Interview number
What year were you born?
Last grade completed in school
How well you can read
Any trouble reading road signs
Any trouble reading newspaper
Are you a Veteran
Veteran-served from:
Veteran-served to:
Did you serve in combat
Any service-related disabilities
Sex
Race
How important is lit-reading
How important is more school
Physical health compared to others
Satisfaction with your physical ability
Any physical health problems
Types of health problems
Hospitalized/seen by doctor this year
Were you an inpatient
Do you have health insurance
How imp is physical health help
When did you first use shelter
Stayed here most time, some or rarely
Stayed where else since first stay
Stayed here how many nights last week?
Time unit for homeless period
Length of homeless period
Where was last reg place
How satisfied with this shelter?
Satisfied-condition or state of repair
Satisfied-amount of space
Satisfied-furniture
Satisfied-staff
Satisfied-amount of privacy you have
Satisfied-security or safety
Satisfied-the other residents
Satisfied-convenience to stores
Satisfied-health services
Satisfied-job services
Compared to other shelters, this is:
Compared to last reg. housing, this is:
Quality of services received here
Do you know about contract bed program
Have you ever had a contract bed
Number of weeks have been in work exp pro
Current status in work exp pro
Number of weeks have been in lit pro
Current status in lit program
Number of weeks in school while in shelter
Current status pertaining to school
Number of weeks in stabilization program
Current status in stabilization program
Number of weeks in holding bed
Current status with holding bed
Number of weeks been working outside
Current employment stat outside shelter
Number of weeks have used emp services
Current status with employment services
Number of weeks in health care
Current status in health care
Number of weeks in other programs
Current status in other programs
How long like to stay here
Feeling about not having reg. place
How important is help with place of your own
Rather share house with others
Contact with service agencies in p year
Contact with Mass Rehab Commission
Received services needed - Mass Rehab
Contact with Dep Pub Welfare
Received services needed - DPW
Contact with DSS
Received services needed - DSS
Contact with Soc Sec Ad
Received services needed - SSA
Contact with other shelters
Received services needed - other shelters
Contact with Vocational rehab
Received services needed - Voc rehab
Contact with Veterans Admin
Received services needed - VA
Contact with DMH
Received services needed - DMH
Contact with Ag for Elderly Af
Received services needed - AEA
Contact with BHA
Received services needed - BHA
Contact with the Bridge
Received services needed - Bridge
Contact with St. Francis
Received services needed - St. Francis
Contact with Travelers Aid
Received services needed - Travelers
Contact with BCH
Received services needed - BCH
Contact with Dep of Immigration
Received services needed - Dep of Immig
Contact with Comm for Blind
Received services needed - Comm for Blind
Contact with any other agencies
Received services needed - other agency
No contact with agencies in past year
Importance of financial benefits
How much do you worry about AIDS
Other residents worry about AIDS?
Do you know anyone with AIDS?
Can get AIDS - being near infected person
Can get AIDS - hugging infected person
Being bitten by an insect can give AIDS
Having sex with infected person
Sharing needles with drug users
Can get AIDS - Giving blood
Can get AIDS from toilet used by infected pers
Can get AIDS - kissing an infected person on mouth
Can get AIDS - Eating food made by infected pers
Sooner or later, Ill prob get AIDS
Theres no cure for AIDS
Infected people can still feel healthy
AIDS only affects gay men
More sex partners, more risk of AIDS
No way drug users can avoid AIDS
Im afraid of being around infected people
It helps alot to use a condom
Only blood test will tell if infected
People can do alot to avoid getting AIDS
Men cant get AIDS from sex w women
People w AIDS die soon after theyre infected
A condom doesnt help once youre infected
Read info at shelter about AIDS?
Have noticed condoms available to shel guests
Received card w condom from staff
Would feel comfortable taking condom from basket
Would feel comfortable asking m stf mem for condom
Would feel comfortable asking f stf mem for condom
Noticed bleach bottles for needles at shelter
Would feel comfortable taking bleach from basket
Would feel comfortable asking stf mem for bleach
Approach stf mem about AIDS if thought might have it
Would like to get tested for AIDS
Like to learn more about AIDS
Have attended AIDS ed meeting here
Attend AIDS ed meeting here in fut at convenient time
Think people w AIDS treated poorly by others
Think shel stf should do more to inform about AIDS
AIDS ed efforts here affected own behavior
AIDS ed efforts here affected behavior of others
Importance of AIDS ed efforts to you now
Marital status
Children in Boston area
Relatives in Boston area
Good friends in the Boston area
Children any place else
Relatives any place else
Good friends any place else
Care of children
Any one special person you count on
Any shelter staff you count on
How much support from shel stf
How much support from friends
How much support from family
Several people I trust
Someone to help me fix things
Friends more interesting than I am
Someone takes pride
Several people I can talk to
No one comfortable to talk to
Often meet with family or friends
Most I know think highly of me
Hard time finding a ride to T
Not always included by friends
No one to give objective advice
Several people I spend time with
Not good at helping w/ friends problems
Trble finding someone to take me to Dr.
Trble finding one to go with me for day
Easily find someone to put me up
No one to share fears with
Someone would help with chores
Someone would give family advice
I am as good at things as others
Someone would go to movie with me
Turn to someone about personal problems
I could get a loan of $25
People do not have confidence in me
Most people enjoy same things as I
Do not often get invited with others
Friends more successful at changes
Hard finding someone to watch my things
No one I trust for advice about money
Could easily find lunch partner
I am more satisfied w/ life than others
Someone would get me if stranded
No one to throw a birthday party for me
Hard to get advice about family crisis
I am closer to my friends than others
One person whose advice I trust
Hard getting help moving to new place
Hard keeping pace with friends
How important is making more friends
Hospitalized for mental/nervous problem
How many times hospitalized
When was last discharge
Asssigned to a com mental h ctr in Boston?
Which mental center do you use
How often do you go to mental h ctr?
Should you be taking medication
What is medication for
Taking the medication as prescribed
How happy/satisfied over past month
So down nothing could cheer you up
Ever think of taking your life
Did not feel like eating this week
Too worn out - not enjoy anything this wk
Feel depressed this week
Feel unhappy about your life this wk
Feel discouraged about future this wk
Feel lonely this wk
Felt dead - dissolved in past year
Mind dominated b forces beyond your control past y
Heard things others dont in past year
Felt thoughts broadcasted in past year
Thought you were possessed in past year
Had visions in past year
People wished to do y harm in past year
Felt you had special powers in past year
Thought something odd was going on in past year
Thoughts taken away by ex force in past year
Have ideas no one would understand in past year
Seemed to hear thoughts spoken aloud in past year
Felt thoughts put into head in past year
Assaulted or robbed in past year
Thought might lose life or die
Nightmares about losing life
Assaulted by someone close as a child
In foster care, instit care or w DSS as child
Run away from home as child
Importance of help w emotional problems now
How Often Drink
Anyone Said Drink Too Much
Ever Treated for Drinking Problem
Treated for Alcohol in Past 30 Days
How Troubled by Alcohol in Past 30 Days
How Important Treatment for Alcohol Problems
How often use street drugs in last year
Ever been treated for drug problem
Been treated for drug prob in past 30 days
How troubled by drug problem in past 30 days
How important is treatment for drug prob now
Currently legal status
Ever been jailed or imprisoned
Involved with DYS when younger
Importance of help with legal problems now
How Difficult to Afford Things
Employed
Employed Now
Looking for Work
Worked in Past
When was the last time you worked?
Longest ever worked on one job
Most ever made in job per hour
Received Financial Benefits in Past Mo.
Type of benefits received in last month
Have Rep Payee
Importance of help w finding job now
Importance of job training now
Indicators of Problems as Child
Indicators of Current Drinking Problem
Indicators of Current Drug Problem
Months Since First Used This Shelter
Months Homeless
Number of Prevention Acts Aware of
Physical Health
Either Job or Welfare
Ability to Read
Current Substance Abuse
Interest in AIDS Education
Tested for AIDS
Literacy Index
Assaulted,Robbed in Last Year
Drinking Problem (inc. treatment interest)
Drug Problem (inc. treatment interest)
Substance Problem (inc. treatment interest)
Legal Problems
Child Abuse/Neglect,Problems
Ever stay with family,friends since coming here
Indication of PTSD
Recoded Ngrade: GED & Voc
Recoded Nrace: 1=white, 2=minority
ln(age-17)
((age-18)**3)*(1/(10**6))
timehml*(1/(10**3))
Any financial benefits past month
Any legal problem
Hit as Child or Runaway
Average for Health Problems Questions: 1-5
Taking Any Psychotropic Medication