Adolescent Interview - University of North Carolina at ...
___ ___ ___ ___ ___ ___ ___ ___
ADOLESCENT INTERVIEW
INTERVIEW ONLY WITH PRIOR PARENT / SURROGATE PERMISSION.
1. Are you and I the only ones who can hear the questions and answers?
1 YES: GO TO 2
2 NO OR NOT SURE: Please make sure only you and I can hear the questions
and answers. We want you to have privacy during the
interview. GO TO 2
2. How old are you?
1 less than 12 years old
2 12 years old
3 13 years old
4 14 years old
5 more than 14 years old
6 Don't Know
7 Refused
3. When were you born? ENTER DK FOR DON’T KNOW, RF FOR REFUSED
____ ____ ____ JAN=01 APR=04 JUL=07 OCT=10
MM/DD/YY FEB=02 MAY=05 AUG=08 NOV=11
MAR=03 JUN=06 SEP=09 DEC=12
4. Are you of Hispanic or Latino origin?
1 YES
2 NO
3 DON'T KNOW
4 REFUSED
5. What is your race? Are you...READ CHOICES AND RECORD MORE THAN ONE IF VOLUNTEERED
1 white
2 black or African American
3 American Indian or Native American, or
4 Asian or Pacific Islander?
5 OTHER: PLEASE SPECIFY OTHER RACE_____________________________
6 DON’T KNOW
7 REFUSED
6. IF ONE RACE IN NO. 5: SKIP TO 7
IF >1 RACE IN NO. 5: Which one category describes your racial background best? Would you say...READ CHOICES
1 white
2 black or African American
3 American Indian or Native American, or
4 Asian or Pacific Islander?
5 OTHER
6 CANNOT CHOOSE ONLY ONE RACE
7 DON'T KNOW
8 REFUSED
7. How important would you say religion is in your life? Would you say religion is...
1 very important
2 somewhat important
3 not very important, or
4 not at all important
5 Don't Know
6 Refused
8. What grade were you in this past April (APRIL 1996)?
1 5th grade or lower
2 6th grade
3 7th grade
4 8th grade
5 9th grade
6 10th grade or higher
7 Don't Know
8 Refused
9. What was your grade average during your last grading period in school? READ CHOICES ONLY IF NECESSARY. IF SCHOOL DIDN'T GIVE LETTER GRADES: If the school had given letter grades, about what grade average do you think you would have had during your last grading period? READ CHOICES ONLY IF NECESSARY.
1 A
2 BETWEEN A AND B
3 B
4 BETWEEN B AND C
5 C
6 BETWEEN C AND D
7 D
8 BETWEEN D AND F
9 F
10 DON'T KNOW
11 REFUSED
10. Are you ever away from home without adults on school nights?
1 YES
2 NO
3 Don't Know
4 Refused
11. Do you have to be home by a certain time on school nights?
1 YES
2 NO
3 NEVER AWAY FROM HOME ON SCHOOL NIGHTS
4 Don't Know
5 Refused
12. Are you ever away from home without adults on weekend nights?
1 YES
2 NO
3 Don't Know
4 Refused
13. Do you have to be home by a certain time on weekend nights?
1 YES
2 NO
3 NEVER AWAY FROM HOME ON WEEKEND NIGHTS
4 Don't Know
5 Refused
14. How much does your family influence what you do? Would you say your family influences you ... READ CATEGORIES
1 very much
2 some
3 not very much, or
4 not at all?
5 Don't Know
6 Refused
15. In your family, would you say there are...READ CHOICES
1 lots of arguments,
2 some arguments,
3 very few arguments, or
4 no arguments?
5 Don't Know
6 Refused
16. Some people think only good things happen from smoking cigarettes, others think only bad things happen, and others think both good and bad things happen. Taking everything into consideration, if you smoked cigarettes now do you think...READ CHOICES
1 only good things would happen,
2 both good and bad things would happen, or
3 only bad things would happen?
4 Don't Know
5 Refused
17. How much have you ever smoked cigarettes in your life. You can just say "stop" after I have said it. Would you say: ... WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 none at all, not even a puff SKIP TO 21
2 one or two puffs but not a whole cigarette GO TO 18
3 1 to 5 whole cigarettes GO TO 18
4 6 to 20 whole cigarettes, or GO TO 18
5 more than 20 whole cigarettes? GO TO 18
6 Don't Know GO TO 18
7 Refused GO TO 18
18. During the last 30 days, on how many days did you smoke cigarettes? IF DON'T KNOW FOR SURE: Well, during the last 30 days, about how many days did you smoke cigarettes?
__ __ DAYS. ENTER DK FOR DON'T KNOW (EVEN APPROXIMATELY), RF FOR REFUSED
IF 00: SKIP TO 20
19. What best describes your cigarette smoking during the last 30 days? You can say "stop" after I have said it. WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 didn't smoke, not even a puff, during the last 30 days
2 a puff or more but less than 1 cigarette per day
3 1 to 5 cigarettes per day
4 6 or more cigarettes per day
5 Don't Know
6 Refused
20. During the last 6 months, did you ever try to quit smoking cigarettes?
1 YES
2 NO
3 NEVER SMOKED ENOUGH TO CONSIDER QUITTING
4 Don't Know
5 Refused
21. During the last 6 months, about how many times did any family members offer you a cigarette?
1 10 OR MORE TIMES
2 6 to 9 times
3 2 to 5 times
4 once
5 never
6 Don't Know
7 Refused
22. How easy would it be for you to get a cigarette at home? Would you say it would be:
1 very easy
2 somewhat easy
3 somewhat difficult, or
4 very difficult?
5 Don't Know
6 Refused
23. When it comes to smoking cigarettes, has anyone in your family talked to you about what you can and cannot do?
1 YES
2 NO
3 Don't Know
4 Refused
24. How many of your 3 best friends smoke cigarettes now?
1 3
2 2
3 1
4 none
5 Don't Know
6 Refused
25. Do you think you will smoke 1 or more cigarettes between now and when you are 18 years of age? Do you think you will...READ CHOICES
1 for sure,
2 probably will,
3 even chance,
4 probably won't, or
5 won't for sure?
6 Don't Know
7 Refused
26. Have you ever tried chewing tobacco (such as Redman, Levi Garrett, or Beechnut) or snuff (such as Skoal, Skoal Bandits, or Copenhagen)?
1 YES: GO TO 27
2 NO: SKIP TO 29
3 Don't Know: SKIP TO 29
4 Refused: SKIP TO 29
27. During the last 30 days, on how many days did you use chewing tobacco or snuff? IF DON'T KNOW FOR SURE: Well, during the last 30 days, about how many days did you use chewing tobacco or snuff?
__ __ DAYS. ENTER DK FOR DON’T KNOW (EVEN APPROXIMATELY), RF FOR REFUSED
28. During the last 6 months, did you ever try to quit using chewing tobacco or snuff?
1 YES
2 NO
3 NEVER USED ENOUGH TO CONSIDER QUITTING
4 DON'T KNOW
5 REFUSED
29. Some people think only good things happen from using chewing tobacco or snuff, others think only bad things happen, and others think both good and bad things happen. Taking everything into consideration, if you used chewing tobacco or snuff now do you think...READ CHOICES
1 only good things would happen,
2 both good and bad things would happen, or
3 only bad things would happen?
4 DON'T KNOW
5 REFUSED
30. During the last 6 months, about how many times has any family member offered you chewing tobacco or snuff?
1 10 OR MORE TIMES
2 6 to 9 times
3 2 to 5 times
4 once
5 never
6 DON'T KNOW
7 REFUSED
31. How easy would it be for you to get chewing tobacco or snuff at home? Would you say it would be:
1 very easy
2 somewhat easy
3 somewhat difficult
4 very difficult
5 DON'T KNOW
6 REFUSED
32. When it comes to using chewing tobacco or snuff, has anyone in your family talked to you about what you can and cannot do?
1 YES
2 NO
3 DON'T KNOW
4 REFUSED
33. How many of your 3 best friends use chewing tobacco or snuff now?
1 3
2 2
3 1
4 none
5 DON'T KNOW
6 REFUSED
34. Do you think you will use chewing tobacco or snuff 1 or more times between now and when you are 18 years of age? Do you think you will...READ CHOICES
1 for sure,
2 probably will,
3 even chance,
4 probably won't, or
5 won't for sure?
6 DON'T KNOW
7 REFUSED
35. In this study, the word "alcohol" includes beer, wine, wine coolers, and liquor. Do not include wine you might have had at church, but include alcohol you might have had with your family. How much alcohol have you ever had in your life? You can just say "stop" after I have said it. Would you say ... WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 none at all, not even a sip SKIP TO 42
2 1 or two sips but not a whole drink SKIP TO 40
3 3 or more sips but never a whole drink at one time SKIP TO 40
4 1 to 5 whole drinks. In this study, a "drink" is a glass of wine, a can of beer, a wine cooler, a shot glass of liquor, or a mixed drink.
5 6 to 20 whole drinks, or
6 more than 20 whole drinks?
7 DON'T KNOW
8 REFUSED
36. Think of all the times you had a drink of alcohol during the last 30 days. A "drink" is a glass of wine, a can of beer, a wine cooler, a shot glass of liquor, or a mixed drink. During the last 30 days, how many whole drinks did you have?
__ __ DRINKS. ENTER DK FOR DON’T KNOW (EVEN APPROXIMATELY), RF FOR REFUSED
IF 00: SKIP TO 39
37. Think back over the last two weeks. How many different times did you have five or more whole drinks in a row?
1 NONE
2 ONCE
3 TWICE
4 3 TO 5 TIMES
5 6 TO 9 TIMES
6 10 OR MORE TIMES
7 DON'T KNOW
8 REFUSED
38. During the last 30 days, on how many days did you get drunk?
__ __ DAYS. ENTER DK FOR DON’T KNOW (EVEN APPROXIMATELY), RF FOR REFUSED
39. During the last 6 months, did you ever try to quit drinking alcohol altogether?
1 YES
2 NO
3 NEVER DRANK ENOUGH TO CONSIDER QUITTING
4 DON'T KNOW
5 REFUSED
40. Have you ever had alcohol when you were not with your parents or other adults in your family?
1 YES
2 NO
3 DON'T KNOW
4 REFUSED
41. Now I am talking about sips. During the last 30 days, on how many days did you have at least a sip of alcohol? IF DON'T KNOW FOR SURE: Well, during the last 30 days, about how many days did you have a sip of alcohol?
__ __ DAYS. ENTER DK FOR DON’T KNOW (EVEN APPROXIMATELY), RF FOR REFUSED
42. Some people think only good things happen from drinking alcohol, others think only bad things happen, and others think both good and bad things happen. Taking everything into consideration, if you drank alcohol now do you think...READ CHOICES
1 only good things would happen,
2 both good and bad things would happen, or
3 only bad things would happen?
4 DON'T KNOW
5 REFUSED
43. During the last 6 months, how many times has any family member offered you alcohol?
1 10 OR MORE TIMES
2 6 to 9 times
3 2 to 5 times
4 once
5 never
6 DON'T KNOW
7 REFUSED
44. How easy would it be for you to get alcohol at home? Would you say it would be:
1 very easy
2 somewhat easy
3 somewhat difficult, or
4 very difficult?
5 DON'T KNOW
6 REFUSED
45. When it comes to drinking alcohol, has anyone in your family talked to you about what you can and cannot do?
1 YES
2 NO
3 DON'T KNOW
4 REFUSED
46. How many of your three best friends drink alcohol now?
1 3
2 2
3 1
4 NONE
5 DON'T KNOW
6 REFUSED
47. Do you think you will have 1 or more drinks of alcohol between now and when you are 18 years of age? Don't include wine at church. Do you think you will...READ CHOICES
1 for sure,
2 probably will,
3 even chance,
4 probably won't, or
5 won't for sure?
6 DON'T KNOW
7 REFUSED
48. During the last 6 months about how many times did you ride in a car with a driver who had been drinking?
1 12 or more times
2 7 - 11 times
3 2 - 6 times
4 1 time
5 no times
6 DON'T KNOW
7 REFUSED
49. How many brothers and sisters do you have? ENTER DK FOR DON’T KNOW, RF FOR REFUSED
___ ___ IF 00 SKIP TO 56
IF 1 GO TO 50
IF 2 OR MORE SKIP TO 53
IF DK OR RF SKIP TO 56
50. Does he or she smoke cigarettes now?
1 YES
2 NO
3 DON'T KNOW
4 REFUSED
51. Does he or she use chewing tobacco or snuff now?
1 YES
2 NO
3 DON'T KNOW
4 REFUSED
52. Does he or she drink alcohol now?
1 YES: SKIP TO 56
2 NO: SKIP TO 56
3 DON'T KNOW: SKIP 56
4 REFUSED: SKIP TO 56
53. How many of your brothers and sisters smoke cigarettes now?
__ __ ENTER DK FOR DON’T KNOW, RF FOR REFUSED
54. How many of your brothers and sisters use chewing tobacco or snuff now?
__ __ ENTER DK FOR DON’T KNOW, RF FOR REFUSED
55. How many of your brothers and sisters drink alcohol now?
__ __ ENTER DK FOR DON’T KNOW, RF FOR REFUSED
56. How many people live in your house, not counting you?
__ __ ENTER DK FOR DON’T KNOW, RF FOR REFUSED
These next questions are about the INSERT NUMBER OF OTHER PEOPLE LIVING IN HOME FROM QUESTION 56 other people who live in your house and what they might have done or said to you during the last 6 months. During the last 6 months, how many of the _____other people living in your house ...WRITE NUMBER ON LINES. ENTER DK FOR DON’T KNOW, RF FOR REFUSED
57. ___ ___ encouraged you not to use alcohol?
58. ___ ___ encouraged you not to have friends who use alcohol?
59. ___ ___ talked to you about the bad things about alcohol?
60. ___ ___ talked to you about what you can or cannot do when it comes to alcohol?
61. ___ ___ talked to you about how they would discipline you if you used alcohol?
62. ___ ___ told you you cannot use alcohol?
63. ___ ___ talked to you about how movies and television can make alcohol look good?
64. ___ ___ talked to you about how to resist peer pressure to use alcohol?
65. ___ ___ asked you to get alcohol for them?
These next questions are similar but they refer to use of tobacco, that is, to cigarettes, chewing tobacco, or snuff. During the last 6 months, how many of the _____other people living in your house ...WRITE NUMBER ON LINES. ENTER DK FOR DON’T KNOW, RF FOR REFUSED.
66. ___ ___ encouraged you not to use tobacco?
67. ___ ___ encouraged you not to have friends who use tobacco?
68. ___ ___ talked to you about the bad things about tobacco?
69. ___ ___ talked to you about what you can or cannot do when it comes to tobacco?
70. ___ ___ talked to you about how they would discipline you if you used tobacco?
71. ___ ___ told you you cannot use tobacco?
72. ___ ___ talked to you about how movies and television can make tobacco look good?
73. ___ ___ talked to you about how to resist peer pressure to use tobacco?
74. ___ ___ asked you to get tobacco for them?
75. During the last 6 months, how many family members encouraged you to do as well as you could in school?
1 NONE
2 1
3 2
4 3 OR MORE
5 DON’T KNOW
6 REFUSED
o MOTHER OR MOTHER SURROGATE IS IDENTIFIED AS PARENT PARTICIPANT IN 4 OF SCREEN AND NAMED IN PARENT INFORMATION: These next questions are about SAY NAME OF PARENT INTERVIEWED. SKIP TO 78.
o FATHER OR FATHER SURROGATE IS IDENTIFIED AS PARENT PARTICIPANT IN 4 OF SCREEN AND NAMED IN PARENT INFORMATION: GO TO 76.
76. Does your mother, or a woman who is like a mother to you, live in your home?
1 YES: She is the woman I will be talking about in this part. SKIP TO 78
2 NO: GO TO 77
3 DON’T KNOW: GO TO 77
4 REFUSED: GO TO 77
77. Does your mother, or a woman who is like a mother to you, live somewhere else?
1 YES: She is the woman I will be talking about in this part. GO TO 78
2 NO: SKIP TO PAGE 16, o FATHER OR FATHER SURROGATE.....
3 DON’T KNOW: SKIP TO PAGE 16, o FATHER OR FATHER SURROGATE.....
4 REFUSED: SKIP TO PAGE 16, o FATHER OR FATHER SURROGATE.....
78. How much would she like or dislike it if you smoked cigarettes now? Would she....READ CHOICES
1 like it a lot,
2 like it some,
3 neither like it nor dislike it,
4 dislike it some, or
5 dislike it a lot?
6 DON’T KNOW
7 REFUSED
79. How much would she like or dislike it if you used chewing tobacco or snuff now? Would she....READ CHOICES
1 like it a lot,
2 like it some,
3 neither like it nor dislike it,
4 dislike it some, or
5 dislike it a lot?
6 DON’T KNOW
7 REFUSED
80. How much would she like or dislike it if you drank alcohol now? Don't include wine at church. Would she....READ CHOICES
1 like it a lot,
2 like it some,
3 neither like nor dislike it,
4 dislike it some, or
5 dislike it a lot?
6 DON’T KNOW
7 REFUSED
Now I am going to read some statements that might describe her. I would like you to tell me if they are always like her, sometimes like her, seldom like her, or never like her. CIRCLE DK FOR DON’T KNOW OR RF FOR REFUSED
81. A So Se N DK RF She helps me out if I have a problem. Would you say this is like her always, sometimes, seldom, or never?
82. A So Se N DK RF She encourages me to do the best in whatever I do. Would you say this is like her always, sometimes, seldom or never?
83. A So Se N DK RF She encourages me to think independently. Would you say this is like her always,
sometimes, seldom, or never?
84. A So Se N DK RF She helps me with my school work if there is something I don't understand READ
CHOICES IF NECESSARY
85. A So Se N DK RF When she wants me to do something, she explains why READ CHOICES IF NECESSARY
86. A So Se N DK RF When I get a poor grade she encourages me to try harder READ CHOICES IF
NECESSARY
87. A So Se N DK RF When I get a good grade she praises me READ CHOICES IFNECESSARY
88. A So Se N DK RF She really knows who my friends are READ CHOICES IF NECESSARY
89. A So Se N DK RF She spends time just talking with me READ CHOICES IF NECESSARY
90. A So Se N DK RF She and I do fun things together READ CHOICES IF NECESSARY
91. A So Se N DK RF She tries to know what I do with my free time READ CHOICES IF NECESSARY
92. A So Se N DK RF She tries to know where I am most afternoons after school READ CHOICES IF
NECESSARY
93. A So Se N DK RF She really knows what I do with my free time READ CHOICES IF NECESSARY
94. A So Se N DK RF She really knows where I am most afternoons after school READ CHOICES IF
NECESSARY
95. A So Se N DK RF She yells at me when I have done something wrong READ CHOICES IF NECESSARY
96. A So Se N DK RF She is a good listener when I need to discuss something serious with her READ CHOICES IF NECESSARY
97. A So Se N DK RF She lets me disagree with her READ CHOICES IF NECESSARY
98. A So Se N DK RF She respects my thoughts and feelings READ CHOICES IF NECESSARY
99. A So Se N DK RF She understands what it is like to be an adolescent. READ CHOICES IF NECESSARY
100. A So Se N DK RF She lets me go around with any people my age that I want to READ CHOICES IF
NECESSARY
101. How often does she kiss or hug you, would you say she kisses or hugs you...READ CHOICES
1 a lot,
2 some,
3 not very much, or
4 never?
5 DON'T KNOW
6 REFUSED
102. How close do you feel toward her? Would you say you feel… READ CHOICES
1 extremely close
2 very close
3 not very close, or
4 not close at all?
5 DON’T KNOW
6 REFUSED
103. Has she ever smoked cigarettes in her life?
1 YES: GO TO 104
2 NO: SKIP TO 105
3 DON'T KNOW: SKIP TO 105
4 REFUSED: SKIP TO 105
104. On the average, about how many cigarettes do you think she now smokes in a day? You can just say "stop" after the closest answer. Would you say she now smokes WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 no cigarettes,
2 some but less than 1 cigarette a day,
3 about 1 cigarette to almost half a pack a day,
4 about a half a pack to a pack a day, or
5 more than a pack a day?
6 KNOW SHE SMOKES BUT DON'T KNOW AMOUNT
7 DON'T KNOW IF SHE SMOKES
8 REFUSED
105. Has she ever had a drink of alcohol in her life?
1 YES: GO TO 106
2 NO: SKIP TO 107
3 DON'T KNOW: SKIP TO 107
4 REFUSED: SKIP TO 107
106. On the average, about how much alcohol do you think she now drinks in a day? You can just say "stop" after the closest answer. Would you say she now drinks WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 none at all,
2 some but not every day,
3 a few sips a day but not a whole drink,
4 1 to 3 drinks a day, or
5 4 or more drinks a day?
6 KNOW SHE DRINKS BUT DON'T KNOW AMOUNT
7 DON'T KNOW IF SHE DRINKS
8 REFUSED
107. Has she ever used chewing tobacco or snuff in her life?
1 YES: GO TO 108
2 NO: SKIP TO BOX AFTER 108
3 DON'T KNOW: SKIP TO BOX AFTER 108
4 REFUSED: SKIP TO BOX AFTER 108
108. On the average, about how much chewing tobacco or snuff do you think she now has in a day? You can just say "stop" after the closest answer. Would you say she now has WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 no chewing tobacco or snuff in a day,
2 about one chew a day,
3 2 to 5 chews a day, or
4 more than 5 chews a day?
6 KNOW SHE USES BUT DON'T KNOW AMOUNT
7 DON'T KNOW IF SHE USES
8 REFUSED
o FATHER OR FATHER SURROGATE IS IDENTIFIED AS PARENT PARTICIPANT IN 4 OF SCREEN AND NAMED IN PARENT INFORMATION: These next questions are about (SAY NAME OF PARENT INTERVIEWED). SKIP TO 111
o MOTHER OR MOTHER SURROGATE IS PARENT PARTICIPANT: GO TO 109
109. Does your father, or a man like a father to you, live in your home?
1 YES: He is the man I will be talking about in this part. SKIP TO 111
2 NO: GO TO 110
3 DON’T KNOW: GO TO 110
4 REFUSED SKIP: GO TO 110
110. Does your father, or a man who is like a father to you, live somewhere else?
1 YES: He is the man I will be talking about in this part. GO TO 111
2 NO: SKIP TO 142
3 DON’T KNOW: SKIP TO 142
4 REFUSED: SKIP TO 142
111. How much would he like or dislike it if you smoked cigarettes now? Would he....READ CHOICES
1 like it a lot,
2 like it some,
3 neither like it nor dislike it,
4 dislike it some, or
5 dislike it a lot?
6 DON’T KNOW
7 REFUSED
112. How much would he like or dislike it if you used chewing tobacco or snuff now? Would he....READ CHOICES
1 like it a lot,
2 like it some,
3 neither like it nor dislike it,
4 dislike it some, or
5 dislike it a lot?
6 DON’T KNOW
7 REFUSED
113. How much would he like or dislike it if you drank alcohol now? Don't include wine at church. Would he....READ CHOICES
1 like it a lot,
2 like it some,
3 neither like nor dislike it,
4 dislike it some, or
5 dislike it a lot?
6 DON’T KNOW
7 REFUSED
Now I am going to read some statements that might describe him. I would like you to tell me if they are always like him, sometimes like him, seldom like him, or never like him. CIRCLE DK FOR DON’T KNOW OR RF FOR REFUSED
114. A So Se N DK RF He helps me out if I have a problem. Would you say this is like him always, sometimes, seldom, or never?
115. A So Se N DK RF He encourages me to do the best in whatever I do. Would you say this is like him always, sometimes, seldom, or never?
116. A So Se N DK RF He encourages me to think independently. Would you say this is like him always, sometimes, seldom, or never?
117. A So Se N DK RF He helps me with my school work if there is something I don't understand READ CHOICES IF NECESSARY
118. A So Se N DK RF When he wants me to do something, he explains why READ CHOICES IF NECESSARY
119. A So Se N DK RF When I get a poor grade he encourages me to try harder READ CHOICES IF NECESSARY
120. A So Se N DK RF When I get a good grade he praises me READ CHOICES IF NECESSARY
121. A So Se N DK RF He really knows who my friends are READ CHOICES IF NECESSARY
122. A So Se N DK RF He spends time just talking with me READ CHOICES IF NECESSARY
123. A So Se N DK RF He and I do fun things together READ CHOICES IF NECESSARY
124. A So Se N DK RF He tries to know what I do with my free time READ CHOICES IF NECESSARY
125. A So Se N DK RF He tries to know where I am most afternoons after school READ CHOICES IF NECESSARY
126. A So Se N DK RF He really knows what I do with my free time READ CHOICES IF NECESSARY
127. A So Se N DK RF He really knows where I am most afternoons after school READ CHOICES IF NECESSARY
128. A So Se N DK RF He yells at me when I have done something wrong READ CHOICES IF NECESSARY
129. A So Se N DK RF He is a good listener when I need to discuss something serious with him READ CHOICES IF NECESSARY
130. A So Se N DK RF He lets me disagree with him READ CHOICES IF NECESSARY
131. A So Se N DK RF He respects my thoughts and feelings READ CHOICES IF NECESSARY
132. A So Se N DK RF He understands what it is like to be an adolescent. READ CHOICES IF NECESSARY
133. A So Se N DK RF He lets me go around with any people my age that I want to READ CHOICES IF NECESSARY
134. How often does he kiss or hug you, would you say he kisses or hugs you...READ CHOICES
1 a lot,
2 some,
3 not very much, or
4 never?
5 DON’T KNOW
6 REFUSED
135. How close do you feel toward him? Would you say you feel...READ CHOICES
1 extremely close
2 very close
3 not very close, or
4 not close at all?
5 DON’T KNOW
6 REFUSED
136. Has he ever smoked cigarettes in his life?
1 YES: GO TO 137
2 NO: SKIP TO 138
3 DON'T KNOW: SKIP TO 138
4 REFUSED: SKIP TO 138
137. On the average, about how many cigarettes do you think he now smokes in a day? You can just say "stop" after the closest answer. Would you say he now smokes WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 no cigarettes,
2 some but less than 1 cigarette a day,
3 about 1 cigarette to almost half a pack a day,
4 about a half a pack to a pack a day, or
5 more than a pack a day?
6 KNOW HE SMOKES BUT DON'T KNOW AMOUNT
7 DON'T KNOW IF HE SMOKES
8 REFUSED
138. Has he ever had a drink of alcohol in his life?
1 YES: GO TO 139
2 NO: SKIP TO 140
3 DON'T KNOW: SKIP TO 140
4 REFUSED: SKIP TO 140
139. On the average, about how much alcohol do you think he now drinks in a day? You can just say "stop" after the closest answer. Would you say he now drinks WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 none at all,
2 some but not every day,
3 a few sips a day but not a whole drink,
4 1 to 3 drinks a day, or
5 4 or more drinks a day?
6 KNOW HE DRINKS BUT DON'T KNOW AMOUNT
7 DON'T KNOW IF HE DRINKS
8 REFUSED
140. Has he ever used chewing tobacco or snuff in his life?
1 YES: GO TO 141
2 NO: SKIP TO 142
3 DON'T KNOW: SKIP TO 142
4 REFUSED: SKIP TO 142
141. On the average, about how much chewing tobacco or snuff do you think he now has in a day? You can just say "stop" after the closest answer. Would you say he now has WHEN STOPPED REPEAT CHOSEN CATEGORY TO VERIFY
1 no chewing tobacco or snuff in a day,
2 about one chew a day,
3 2 to 5 chews a day, or
4 more than 5 chews a day?
5 KNOW HE USES BUT DON’T KNOW AMOUNT BUT KNOW HE USES
6 DON'T KNOW IF HE USES
7 REFUSED
142. IF PARENT INTERVIEW COMPLETED AND PARENT REFUSED TO GIVE ADDRESS: SKIP TO NEXT PAGE
IF PARENT HAS NOT REFUSED TO GIVE ADDRESS: We are finished except for getting your mailing address. Could you tell me your mailing address? PRINT FULL MAILING ADDRESS VERY CAREFULLY. INCLUDE ZIP WHEN KNOWN. READ BACK AS NECESSARY TO MAKE SURE IT IS 100% CORRECT AND COMPLETE.
___________________________________________
___________________________________________
___________________________________________
___________________________________________
GO TO NEXT PAGE
o PARENT HAS COMPLETED INTERVIEW
o ADOLESCENT NAME RECORDED: That is it! Thank you so very much for your time. TERMINATE
o ADOLESCENT NAME NOT RECORDED. Now I only need to know your full name. RECORD IT ____________________________________ THEN Thank you very much for your time TERMINATE
o PARENT HAS NOT COMPLETED INTERVIEW
o ADOLESCENT NAME RECORDED: That is it! Thank you so very much for your time.
o PARENT AGREED TO INTERVIEW THIS CALL (SEE PARENT INFORMATION). Now I need to interview NAME PARENT IDENTIFIED IN SCREEN AND NAMED ON PARENT INFORMATION. Please ask her/him to come to the phone.
o PARENT AGREED TO INTERIEW LATER CALL OR NOT AT ALL (SEE PARENT INFORMATION): TERMINATE: Thanks you for your time. Goodbye.
o ADOLESCENT NAME NOT RECORDED. Now all I need to know is your full name. RECORD IT ________________________________
o PARENT AGREED TO INTERVIEW THIS CALL (SEE PARENT INFORMATION). Now I need to interview NAME PARENT IDENTIFIED IN SCREEN AND NAMED ON PARENT INFORMATION. Please ask her/him to come to the phone.
o PARENT AGREED TO INTERIEW LATER CALL OR NOT AT ALL (SEE PARENT INFORMATION): TERMINATE: Thanks you for your time. Goodbye.
COMPLETE AFTER ADOLESCENT INTERVIEW
RECORD DATE ADOLESCENT INTERVIEW COMPLETED
____ ____ ____ JAN=01 APR=04 JUL=07 OCT=10
MM/DD/YY FEB=02 MAY=05 AUG=08 NOV=11
MAR=03 JUN=06 SEP=09 DEC=12
1. how much privacy do you think the adolescent had during his/her interview?
1. complete privacy
2. some privacy
3. a little privacy
4. no privacy
interviewer initials__________________
................
................
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