Part One: Create a Survey Research Method Data SW 4810 10/26/2013 By: Heather Warczinsky
2 Measurments in Social Work Reserach The desired outcome that I picked to conduct a survey for women and children who are a target or witness of domestic violence would be of knowledge and behavior. I believe that the agency provides the services to the women and children to help change their behavior and knowledge on domestic violence and why it is important to get out of the situation for themselves and children sake. By conducting this survey to the women in the shelter will help give us knowledge on the outcome on how much they have learned and if their behavior will change when they leave the shelter. 1. What was the gender of the abuser? a. Male b. Female 3. Are you a victim of domestic violence? a. Yes b. No 4. Do you have children? a. Yes b. No 5. How many kids do you have? a. 0 b. 1 c. 2 d. More then 3 6. How often did your children witness the domestic violence? a. Often b. Never 7. Is counseling for children who witness domestic violence effective? a. Yes b. No 8. Were alcohol or drugs involved in the domestic violence? a. Yes b. No
3 Measurments in Social Work Reserach 8. How old are you? a. 15-20 b. 21-30 c. 31-40 d. 40 or up 9. How many abusive relationships have you had? a. 1 b. 2 c. 3 d. 4 or more 10. Does your friends and family know about it? a. Yes b. No 11. Are you in love with the abuser? a. Yes b. no 12. Do you have a job? a. yes b. no 13. Have you ever been to a domestic violence shelter before this one? a. Yes b. No 14. What is the abuser relationship to you? a. Boyfriend b. Girlfriend c. Exs d. Spouse e. Other
4 Measurments in Social Work Reserach 15. What is your ethnicity? a. Caucasian b. African- American c. Mexican d. Other 16. Has the abuser ever had a gun or knife on them? a. Yes b. No 17. Are you scared to leave your abuser? a. Yes b. No 18. After the shelter, do you plan on going back to your abuser? a. Yes b. No 19. What type of area do you live at? a. Urban b. Rural c. Suburban d. Other