Employee Survey - New


Start of Block: Consent Form

Q1 We are conducting a research study to understand how the coronavirus, or Covid-19, has impacted employees of small businesses, like you. Your responses will help us communicate to policymakers and provide better recommendations for what the government can do to help you in this time of crisis.      We expect the survey to take approximately 10 minutes to complete. We understand that this is a difficult time for everyone, so we really appreciate your time.         
Your answers in the surveys will be confidential: The records of these surveys will be kept private and secure. The data will not be used for commercial purposes, and your responses will remain strictly confidential. In any report that we make public, we will not include any information that will make it possible to identify you. Only the research team will have access to your personal information. We may link your survey responses to data on your hours worked as indicated through the Homebase system. We will remove identifiers prior to linking to Homebase data. You can decide to withdraw from the study at any point, and data collected up until the point of withdrawal may still be included in analysis.  
 Risks and Benefits: The research team does not anticipate any risks to you completing this survey. The resulting data may offer important insights to fight the coronavirus that may be used to inform policy makers and for academic research.  
 Questions: If you have questions, you may can contact the University of Chicago Social & Behavioral Sciences Institutional Review Board (IRB) Office by phone at (773) 702-2915, or by email at sbs-irb@uchicago.edu (reference IRB20-0662, Principal Investigator, Marianne Bertrand). If you have any questions or comments about the study, please do not hesitate to contact us via email at salma.nassar@chicagobooth.edu.    Thank you very much for taking part in our study and stay safe and healthy.       By clicking "Agree." you confirm that you are at least 18 years old and agree to participate int he research. If you do not wish to participate, you can simply close this window.        
o	I agree to participate in the research  (15) 
o	I do NOT agree to participate in the research  (16) 

Skip To: End of Survey If We are conducting a research study to understand how the coronavirus, or Covid-19, has impacted e... = I do NOT agree to participate in the research
End of Block: Consent Form

Start of Block: Module 1: Employment Status

Q2 As of January 2020, did you hold more than one job including self-employment businesses or gigs and part-time, evening or weekend work?
o	Yes, more than one job  (1) 
o	No,  only one job  (2) 


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Q3 On average, how many hours  per week did you work in January 2020? 
o	Less than 20 hours  (1) 
o	20-40 hours  (2) 
o	More than 40 hours  (3) 


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Q4 Are you      currently employed?
o	Yes  (1) 
o	No  (2) 


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Display This Question:
If Are you currently employed? = Yes

Q5 Did you lose      any hours last week due to the coronavirus?
o	Yes  (1) 
o	No  (2) 


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Q6 Please answer the following questions about your job at the business where you use Homebase.


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Q7 What impact      has the coronavirus outbreak had on your employment status at the business where you use Homebase?  
o	I chose to work fewer hours  (7) 
o	I chose to work more hours  (8) 
o	My work hours were reduced by my employer  (9) 
o	My work hours were increased by my employer  (10) 
o	I have been laid off  (11) 
o	I was furloughed or temporarily assigned 0 paid hours but am still technically employed  (12) 
o	I decided not to work to protect myself/my family from exposure to coronavirus  (13) 
o	I am unable to work because I am caring for a family member  (14) 
o	There has been no impact on my employment status  (15) 


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Display This Question:
If What impact has the coronavirus outbreak had on your employment status at the business where you... = My work hours were reduced by my employer
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I was furloughed or temporarily assigned 0 paid hours but am still technically employed
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I am unable to work because I am caring for a family member
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I decided not to work to protect myself/my family from exposure to coronavirus

Q8 Are you      getting paid for any hours that you are not working? 
o	Yes  (1) 
o	No  (2) 


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Display This Question:
If Are you getting paid for any hours that you are not working?  = Yes

Q9 Has your pay changed since the coronavirus outbreak?
o	No. My current weekly pay is the same as before  (1) 
o	Yes. My current weekly pay is more than before  (2) 
o	Yes. My current weekly pay is less than before  (3) 


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Display This Question:
If What impact has the coronavirus outbreak had on your employment status at the business where you... = My work hours were reduced by my employer
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I have been laid off
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I was furloughed or temporarily assigned 0 paid hours but am still technically employed
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I decided not to work to protect myself/my family from exposure to coronavirus
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I am unable to work because I am caring for a family member
Or Are you currently employed? = No

Q10 Has your employer encouraged you to file for unemployment benefits?
o	Yes  (1) 
o	No  (2) 


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Display This Question:
If What impact has the coronavirus outbreak had on your employment status at the business where you... = I have been laid off
Or Are you currently employed? = No

Q11 Has your employer expressed a desire to hire you back after the coronavirus      pandemic is resolved?
o	Yes  (1) 
o	No  (2) 
o	Don’t know  (3) 


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Display This Question:
If What impact has the coronavirus outbreak had on your employment status at the business where you... = My work hours were reduced by my employer
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I have been laid off
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I was furloughed or temporarily assigned 0 paid hours but am still technically employed
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I decided not to work to protect myself/my family from exposure to coronavirus
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I am unable to work because I am caring for a family member
Or Are you currently employed? = No

Q12 Are you      currently looking for a job? 
o	Yes, I have already started looking for a new job  (1) 
o	No, but I am considering it  (2) 
o	No  (3) 


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Display This Question:
If Are you currently looking for a job?  = No
 

Q13 What are the      reasons that you are not searching for a job right now? (Check up to 3 options)
▢	I have already been hired back by the business where I used Homebase  (1) 
▢	I expect to be rehired once the business where I used Homebase recovers  (2) 
▢	I worry that if I work, I may catch the coronavirus  (3) 
▢	I want to spend more time with my family  (4) 
▢	I have a family member who has coronavirus who needs my care  (5) 
▢	I have children and/or dependents who need my care at home  (6) 
▢	I don’t believe I would be able to find a job given the current conditions.  (7) 
▢	I don’t think I am allowed to work because of the stay-at-home order  (8) 
▢	Given financial support I received from the government, it does not make financial sense for me to work right now  (9) 
▢	Other  (10) ________________________________________________


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Q14 What was      your average hourly wage as of January 2020 (without tips)?
o	$5-$7.49  (1) 
o	$7.50-$9.99  (2) 
o	$10-$12.49  (3) 
o	$12.50-$14.99  (4) 
o	$15-$17.49  (5) 
o	$17.50-$19.99  (6) 
o	$20 -$22.49  (7) 
o	$22.50-$24.99  (8) 
o	$25 or higher  (9) 


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End of Block: Module 1: Employment Status

Start of Block: Module 2: Relationship with Employer
Display This Question:
If Are you currently employed? = No
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I have been laid off

Q15 Think about the business where you used Homebase before the coronavirus outbreak. How  much do you agree or disagree with the following statements?
	Strongly agree (1)	Somewhat agree (2)	Neither agree nor disagree (3)	Somewhat disagree (4)	Strongly disagree (5)
I liked my manager (1) 	o		o		o		o		o	
I liked my co-workers (2) 	o		o		o		o		o	
I was satisfied with my wages (3) 	o		o		o		o		o	
I found meaning in the work I did (4) 	o		o		o		o		o	



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Display This Question:
If Are you currently employed? = Yes
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I chose to work fewer hours
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I chose to work more hours
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = My work hours were reduced by my employer
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = My work hours were increased by my employer
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I was furloughed or temporarily assigned 0 paid hours but am still technically employed
And If
What impact has the coronavirus outbreak had on your employment status at the business where you... != I have been laid off
And If
Think about the business where you used Homebase before the coronavirus outbreak. How much do you... , Strongly agree Is Not Displayed

Q16 Think about the business where you used Homebase before the coronavirus outbreak. How  much do you agree or disagree with the following statements?
	Strongly agree (18)	Somewhat agree (19)	Neither agree nor disagree (20)	Somewhat disagree (21)	Strongly disagree (22)
I like my manager (1) 	o		o		o		o		o	
I like my co-workers (2) 	o		o		o		o		o	
I am satisfied with my wages (3) 	o		o		o		o		o	
I find meaning in the work I do (4) 	o		o		o		o		o	



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Display This Question:
If Think about the business where you used Homebase before the coronavirus outbreak. How much do you... , Strongly agree Is Displayed

Q17 How likely do you think  it is that the business where you used Homebase will offer to hire you back? 
o	Very Likely  (1) 
o	Likely  (2) 
o	Somewhat likely  (3) 
o	Somewhat unlikely  (4) 
o	Unlikely  (5) 
o	Very Unlikely  (6) 


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Display This Question:
If How likely do you think it is that the business where you used Homebase will offer to hire you ba... = Very Likely
Or How likely do you think it is that the business where you used Homebase will offer to hire you ba... = Likely
Or How likely do you think it is that the business where you used Homebase will offer to hire you ba... = Somewhat likely

Q18 When do you      expect that the business where you used Homebase will hire you back?
o	May 1  (1) 
o	June 1   (2) 
o	July 1  (3) 
o	August 1  (4) 
o	September 1  (5) 
o	October 1  (6) 
o	November 1  (8) 
o	December 1  (10) 
o	Sometime in 2021  (11) 


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Display This Question:
If When do you expect that the business where you used Homebase will hire you back? , May 1 Is Displayed

Q19 If the business where you used Homebase offers to hire you back, would you return to that employer? 
o	Yes, I plan to go back  (1) 
o	No, I do not plan to go back  (2) 
o	I am undecided  (3) 


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Display This Question:
If If the business where you used Homebase offers to hire you back, would you return to that employe... = No, I do not plan to go back
Or If the business where you used Homebase offers to hire you back, would you return to that employe... = I am undecided

Q20 Why don't you want to return to the business where you used Homebase? 
o	I don’t want to return to the workforce / plan to retire  (1) 
o	My employer cares more about profits than their employees  (2) 
o	I don’t like my manager  (3) 
o	I don’t like co-workers  (4) 
o	I want to look for a similar job but with better benefits (for example, a higher wage)  (5) 
o	I want to look for a job in a different industry  (6) 
o	Others in my household are working and that is enough for now   (7) 


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Display This Question:
If Are you currently employed? = No
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I have been laid off

Q21 Think  about the job where you used Homebase. What was your occupation? 
________________________________________________________________


Display This Question:
If Are you currently employed? = No
Or What impact has the coronavirus outbreak had on your employment status at the business where you... != I have been laid off
And If
If Think about the job where you used Homebase. What was your occupation?  Text Response Is Not Displayed

Q22 Think  about the job where you used Homebase. What is your occupation? 
________________________________________________________________


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End of Block: Module 2: Relationship with Employer

Start of Block: Module 3: Access to governmental Service/Unemployment Benefits
 

Q23 Between      November 1, 2019 and March 1, 2020, did you or anyone in your immediate      family (Check all that apply):
▢	Receive SNAP (food stamp) benefits  (1) 
▢	Receive unemployment benefits  (2) 
▢	Not applicable  (3) 


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Q24 Since March 1, 2020, have you (Check all that apply):
▢	Taken out a payday loan  (1) 
▢	Borrowed money from family or friends  (2) 
▢	Applied for housing or rental assistance  (3) 
▢	Applied for SNAP (food stamp) benefits    (4) 
▢	Received unemployment benefits  (5) 
▢	Requested Emergency Supplemental SNAP (food stamp) benefits  (6) 
▢	Sold items at a pawn shop or online  (7) 
▢	Made an early withdrawal of funds from a retirement saving plan  (8) 
▢	Missed a payment for a credit card or a loan  (9) 
▢	Missed a mortgage or rent payment  (10) 
▢	⊗None of the above  (11) 


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Display This Question:
If Are you currently employed? = No
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = My work hours were reduced by my employer
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I have been laid off
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I was furloughed or temporarily assigned 0 paid hours but am still technically employed
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I decided not to work to protect myself/my family from exposure to coronavirus
Or What impact has the coronavirus outbreak had on your employment status at the business where you... = I am unable to work because I am caring for a family member

Q25 Have you applied for unemployment benefits due to the coronavirus?
o	Yes  (1) 
o	No  (2) 


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Display This Question:
If Have you applied for unemployment benefits due to the coronavirus? = No

Q26 There are a      variety of reasons why people might not apply for unemployment insurance      benefits. What are the reasons you have not applied for unemployment      insurance benefits? [Check all that apply]
▢	Plan to file soon  (1) 
▢	Voluntarily left last job or retired  (2) 
▢	Did not know benefits existed  (3) 
▢	Did not know I was eligible or did not know where or how to apply  (4) 
▢	Expect to start or return to a job soon   (5) 
▢	Application was too confusing, technical, or difficult to understand  (6) 
▢	Tried to file by phone or internet but application system wasn’t functioning  (7) 
▢	Too much like charity or welfare  (8) 
▢	Worried filing might impact future job  (9) 
▢	The amount of work required to file for unemployment wouldn’t lead to the results I need   (10) 
▢	No access to telephone, computer, or internet or application/assistance not available in my language  (11) 


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Display This Question:
If Have you applied for unemployment benefits due to the coronavirus? = Yes

Q27 Have you received any unemployment benefits due to the coronavirus?
o	Yes  (1) 
o	No  (2) 


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Display This Question:
If Have you received any unemployment benefits due to the coronavirus? = No

Q28 Why didn’t      you receive any unemployment benefits?
o	Waiting for approval of application  (1) 
o	Application approved, but waiting period not over  (2) 
o	Left job voluntarily, quit, or dismissed for conduct or cause  (3) 
o	Earnings or hours too low to quality  (4) 
o	Disqualified (fraud, failed to report on time, refused work referral/work offer, incarceration)  (5) 
o	Withheld for child support or overpayment  (6) 
o	Other (Please specify)  (7) ________________________________________________


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End of Block: Module 3: Access to governmental Service/Unemployment Benefits

Start of Block: Module 4: Wellbeing (physical and psychological)
 

Q29 Between November 2019 and January 2020, were you or was anyone in your household covered by health insurance or some other kind of health care plan, including health insurance obtained through employment, or purchased directly, or through a government program like Medicare and Medicaid that provide medical care or help pay medical bills? (Check all that apply)
▢	Me  (1) 
▢	My spouse/partner  (2) 
▢	My dependents  (3) 
▢	No one in my household  (4) 


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Display This Question:
If Between November 2019 and January 2020, were you or was anyone in your household covered by healt... = Me

Q30 What type of      health insurance plan or health insurance coverage did you have between November 2019 to January 2020? Was it through an employer, private      insurance, Medicare, Medi-gap or somewhere else? Please indicate ALL the      plans or coverage you had.
▢	Homebase employer provided health insurance  (1) 
▢	Other employer provided health insurance  (2) 
▢	Private health insurance purchased  (3) 
▢	Medicare  (4) 
▢	Medi-GAP/Supplemental  (5) 
▢	Medicaid  (6) 
▢	American Indian/Alaska Native Health insurance  (7) 
▢	Other state-sponsored plan (not Medicaid)  (8) 
▢	Other government program  (9) 
▢	Other  (10) 


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Q31 Do you      currently have health care coverage?
o	Yes  (1) 
o	No  (2) 


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Q32 Think about the next few months, how worried are you about 
	Not at all (1)	Slightly (2)	Moderately (3)	Considerably (4)	A great deal (5)
Being without work (1) 	o		o		o		o		o	
The fact that people I care about may lose their job(s) (2) 	o		o		o		o		o	
Not being able to pay the mortgage and other expenses (3) 	o		o		o		o		o	



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Q33 Think about the next few months, how worried are you about 
	Not at all (1)	Slightly (2)	Moderately (3)	Considerably (4)	A great deal (5)
The fact that my investments (such as retirement or college savings) will be negatively impacted (7) 	o		o		o		o		o	
Not being able to afford proper health coverage for my family and myself (8) 	o		o		o		o		o	
Not being able to provide basic needs such as food for my family and myself (9) 	o		o		o		o		o	



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End of Block: Module 4: Wellbeing (physical and psychological)

Start of Block: Module 5: Demographics

Q34 What is your      gender? 
o	Male  (1) 
o	Female  (2) 
o	Non-binary  (3) 



Q35 What is your      age?
o	18-25  (1) 
o	26-37  (2) 
o	38-49  (3) 
o	50-64  (4) 
o	65 or above  (5) 



Q36 What is your      household income in 2019 (before taxes) ?
o	Less than $15,000  (1) 
o	$15,000-$24,999  (2) 
o	$25,000-$34,999  (3) 
o	$35,000-$44,999  (4) 
o	$45,000-$54,999  (5) 
o	$55,000-$64,999  (6) 
o	$65,000-$74,999  (7) 
o	$75,000-$84,999  (8) 
o	More than $85,000  (9) 



Q37 What is your      marital status?
o	Single  (1) 
o	Married  (2) 
o	Living with partner  (3) 
o	Separated  (4) 
o	Divorced  (5) 
o	Widowed  (6) 



Q38 What is your highest level of education? 
o	Some high school  (1) 
o	High school graduate  (2) 
o	Two-year degree/some college  (3) 
o	Bachelor’s degree  (4) 
o	Master’s degree or more  (5) 



Q39 What is your      race? (Check all that apply)
▢	Hispanic or Latino or Spanish Origin of any race  (1) 
▢	American Indian or Alaskan Native  (2) 
▢	Asian  (3) 
▢	Native Hawaiian or Other Pacific Islander  (4) 
▢	Black or African American  (5) 
▢	White  (6) 



Q40 Do you have children?
o	Yes  (1) 
o	No  (2) 


Display This Question:
If Do you have children? = Yes

Q41 How many children under the age of 18 live in your household? 
o	1  (1) 
o	2  (2) 
o	3  (3) 
o	4  (4) 
o	More than 4  (5) 

End of Block: Module 5: Demographics


