SOP BOILERPLATE FOR GOVERNMENT & ACADEMIC FIELD …



PARENT SURVEYNote: The following placeholders are used throughout the survey: “DOV_NAME1” for the child’s name, “DOV_NAME2” for “your son” or “your daughter”, “DOV_CHILDGENDER1” for “she” or “he”, “DOV_CHILDGENDER2” for “him” or “her”, “DOV_CHILDGENDER3” for “his” or “her” and “DOV_CHILDGENDER4” for “himself” or “herself”.P1. In the past year (since [Wave1 Survey Date]) has [DOV_name1] ever told you [DOV_CHILDGENDER3] girlfriend/boyfriend did ANY of the following to [DOV_CHILDGENDER2]: Tried to turn friends against [DOV_CHILDGENDER2]Did something to make [DOV_CHILDGENDER2] feel jealousDestroyed or threatened to destroy something [DOV_CHILDGENDER1] valuedBrought up something bad [DOV_CHILDGENDER1] had done in the pastSaid things just to make [DOV_CHILDGENDER2] angrySpoke to [DOV_CHILDGENDER2] in a hostile or mean tone of voiceInsulted [DOV_CHILDGENDER2] with put-downsSaid things to [DOV_CHILDGENDER3] friends about [DOV_CHILDGENDER2] to turn them against [DOV_CHILDGENDER2]Ridiculed or made fun of [DOV_CHILDGENDER2] in front of othersKept track of who [DOV_CHILDGENDER1] was with and where [DOV_CHILDGENDER1] wasBlamed [DOV_CHILDGENDER2] for the problemAccused [DOV_CHILDGENDER2] of flirting with another guy/girlDeliberately tried to frighten [DOV_CHILDGENDER2]Ridiculed or made fun of [DOV_CHILDGENDER2] in front of othersThreatened to hurt [DOV_CHILDGENDER2]Threatened to end the relationshipThreatened to hit [DOV_CHILDGENDER2] or throw something at [DOV_CHILDGENDER2]Spread rumors about [DOV_CHILDGENDER2]Threatened [DOV_CHILDGENDER2] with a knife or gun (including waving or pointing a knife)Yes (at least one of these)No (none of these)No known boyfriend/girlfriend[Skipped if “No” or “No known boyfriend/girlfriend”]P2. What did you do when [DOV_NAME1] told you this? Discussed with [DOV_NAME2]Discussed with other adult, a family member or close friendReported to [DOV_NAME1]’s girlfriend’s/boyfriend’s parentsReported to school officialsReported to policeDiscussed with clergyOther[skipped if parent responds “No known boyfriend/girlfriend” to P1]P3. In the past year (since [Wave1 Survey Date]) has [DOV_NAME1] ever told you [DOV_CHILDGENDER3] girlfriend/boyfriend:Threw something at [DOV_CHILDGENDER2]Kicked, hit, or punched [DOV_CHILDGENDER2]Slapped [DOV_CHILDGENDER2] or pulled [DOV_CHILDGENDER3] hairPushed, shoved, or shook [DOV_CHILDGENDER2]Choked [DOV_CHILDGENDER2]Used a knife or fired a gunScratched [DOV_CHILDGENDER2] or bent [DOV_CHILDGENDER3] fingersBurned [DOV_CHILDGENDER2]Bit [DOV_CHILDGENDER2]Yes (at least one of these)No (none of these)[skipped if p3 is “No”]P4. What did you do when [DOV_NAME1] told you this? Discussed with [DOV_NAME2]Discussed with other adult, a family member or close friendReported to [DOV_NAME1]’s girlfriend’s/boyfriend’s parentsReported to school officialsReported to policeDiscussed with clergyOtherP5. What is your current marital status? Are you…MarriedWidowed Divorced Separated Not married but living with a partnerNever married[Skip if ‘Married” or “Not married but living with a partner”]P6. Are you currently seeing or dating anyone? YesNo P7. What is [DOV_Name2]’s current grade level in school?3rd grade 4th grade 5th grade 6th grade 7th grade 8th grade 9th grade 10th grade 11th grade 12th grade 1st year of college 2nd year of college 3rd year of college4th year of collegeTechnical or vocational school%%DOV_NAME%% is not currently attending schoolP8. Does [DOV_Name2] live with you most or all of the time?Yes, living at home most or all of the timeNo, only living at home during school holidaysNo, living elsewhere most of the timeCHILD SURVEYNote: The following placeholders are used throughout the survey: [DOV_PARTNERNAME] for “your partner”, “your ex”, or the name provided; DOV_PARTGENDER1 for “he” or “she”; DOV_PARTGENDER2 for “him” or “her”; DOV_PARTGENDER3 for “his” or “her”. C1. Do you currently go to school or college? Or, if you are currently on break, will you be going to school/college in the upcoming school year?YesNoC2. On an average day, do you go online (using the internet or email): Not at all Less than 30 minutes More than 30 minutes and under two hours More than 2 hours C3. On an average day, do you send or receive: No text messages 1 to 10 text messages 11 to 20 text messages 21 to 50 text messages51 to 100 text messages101-200 text messagesMore than 200 text messagesThe next questions ask for your feelings regarding your mother and father, or the adults that fill the role of mother and father for you. C4. Do you have a mother or an adult woman who is like a mother to you? Yes No C5. Do you have a father or an adult man who is like a father to you? YesNo Please choose whether you strongly agree, agree, neither agree nor disagree, or strongly disagree with each of the following statements. Strongly Agree (1)Agree (2)Neither Agree nor Disagree (3)Disagree (4)Strongly Disagree (5)C6. Your mother encourages you to be independent.C7. When you do something wrong that is important, your mother talks about it with you and helps you understand why it is wrong.C8. You are satisfied with the way your mother and you communicate with each other.C9. Overall, you are satisfied with your relationship with your mother.Please choose whether you strongly agree, agree, neither agree nor disagree, or strongly disagree with each of the following statements. Strongly Agree (1)Agree (2)Neither Agree nor Disagree (3)Disagree (4)Strongly Disagree (5)C10. You are satisfied with the way your father and you communicate with each other.C11. Overall, you are satisfied with your relationship with your father.C12. Your father encourages you to be independent.C13. When you do something wrong that is important, your father talks about it with you and helps you understand why it is wrong.Which of the following things have you done with your parent or another adult in your home in the past four weeks?Yes (1)No (2)C14. Have you talked about dating, or someone you have a crush on?C15. Have you talked through a situation that was making you angry or upset?How strongly do you agree or disagree with the following statements? Strongly agree (1)Agree somewhat (2)Disagree somewhat (3)Strongly disagree (4)C16. Most girls and women cannot be trusted.C17. In a dating relationship the boy should be smarter than the girl.C18. Girls are always trying to manipulate boys.C19. In a dating relationship, both people should have about equal power.C20. Swearing is worse for a girl than for a boy.C21. On a date, the boy should be expected to pay all expenses.C22. Girls should have the same freedom as boys.C23. It is all right for a girl to ask a boy out on a date.C24. It is more important for boys than girls to do well in school.C25. Most boys and men cannot be trusted.Yes (1)No (2)C26. Does it seem to you that the adults in your house take out their frustrations on each other?C27. Do you ever get the message from a parent that romantic relationships never work out?C28. Do you ever get the message from a parent that boys cannot be trusted?C29. Do you ever get the message from a parent that girls cannot be trusted?In general, how much time during the past month…All of the time (1)Most of the time (2)A good bit of the time (3)Some of the time (4)A little of the time (5)None of the time (6)C30. Have you felt particularly nervous?C31. Have you felt so down in the dumps nothing could cheer you up?C32. Have you felt calm and peaceful?C33. Have you felt downhearted and blue?C34. Have you been happy?Rate each of the following statements on a scale of 1 to 5, where 1 means that you think the statement is not at all like you, and 5 means that you think the statement is very much like you.Not at all like you (1)(2)(3)(4)Very much like you (5)C35. Some of my friends think I get angry easilyC36. Sometimes I lose my cool or freak out for no good reasonC37. I have trouble controlling my temperPlease choose whether you strongly agree, agree, disagree, or strongly disagree with the following statements. It is OK for someone to hit their boyfriend …Strongly agree (1)Agree (2)Disagree (3)Strongly disagree (4)C38. …because he made her or him mad.C39. …because he insulted her or him in front of friends.C40. …because he made her or him jealous on purpose.C41. …because he was cheating.C42. …because he hit her or him first.Please choose whether you strongly agree, agree, disagree, or strongly disagree with the following statements. It is OK for someone to hit their girlfriend …Strongly agree (1)Agree (2)Disagree (3)Strongly disagree (4)C43. …because she made him or her mad.C44. …because she insulted him or her in front of friends.C45. …because she made him or her jealous on purpose.C46. …because she was cheating.C47. …because she hit him or her first.Please choose whether you strongly agree, agree, disagree, or strongly disagree with the following statement. C48. It’s OK to date more than one person at a time.Strongly agreeAgreeDisagreeStrongly disagree[Asked only if if child is age 12 or older]C49. It’s OK to have sex with someone you don’t love.Strongly agreeAgreeDisagreeStrongly disagree[Asked only if if child is age 12 or older]The next questions ask about sexual intercourse. Sometimes this is called making love, having sex, or going all the way.C50. Have you had sexual intercourse in the last 12 months? YesNoI’m not sure [if YES]C51. About how old were you when you had sexual intercourse for the first time? 8 years old or younger 9 years old 10 years old [if child age>10] 11 years old [if child age >11] 12 years old [if child age >12] 13 years old [if child age >13] 14 years old [if child age >14] 15 years old [if child age >15] 16 years old [if child age >16] 17 years old [if child age >17] 18 years old [if child age >18] 19 years old[IF yes] C52. In the last 12 months, with how many people have you had sexual intercourse? 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 people 9 people 10 or more people The next questions are about dating relationships.By dating, we mean a relationship with a boy or a girl who you are "going with," "dating," "going steady with" or have had that kind of relationship with. This includes anyone who is or was your boyfriend or girlfriend, where you liked someone and they liked you back. C53. Do your parents allow you to date? YesNoC54. Are you currently dating someone?YesNoI don’t know[if no]C55. Have you dated someone in the past year, in other words, since [MONTH] 2013? YesNo I don’t know[IF CHILD IS DATING OR DATED IN PAST YEAR]C56. Do your parents usually know where you are when you are out on a date? Would you say always, sometimes, or never?AlwaysSometimesNeverC57. What was the length of your longest dating relationship? At least 1 weekMore than 1 week and less than one month1 to 6 monthsMore than 6 months and less than a yearMore than 1 year but less than 2More than 2 years but less than 3Three years or moreC58. How many different people have you dated?1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 people 9 people 10 or more people C59. [(IF DATING: Think about your partner in your current dating relationship.) (If DATED IN PAST YEAR: Think about your partner in your most recent dating relationship.)]We will call that person [your partner/ your ex)].Or, if you want to give his or her first name or initials, we can use that name. Would you like to give a name? Yes NoC60. What do you want to call this person? [SMALL TEXT BOX]C61. Is [DOV_PARTNERNAME] male or female?MaleFemaleC62. Thinking about [DOV_PARTNERNAME] in your [current/most recent] dating relationship…How old is [DOV_PATNERNAME]?[NUMBER BOX] years oldC63. Does [DOV_PARTNERNAME] currently go to school or take any academic or technical classes?YesNoI don’t knowC64. What grade in school is [DOV_PARTNERNAME]?3rd grade 4th grade 5th grade 6th grade 7th grade 8th grade9th grade 10th grade 11th grade 12th grade 1st year of college 2nd year of college 3rd year of college4th year of collegeTechnical or vocational school[DOV_PARTNERNAME] is not currently attending schoolC65. Do you currently attend the same school as [DOV_PARTNERNAME]? orWhen you were dating [DOV_PARTNERNAME] did you attend the same school as DOV_PARTGENDER2?YesNo [Asked only if child is age 16 or older]C66. Are you currently living with [DOV_PARTNERNAME]? orWhen you were dating [DOV_PARTNERNAME] did you live with DOV_PARTGENDER2?Yes, we both live/lived in the same home most of the timeNo, but we both spend/spent the night at each other’s home from time to timeNo, we live/lived in separate homes and do/did not spend the night at each other’s home.[Asked only if child is currently dating or dated in past year]C67. In the last 4 weeks, did [DOV_PARTNERNAME] work —for pay— for anyone outside DOV_PARTGENDER3 home? This includes both regular jobs and things like baby-sitting or yard work.] ORWhen you were dating [DOV_PARTNERNAME], did DOV_PARTGENDER1 work—for pay—for anyone outside DOV_PARTGENDER3 home? This includes both regular jobs and things like baby-sitting or yard work.YesNoI don’t know [Asked only if child is age 12 or older]C68. Have you ever had sexual intercourse with [DOV_PARTNERNAME]? ORDid you ever have sexual intercourse with [DOV_PARTNERNAME]?YesNoHow often do/did you talk to [DOV_PARTNERNAME] about… Never (1)Rarely (2)Sometimes (3)Often (4)Very Often (5)C69. Something really great that happened?C70. Something really bad that happened?C71. Your private thoughts and feelings? Thinking about your current or most recent dating relationship … how much do you agree or disagree with the following statements? Strongly agree(1)Agree (2)Neutral (3)Disagree (4)Strongly disagree (5)C72. [DOV_PARTNERNAME] sometimes wants/wanted to control what you do/didC73. [DOV_PARTNERNAME] always tries/tried to change you.C74. You sometimes try/tried to control what [DOV_PARTNERNAME] does/did.C75. You always try/tried to change [DOV_PARTNERNAME].C76. [DOV_PARTNERNAME] tells/told you what to wear or not wear.C77. [DOV_PARTNERNAME] expects/expected you to respond immediately to texts or phone calls.C78. Sometimes you don’t/didn’t know quite what to say with [DOV_PARTNERNAME].C79. You would be/were uncomfortable having intimate conversations with [DOV_PARTNERNAME].C80. Sometimes you find/found it hard to talk about your feelings with [DOV_PARTNERNAME].C81. Sometimes you feel/felt you need/needed to watch what you say/said to [DOV_PARTNERNAME].C82. [DOV_PARTNERNAME] cares/cared about you.C83. [DOV_PARTNERNAME] and you are/were practically inseparable.C84. You would rather be/have been with [DOV_PARTNERNAME] than anyone else.C85. You are/were very attracted to [DOV_PARTNERNAME].C86. [DOV_PARTNERNAME] always seems/seemed to be on your mind.[Asked only if child is age 12 or older]C87. The sight of [DOV_PARTNERNAME] turns/turned you on.C88. Did you ever flirt with someone besides DOV_PARTNERNAME while you were dating PARTGENDER2?YesNoC89. Did DOV_PARTNERNAME ever flirt with someone besides you while you were dating?YesNoC90. How many times have you and DOV_PARTNERNAME broken-up or ended the relationship? or How many times did you and [DOV_PARTNERNAME] break up or end the relationship?1. Never [Only an option if currently dating]2. Once, and we are not together now3. Once, but we got back together [Only an option if currently dating]4. 2-9 times5. 10 or more timesThe following questions ask you about how often things may have happened with [DOV_PARTNERNAME]. As a guide, use the following scale:Never means this has never happened in your relationshipSeldom means this has happened only 1-2 times in your relationshipSometimes means this has happened about 3-5 times in your relationshipOften: means this has happened 6 times or more in your relationshipNever (1)Seldom (2)Sometimes (3)Often (4)[Asked only if child is age 12 or older]C91. You touched [DOV_PARNTER_NAME] sexually when DOV_PARTGENDER1 didn’t want you to.[Asked only if child is age 12 or older]C92. [DOV_PARTNERNAME] touched you sexually when you didn’t want DOV_PARTGENDER2 to. C93. You tried to turn [DOV_PARTNERNAME]’s friends against DOV_PARTGENDER2. C94. [DOV_PARTNERNAME] tried to turn your friends against you. C95. You did something to make [DOV_PARTNERNAME] feel jealous. C96. [DOV_PARTNERNAME] did something to make you feel jealous. C97. You destroyed or threatened to destroy something [DOV_PARTNERNAME] valued. C98. [DOV_PARTNERNAME] destroyed or threatened to destroy something you valued.C99. You brought up something bad [DOV_PARTNERNAME] had done in the past. C100. [DOV_PARTNERNAME] brought up something bad you had done in the past. C101. You threw something at [DOV_PARTNERNAME]. C102. [DOV_PARTNERNAME] threw something at you.C103. You said things just to make [DOV_PARTNERNAME] angry.C104. [DOV_PARTNERNAME] said things just to make you angry.C105. You spoke to [DOV_PARTNERNAME] in a hostile or mean tone of voice.C106. [DOV_PARTNERNAME] spoke to you in a hostile or mean tone of voice.[Asked only if child is age 12 or older]C107. You forced [DOV_PARTNERNAME] to have sex when DOV_PARTGENDER1 did not want to.[Asked only if child is age 12 or older]C108. [DOV_PARTNERNAME] forced you to have sex when you did not want to. [Asked only if child is age 12 or older]C109. You threatened [DOV_PARTNERNAME] in an attempt to have sex with DOV_PARTGENDER2 .[Asked only if child is age 12 or older]C110. [DOV_PARTNERNAME] threatened you in an attempt to have sex with you. C111. You insulted [DOV_PARTNERNAME] with put-downs. C112. [DOV_PARTNERNAME] insulted you with put-downs. C113. You kissed [DOV_PARTNERNAME] when DOV_PARTGENDER1 didn’t want you to. C114. [DOV_PARTNERNAME] kissed you when you didn’t want DOV_PARTGENDER2 to. C115. You said things to [DOV_PARTNERNAME]’s friends about [DOV_PARTNERNAME] to turn them against DOV_PARTGENDER2 .C116. [DOV_PARTNERNAME] said things to your friends about you to turn them against you.C117. You ridiculed or made fun of [DOV_PARTNERNAME] in front of others.C118. [DOV_PARTNERNAME] ridiculed or made fun of you in front of others.C119. You kept track of who [DOV_PARTNERNAME] was with and where DOV_PARTGENDER1 was. C120. [DOV_PARTNERNAME] kept track of who you were with and where you were. C121. You blamed [DOV_PARTNERNAME] for the problem. C122. [DOV_PARTNERNAME] blamed you for the problem. C123. You kicked, hit, or punched [DOV_PARTNERNAME].C124. [DOV_PARTNERNAME] kicked, hit, or punched you. C125. You accused [DOV_PARTNERNAME] of flirting with another girl or guy. C126. [DOV_PARTNERNAME] accused you of flirting with another girl or guy.C127. You tried to frighten [DOV_PARTNERNAME] on purpose.C128. [DOV_PARTNERNAME] tried to frighten you on purpose. C129. You slapped [DOV_PARTNERNAME] or pulled DOV_PARTGENDER3 hair.C130. [DOV_PARTNERNAME] slapped you or pulled your hair.C131. You threatened to hurt [DOV_PARTNERNAME]. C132. [DOV_PARTNERNAME] threatened to hurt you. C133. You threatened to end the relationship. C134. [DOV_PARTNERNAME] threatened to end the relationship.C135. You threatened to hit [DOV_PARTNERNAME] or throw something at DOV_PARTGENDER2 . C136. [DOV_PARTNERNAME] threatened to hit you or throw something at you. C137. You pushed, shoved, or shook [DOV_PARTNERNAME].C138. [DOV_PARTNERNAME] pushed, shoved, or shook you.C139. You spread rumors about [DOV_PARTNERNAME].C140. [DOV_PARTNERNAME] spread rumors about you.C141. You threatened [DOV_PARTNERNAME] with a knife or gun (including waving or pointing a knife).C142. [DOV_PARTNERNAME] threatened you with a knife or gun (including waving or pointing a knife).C143. You choked [DOV_PARTNERNAME].C144. [DOV_PARTNERNAME] choked you. C145. You used a knife or fired a gun. C146. [DOV_PARTNERNAME] used a knife or fired a gun. C147. You scratched [DOV_PARTNERNAME] and/or bent DOV_PARTGENDER3 fingers.C148. [DOV_PARTNERNAME] scratched you and/or bent your fingers.C149. You burned [DOV_PARTNERNAME].C150. [DOV_PARTNERNAME] burned you.C151. You bit [DOV_PARTNERNAME].C152. [DOV_PARTNERNAME] bit you. [If victim of physical violence, the act of violence reported is shown below]C153. You just told us that [DOV_PARTNERNAME] has, in the last year, has done the following:Threw something at youKicked, hit, or punched youSlapped or pulled your hairPushed, shoved, or shook youChoked youUsed a knife or fired a gunScratched and/or bent your fingersBurned youBit youPlease select which of these action(s) occurred most recently.Threw something at youKicked, hit, or punched youSlapped or pulled your hairPushed, shoved, or shook youChoked youUsed a knife or fired a gunScratched and/or bent your fingersBurned youBit youYou are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C154: Think back to the time this happened most recently. Were you or [DOV_PARTNERNAME] using alcohol or other drugs at the time?You were using alcohol or other drugs[DOV_PARTNERNAME] was using alcohol or other drugsYou both were using alcohol or other drugsNeither of you were using alcohol or other drugsYou are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C155. How did you react to what happened? Did you…Yes (1)No (2)a. Fight back to defend yourself?b. Fight back out of anger?c. Choose not to do anything?d. Ignore it?e. Try to turn it into a joke?f. Yell, call, or text for help?g. Not know what to do?h. Leave the scene?i. Laugh?j. Cry?k. Do nothing (because you were limited by your injuries)?You are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C156.How upset were you because of what happened? Would you say…Very upsetSomewhat upsetNot upsetYou are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C157. How angry were you because of what happened? Would you say…Very angrySomewhat angryNot angryYou are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C158. Did any of the following occur right before this happened?Yes (1)No (2)You hit [DOV_PARTNERNAME]You yelled at/ said things [DOV_PARTNERNAME] did not like[DOV_PARTNERNAME] was jealous of another guy/girlYou are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]What did you do afterward? Did you…Yes (1)No (2)C159. Report the incident to a teacher, guidance counselor or other adult at school?C160. Talk to another adult such as a minister or a therapist?C161. Contact the police?C162. Talk to a parent or other adult family member?C163. Talk to a brother or sister?C164. Talk to a friend or friends?C165. Keep it to yourself?[IF YES]When you did each of these things, how helpful were they?Very helpful (1)234Not helpful at all (5)C159a. Reported the incident to a teacher, guidance counselor or other adult at schoolC160a. Talked to another adult such as a minister or a therapistC161a. Contacted the policeC162a Talked to a parent or other adult family member. C163a. Talked to a brother or sisterC164a. Talked to a friend or friendsYou are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C166. Did this experience change your relationship with [DOV_PARTNERNAME]? Yes, relationship ended Yes, it got betterYes, it got worse No, relationship stayed the same [If perpetrated physical violence, the act of violence reported is shown below]C167. You told us that you have, in the last year, done the following to [DOV_PARTNERNAME]:Threw something at [DOV_PARTGENDER2]Kicked, hit, or punched DOV_PARTGENDER2Slapped or pulled DOV_PARTGENDER2 hairPushed, shoved, or shook DOV_PARTGENDER2Choked DOV_PARTGENDER2Used a knife or fired a gunScratched and/or bent DOV_PARTGENDER3 fingersBurned DOV_PARTGENDER2Bit DOV_PARTGENDER2Please select which of these actions occurred most recently.Threw something at [DOV_PARTGENDER2]Kicked, hit, or punched DOV_PARTGENDER2Slapped or pulled DOV_PARTGENDER2 hairPushed, shoved, or shook DOV_PARTGENDER2Choked DOV_PARTGENDER2Used a knife or fired a gunScratched and/or bent DOV_PARTGENDER3 fingersBurned DOV_PARTGENDER2Bit DOV_PARTGENDER2You are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C168: Think back to the time this happened most recently. Were you or [DOV_PARTNERNAME] using alcohol or other drugs at the time?You were using alcohol or other drugs[DOV_PARTNERNAME] was using alcohol or other drugsYou both were using alcohol or other drugsNeither of you were using alcohol or other drugsYou are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C169. How did you react to what happened? Did you…Yes (1)No (2)a. Ignore it?b. Try to turn it into a joke?c. Not know what to do?d. Leave the scene?e. Laugh?f. Cry?You are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C170. Did any of the following occur right before this happened?Yes (1)No (2)[DOV_PARTNERNAME] hit you[DOV_PARTNERNAME] yelled at/ said things you did not likeYou were jealous of another guy/girlYou are answering questions about the last time you did the following to [DOV_PartnerName]:[selected response shown]C171. Did this experience change your relationship with [DOV_partnername]? Yes, relationship ended Yes, it got betterYes, it got worse No, relationship stayed the same The following statements describe how safe your relationship with [DOV_PARTNERNAME] (has) felt. Please indicate how often you…Never(1)Seldom(2)Sometimes (3)Often (4)C172. … felt afraid of being seriously hurt by [DOV_PARTNERNAME]? C173. …think that [DOV_PARTNERNAME] has felt afraid of being seriously hurt by you?Never means this has never happened in your relationship.Seldom means this has happened only 1 – 2 times in your relationship.Sometimes means this has happened about 3 – 5 times in your relationship.Often means this has happened 6 times or more in your relationship.Please indicate how often you…Never(1)Seldom(2)Sometimes(3)Often(4)C174. … have been/were physically hurt by [DOV_PARTNERNAME]? C175. …have physically hurt [DOV_PARTNERNAME]?In the last 12 months, how often has anyone done the following to you IN PERSON? Never (1)Once (2)More than once (3)[Asked only if child is age 12 or older]C176. Made unwelcome sexual comments, jokes, or gestures to or about youC177. Called you gay or lesbian in a negative way[Asked only if child is age 12 or older]C178. Touched you in an unwelcome sexual way[Asked only if child is age 12 or older]C179. Flashed or exposed themselves to you[Asked only if child is age 12 or older]C180. Showed you sexy or sexual pictures that you didn’t want to see[Asked only if child is age 12 or older]C181. Physically intimidated you in a sexual way[Asked only if child is age 12 or older]C182. Forced you to do something sexual[if all items “Never”, respondent will skip this question]C183. You just said that someone [LIST ALL ITEMS EXPERIENCED AT LEAST ONCE FROM PREVIOUS QUESTION] IN PERSON.Click each person who did any of these things to you.A Dating partner or ex-partnerA Friend or Ex-friendAn acquaintance about your ageA Stranger about your ageAn Adult you knowAn Adult strangerSomeone elseI don’t knowIn the last 12 months, how often has anyone done the following to you through text, e-mail, Facebook, or other electronic means? Would you say never, once, or more than once?Never (1)Once (2)More than once (3)[Asked only if child is age 12 or older]C184. Sent you unwelcome sexual comments, jokes, or gestures or posted them about you? [Asked only if child is age 12 or older]C185. Spread unwelcome sexual rumors about you?C186. Called you gay or lesbian in a negative way? [if all items “Never”, respondent will skip this question]C187. You just said that someone [LIST ALL ITEMS EXPERIENCED AT LEAST ONCE FROM PREVIOUS QUESTION] through text, e-mail, Facebook, or other electronic means. [space]Click each person who did any of these things to you.A Dating partner or ex-partnerA Friend or Ex-friendAn acquaintance about your ageA Stranger about your ageAn Adult you knowAn Adult strangerSomeone elseI don’t knowIn the last 12 months , how often have you done the following to someone else IN PERSON?Never (1)Once (2)More than once (3)[Asked only if child is age 12 or older]C188. Made unwelcome sexual comments, jokes or gestures to or about them? C189. Called them gay or lesbian in a negative way? [Asked only if child is age 12 or older]C190. Touched them in an unwelcome sexual way? [Asked only if child is age 12 or older]C191. Flashed or exposed yourself to them? [Asked only if child is age 12 or older]C192. Showed them sexy or sexual pictures that they didn’t want to see? [Asked only if child is age 12 or older]C193. Physically intimidated them in a sexual way? [Asked only if child is age 12 or older]C194. Forced them to do something sexual? [if all items “Never”, respondent will skip this question]C195. You just said that you [LIST ALL ITEMS DONE AT LEAST ONCE FROM PREVIOUS QUESTION] IN PERSON. Click each person that you did any of these things to.A Dating partner or ex-partnerA Friend or Ex-friendAn acquaintance about your ageA Stranger about your ageAn Adult you knowAn Adult strangerSomeone elseI don’t knowIn the last 12 months , have you done the following to someone else through text, e-mail, Facebook, or other electronic means? Would you say never, once, or more than once?Never (1)Yes, once (2)Yes, more than once (3)[Asked only if child is age 12 or older]C196. Sent them unwelcome sexual comments, jokes, or gestures or posted them about them?[Asked only if child is age 12 or older]C197. Spread unwelcome sexual rumors about them?C198. Called them gay or lesbian in a negative way? [if all items “Never”, respondent will skip this question]C199. You just said that you [LIST ALL ITEMS DONE AT LEAST ONCE FROM PREVIOUS QUESTION] through text, e-mail, Facebook, or other electronic means. To whom were you doing these things? Click each person that you did any of these things to.A Dating partner or ex-partnerA Friend or Ex-friendAn acquaintance about your ageA Stranger about your ageAn Adult you knowAn Adult strangerSomeone elseI don’t knowThe following questions ask about your experiences online, on email, through instant messaging (IM), or in a text. In the last 12 months, how often, if ever, did someone ever do the following things to you online, on email, through instant messaging (IM), or in a text?Never (1)Once (2)More than once (3)C200. Someone made a rude or mean comment to you. C201. Someone spread rumors about you, whether they were true or not. C202. Someone made a threatening or aggressive comment to you. [Asked only if child is age 12 or older]C203. Someone tried to get you to talk about sex when you did not want to. [Asked only if child is age 12 or older]C204. Someone online asked you for sexual information about yourself when you did not want to tell the person, e.g., really personal questions, like what your body looks like or sexual things you have done. [Asked only if child is age 12 or older]C205. Someone asked you to do something sexual when you did not want to do it. [if all items “Never”, respondent will skip this question]C206. You just said that someone [LIST ALL ITEMS EXPERIENCED AT LEAST ONCE FROM PREVIOUS QUESTION] online, on email, through instant messaging (IM), or in a text. Who was doing this? Click each person who did any of these things to you.A Dating partner or ex-partnerA Friend or Ex-friendAn acquaintance about your ageA Stranger about your ageAn Adult you knowAn Adult strangerSomeone elseI don’t knowIn the last 12 months, how often, if at all, did you do the following to others online, on email, through instant messaging (IM), or in a text?Never (1)Once (2)More than once (3)C207. Made rude or mean comments to anyone. C208. Spread rumors about someone, whether they were true or not.C209. Made aggressive or threatening comments to anyone. [Asked only if child is age 12 or older]C210. Tried to get someone else to talk about sex when they did not want to. [Asked only if child is age 12 or older]C211. Asked someone to do something sexual when the other person did not want to do it. C212. Sent a text message or email that said rude or mean things. [Asked only if child is age 12 or older]C213. Sent a picture text message or email that was sexual in any way when that person did not want to receive it. [if all items “Never”, respondent will skip this question]C214. You just said that you [LIST ALL ITEMS DONE AT LEAST ONCE FROM PREVIOUS QUESTION] online, on email, through instant messaging (IM), or in a text. To whom were you doing these things?Click each person that you did any of these things to.A Dating partner or ex-partnerA Friend or Ex-friendAn acquaintance about your ageA Stranger about your ageAn Adult you knowAn Adult strangerSomeone elseI don’t knowC215. In the last 4 weeks, did you work—for pay—for anyone outside your home? This includes both regular jobs and things like baby-sitting or yard work.YesNoC216. In the last 12 months, has an adult — for example, your parent or a teacher — ever talked to you about good ways to choose when to save or spend your money?YesNoC217. What is your primary source of spending money? Is it your…Regular job or occasional workParentsGrandparentsOther relativesBoyfriend or girlfriend [IF CURRENTLY DATING ONLY]C218. How concerned are you about not having enough money?Not at all concernedNot too concernedSomewhat concernedPretty concernedVery concerned[IF CURRENTLY DATING OR DATED IN THE PAST YEAR ONLY]C219. In the past 12 months, has [DOV_PARTNERNAME] lent you money? OR Did [DOV_PARTNERNAME] ever lend you money?YesNo[IF CURRENTLY DATING OR DATED IN THE PAST YEAR ONLY]C220. In the past 12 months, has [DOV_PARTNERNAME] ever told you how to spend your money? OR Did [DOV_PARTNERNAME] ever tell you how to spend your money?YesNo[IF CURRENTLY DATING OR DATED IN THE PAST YEAR ONLY]C221. In the last 12 months, has [DOV_PARTNERNAME] asked you to lend DOV_PARTGENDER2 money? OR Did [DOV_PARTNERNAME] ever ask you to lend DOV_PARTGENDER2 money?]YesNo[IF CURRENTLY DATING OR DATED IN THE PAST YEAR ONLY]C222. People fight with one another over many different things. During your relationship, how often have/did you and [DOV_PARTNERNAME] fought/fight about money issues? NeverHardly everSometimesOftenVery often[IF CURRENTLY DATING OR DATED IN THE PAST YEAR ONLY]How strongly do you agree or disagree with the following about [DOV_PARTNERNAME]?Strongly Disagree(1)Disagree (2)Neither agree nor disagree (3)Agree (4)Strongly Agree (5)C223. [DOV_PARTGENDER1] makes/made you feel bad when [DOV_PARTGENDER1] helps/helped you financially. C224. You expect/expected [DOV_PARTGENDER2] to help you out financially. C225. [DOV_PARTGENDER1] never lets/let you forget it when [DOV_PARTGENDER1] helps/helped you out financially. C226. [DOV_PARTGENDER1] resents/resented having to help you out financially. [IF CURRENTLY DATING OR DATED IN THE PAST YEAR ONLY]When thinking about your relationship with [DOV_PARTNERNAME], how strongly do you agree or disagree with the following?Strongly Disagree (1)Disagree (2)Neither agree nor disagree (3)Agree (4)Strongly Agree (5)C227. You make/made [DOV_PARTGENDER2] feel bad when you help/helped [DOV_PARTGENDER2] financially. C228. [DOV_PARTGENDER1] expects/expected you to help [DOV_PARTGENDER2] out financially. C229. You never let [DOV_PARTGENDER2] forget when I have/had to help [DOV_PARTGENDER2] financially.C230. You resent/resented having to help [DOV_PARTGENDER2] out financially. C231. At any time in the last 12 months, did you SEE a parent get pushed, slapped, hit, punched, or beat up by another parent, or their boyfriend or girlfriend?YesNoC232. At any time in the last 12 months, did you HEAR a parent get pushed, slapped, hit, punched, or beat up by another parent, or their boyfriend or girlfriend?YesNoC233. At any time in the last 12 months, did you SEE a parent hit, beat, kick, or physically hurt your brothers or sisters, not including a spanking on the bottom?YesNoI have no siblingsC234. At any time in the last 12 months, did one of your parents, because of an argument, break or ruin anything belonging to another parent, punch the wall, or throw something?YesNoC235. At any time in the last 12 months, in real life, did you SEE anyone get attacked on purpose with a stick, rock, gun, knife, or other thing that would hurt? Somewhere like: at home, at school, at a store, in a car, on the street, or anywhere else?YesNoIn the past 12 months, how often did you…Never (1)Once (2)More than once (3)C236. Deliberately damage property that didn’t belong to you (including painting graffiti or signs)? C237. Get into a serious physical fight [IF C60 ORC61 =1 insert: with someone other than a dating partner]? C238. Drive a car without its owner’s permission?C239. Steal something worth more than $50? C240. Sell marijuana or other drugs?C241. Steal something worth less than $50?C242. In the last 12 months, have you been initiated into a named gang?YesNoIn the last year, how many times have you...Never (1)1-2 times (2)3-5 times (3)6-9 times (4)10 or more times (5)C243. Used marijuana or weed (like pot, hash, or reefer)?C244. Used a prescription drug when it was not prescribed for you or that you took only for the experience or feeling it caused?C245. During the PAST 12 MONTHS, did you drink any alcohol (more than a few sips)? Do not count sips of alcohol taken during family or religious events. YesNo[If drank alcohol]Yes (1)No (2)C246. Have you ever ridden in a CAR driven by someone (including yourself) who was “high” or had been using alcohol or drugs?C247. Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?C248. Do you ever use alcohol or drugs while you are by yourself, or ALONE?C249. Do you ever FORGET things you did while using alcohol or drugs?C250. Do your FAMILY or FRIENDS ever tell you that you should cut down on your drinking or drug use?C251. Have you ever gotten into TROUBLE while you were using alcohol or drugs?C252. Do you have any friends (other than your boyfriend or girlfriend) that you hang out with regularly? or Do you have any friends you hang out with regularly?YesNoC252_INTRO:Please enter the first names, initials, or nicknames of up to 5 of your best friends, starting with your best friend. [IF DATING: Even if you consider the person you are dating to be your best friend, we want you to name up to 5 other friends. Do not include the name of the person you are dating in your list of your best friends.]It’s OK if you don’t have 5 people to list. FRIEND 1 NAME: _______[small textbox] ________FRIEND 1 NAME _______[small textbox] ________FRIEND 3 NAME: _______[small textbox] ________FRIEND 4 NAME: _______[small textbox] ________FRIEND 5 NAME: _______[small textbox] ________Please answer the following questions about each of your friends.[FRIEND 1 NAME][FRIEND 2 NAME][FRIEND 3 NAME][FRIEND 4 NAME][FRIEND 5 NAME]Is this friend male or female?MALE/FEMALEMALE/FEMALEMALE/FEMALEMALE/FEMALEMALE/FEMALEHow old is this friend?Did you talk on the telephone or text with this friend during the past seven days?Yes/NoYes/NoYes/NoYes/NoYes/NoDid you talk to this friend about a problem during the past seven days? Yes/NoYes/NoYes/NoYes/NoYes/No[IF CURRENTLY DATING ONLY].Does {PARTNER_NAME} approve of this friend? Yes/NoYes/NoYes/NoYes/NoYes/No[IF CURRENTLY DATING ONLY].Does this friend approve of {PARTNER_NAME}? Yes/NoYes/NoYes/NoYes/NoYes/NoHas this friend ever hit, slapped, or physically hurt other people (that you know of) on purpose? Yes/NoYes/NoYes/NoYes/NoYes/NoHas this friend ever hit, slapped, or physically hurt his/her romantic partner (that you know of) on purpose?Yes/NoYes/NoYes/NoYes/NoYes/No[only asked of high school children currently dating]C253. We are interested in talking to [DOV_PARTNERNAME] about [DOV_PARTGENDER3] relationships, behavior, and health. We will not share your answers with [DOV_PARTNERNAME] and vice versa. Your own answers to this survey and [DOV_PARTNERNAME]’s answers to any survey will remain private. Would you be willing to share a survey link with [DOV_PARTNERNAME] to do a similar study at some point in the future? Your partner could make their own choice about whether to participate in that study.Yes I would share a linkNo I would not share a linkC254. Were you alone when you completed this survey?Yes1No2[only asked if child was not alone when survey was completed]C255. Could someone else see your responses?Yes1No2I don’t know3[only asked if child is 18 or older]Thank you for taking this second survey in this very important project! We may contact you again next year for the third STRiV survey. Please provide your email address below so that we may get in touch with you at that time: [textbox][only asked if child is 18 or older]It is very important that we are able to reach you for the third STRiV survey. In case we are unable to reach through the email address you provided in the previous question, can you provide an alternate email address and phone number for yourself? It is very important for us to hear back from you for the third survey that we may be sending out next year so we can ensure the researchers have complete data for this new and important study. Alternate Email [textbox]Phone number [000-999] - [000-999] - [0000-9999] ................
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