Appendix: Survey Instrument Questions
Display to Respondent: For the purposes of this survey, “housing- related challenges” are issues or events that impact a students’ physical residence. This could include homelessness, evictions, frequent moves, overcrowded living conditions, or poor housing quality. “Neighborhood resources” can include the presence of religious and cultural centers, neighborhood safety, and access to grocery stores, libraries, green spaces, or health care clinics. 1. Please rank the following challenges in order of how you think they impact a student’s academic performance, from “most negatively impacts” to “least negatively impacts.” n Housing-related challenges n Lack of neighborhood resources n L ack of school resources, such as books or extracurricular activities n Lack of support or engagement from a parent or guardian n Limited access to the Internet and/or appropriate technology n Behavioral challenges or concerns n Lack of social-emotional skills
5. In your opinion, which of the following are most negatively impacted by a student’s housing-related challenges? Please select up to three (3). n Literacy n Analytical and problem-solving skills n School attendance n Attention in the classroom
n Grade advancement n Social-emotional skills n Physical health n Mental health n Other (please specify)
6. In a typical school year, how common is it for the students you work with to experience some form of housing-related challenges? n Very common n Somewhat common
n Not too common n Not at all common
n Physical and/or mental health concerns n Difficulty with transportation to/from school
7. How would you typically learn that a student is experiencing housing-related challenges? Please select all that apply. n From the student n From the student’s parent or guardian
2. In your opinion, to what extent do housing-related challenges have an impact on students’ academic performance?
n Through another student or peer n From teachers or school staff n From school administrators n Other (please specify)
n Significant impact n Moderate impact n Slight impact n No impact
8. Would you be able to identify when a student may be experiencing housing-related challenges, such as homelessness, frequent moves, or poor housing quality?
3. In your opinion, to what extent do neighborhood resources impact students’ academic performance?
n Significant impact n Moderate impact n Slight impact n No impact
n Definitely would n Probably would n Probably would not n Definitely would not
4. Which of the following housing-related challenges would you expect to most negatively impact students’ academic performance? Please select up to three (3). n Evictions
9. To what extent do you agree or disagree with the following statement: “Currently, I do not know how to connect a student experiencing housing-related challenges with available support services.” n Agree strongly n Agree somewhat n Disagree somewhat n Disagree strongly
n Frequent moves n Homelessness n Overcrowded living conditions n Student’s family cannot pay housing costs
n Poor housing quality, such as mold or pest infestation n Lack of access to basic utilities, such as electricity or heat n Other
Growing Up & Out of Poverty
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