Page 226 - QAP Manual 2020

NCI™ ADULT IN-PERSON SURVEY (IPS) 2020-21

71. Who did you usually go with when you went to restaurants or coffee shops?

Check ALL THAT APPLY.

98. Not applicable – person didn’t go out to a restaurant or coffee shop
1. Alone
2. Friends
3. Family
4. Housemates or coworkers
5. Staff
6. Others not listed

99. Don’t know, no response, unclear response

72. Think about how often you went to a restaurant or coffee shop in the past month.
Would you like to go out to a restaurant or coffee shop more, less, or the same
amount as now?

Other respondent: Think about the number of times this person went to a restaurant or coffee
shop in the past month. Do you think this person would like to go to a restaurant or coffee
shop…

Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other

1. More
2. Less
3. The same amount as now
99. Don’t know, no response, unclear response

73. How many times did you participate in a religious service or spiritual practice (either
in person or online) in the past month? (Examples: church, synagogue, study, or other
place of worship)

Other respondent: In the past month, how many times did this person participate in a religious
service or spiritual practice?
Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other

□ 1. Did not go out for religious/spiritual practice →Code CA-10 and 74 as ‘Not

applicable’
□ 2. One or two times
□ 3. Three or four times
□ 4. Five or more times
□ 99. Don’t know, no response, unclear response →Code CA-10 and 74 as ‘Don’t know,
no response, unclear response’

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