C8
REFUSED  -7  GO TO PROG. NOTE BEFORE C8
DON'T KNOW  -8  GO TO PROG. NOTE BEFORE C8

C7. What kinds of specialized assistance or equipment?

(HLPTYP1 TO HLPTYP17; OTHER SPECIFY (91) IS HLPTYPOS)

[IF ASKED: THIS IS ASSISTANCE/EQUIPMENT TO TRAVEL OUTSIDE THE HOME.]

[CODE ALL THAT APPLY. USE CTRL/P TO EXIT.]

TYPES OF ASSISTANCE:
ASSISTANCE FROM ANOTHER PERSON WHILE INSIDE THE HOME - 1
ASSISTANCE FROM ANOTHER PERSON WHILE OUTSIDE THE HOME - 2
INTERPRETER - 3
PROFESSIONAL CARE SUCH AS REHABILITATION OR COUNSELING - 4
SERVICE ANIMAL - 5
TYPES OF EQUIPMENT:
MANUAL WHEELCHAIR - 6
ELECTRIC SCOOTER OR WHEELCHAIR - 7
CANE, CRUTCHES OR WALKER - 8
LEG, ARM, BACK BRACE - 9
PROSTHETIC DEVICE (E.G., ARTIFICIAL ARM, HAND, LEG, FOOT) - 10
AUTOMOTIVE ADAPTIVE AID (E.G., HAND CONTROLS) - 11
PUBLIC TRANSPORTATION AID, (E.G., WHEELCHAIR LIFT, KNEELING BUS, ETC.) - 12
HEARING AID - 13
MAGNIFIERS OR HIGH-POWERED GLASSES - 14
OXYGEN - 15
MEDICATION - 16
OTHER (SPECIFY) ______________________________ 91
REFUSED  -7
DON'T KNOW  -8

PROGRAMMER NOTE:

USE 1ST DISPLAY (1ST SENTENCE) IF C2 IS 0. ELSE, USE 2ND DISPLAY.

C8. {You told me that {you do/NAME/AGE/SEX OF HHM does} not leave the home. Is this because {you have /s(he) has} difficulties in getting the transportation that {you need/{he/she} needs}?} {Do you/does NAME/AGE/SEX OF HHM} have any difficulties in getting the transportation that {you need/{he/she} needs}?
(HAVEPROB)

YES  1
NO  2  GO TO SECTION D
REFUSED  -7  GO TO SECTION D
DON'T KNOW  -8  GO TO SECTION D

C9. What kinds of difficulties?
[PROBE: Anything else?]

(TRNPRB1 TO TRNPRB13; OTHER SPECIFY (91) IS TRNPRBOS)

[CODE ALL THAT APPLY. USE CTRL/P TO EXIT.]

TRANSPORTATION RELATED: DON'T HAVE A CAR  1
NO/LIMITED PUBLIC TRANSPORTATION IN COMMUNITY  2
NO/LIMITED TAXI SERVICE IN COMMUNITY  3
BUSES DON'T RUN ON TIME  4
BUSES DON'T RUN WHEN NEEDED  5
BUS STOPS ARE TOO FAR AWAY  6
TRANSPORTATION DOES NOT ACCOMMODATE SPECIAL EQUIPMENT [E.G., WALKER, CANE, WHEELCHAIR]  7
DISABILITY RELATED:
PHYSICAL/ OTHER DISABILITY MAKES TRANSPORTATION HARD TO USE  8
OTHER:
COSTS TOO MUCH  9
DON'T WANT TO ASK OTHERS FOR HELP/ INCONVENIENCE OTHERS  10
THERE'S NO ONE I CAN DEPEND ON  11
FEAR OF CRIME STOPS ME FROM GOING PLACES  12
OTHER (SPECIFY) __________________________ 91
REFUSED  -7
DON'T KNOW  -8