VIVIR - Acceptability of Screening Questions for Identification of Perpetrators of Violence Survey

1.Is your partner, or people at home, ever scared of you?(Required.)

2.Have you ever physically hurt someone you care about?(Required.)

3.Have you ever been so angry at home that you have hit someone, a wall or furniture?(Required.)

4.Is it very important to make sure no one takes advantage of you?(Required.)

5.Are you frustrated when people at home don’t appreciate what you do for them?(Required.)

6.Have you ever been concerned that you could not control your anger at home?(Required.)

7.Do you think people at home make an extra effort to avoid making you angry?(Required.)

8.Have you used force or the threat of force to settle a disagreement with your partner or someone you care about?(Required.)

9.Have you ever felt that you might need help with your anger?(Required.)

10.Have you had to respond with force when your partner or someone you care about has used force against you?(Required.)

11.Have you ever been reported to the police or other authorities after a violent incident?(Required.)

12.Has anyone else ever suggested that you might need help managing or controlling your anger?(Required.)

13.Do you have any comments about these questions?

*DO NOT INCLUDE ANY PERSONAL IDENTIFIERS HERE

14.What is your sex?

Female

Male

Prefer not to disclose

Other (specify)

16.If you are willing to be contacted for participation in an anonymous qualitative interview regarding the screening questions, please provide your email below.