The author(s) shown below used Federal funds provided by the U.S. 

Department of Justice and prepared the following final report: 

Document Title: Use and Outcomes of Protection Orders by 

Battered Immigrant Women 

Author(s): Mary Ann Dutton ; Nawal Ammar ; Leslye Orloff ; 

Darci Terrell 

Document No.: 218255 

Date Received: April 2007 

Award Number: 2003-WG-BX-1004 

This report has not been published by the U.S. Department of Justice. 

To provide better customer service, NCJRS has made this Federallyfunded grant final report available electronically in addition to 

traditional paper copies. 

Opinions or points of view expressed are those 

of the author(s) and do not necessarily reflect 

the official position or policies of the U.S. 

Department of Justice. 
This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Use and Outcomes of 

Protection Orders by 

Battered Immigrant Women 

REVISED FINAL TECHNICAL REPORT 

Mary Ann Dutton 

Nawal Ammar 

Leslye Orloff 

Darci Terrell 

November 10, 2006 

Prepared for: 

National Institute of Justice 

Office of Justice Programs 

U.S. Department of Justice 

810 Seventh Street, NW 

Washington, DC 20531 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ACKNOWLEDGEMENTS 

The authors wish to thank the following for their support during this study: our National 

Institute of Justice project monitor, Nicole Gaskin-Laniyan, Ph.D., and the myriad of 

organizations and individuals from across the country who gave their time to the study by 

reviewing the study instrument, recruiting and consenting study subjects, and administering the 

study instrument. These individuals and organizations include: 

Iowa Coalition Against Domestic Violence (Des Moines, IA): Sonia Parras, Maria Lazzarino, 

Kristen Schmidt, Kelly Davydov, Christine Kellogg, Chinyere Ukabiala, Tina Fisher, Xochitl 

Villeneuve, Sarabeth Anderson, Benjamin Bermmann, Jessica Armstrong, Jessica Taylor, Isabel 

Conn, Alejandrina Menjivar, and Josie Mines. 

Texas Rio Grande Legal Aid (Austin, TX): Laura Martinez, Lori Barrios, Elaine Ramirez, and 

Juanita Coria. 

A Woman’s Place of Merced County (Merced, CA): Diana Almanza, Jesse Diaz, C.J. 

Wunder, and Alice Wiley. 

Alliance for Battered and Abused International Women (Cincinnati, OH) (with assistance 

from YWCA of Greater Cincinnati, Legal Aid Society of Greater Cincinnati, Su Case 

Hispanic Center of Greater Cincinnati, and Legal Aid of the Bluegrass (Covington, KY): 

Amelia Berry, Seán Arthurs, Carson Wasserman, Monica Ibarra-Burke, and Whitney Benson. 

The Bridge – A Refuge for Women (Pasadena, TX): Karen Amaya, Jenny Martinez, Alice 

Leal, and JoAnn Estrada. 

Shelter for Abused Women and Children (Naples, FL): Susana Colaluci 

Task Force on Family Violence (Milwaukee, WI): Nou Vang 

Family Tree – Housing and Family Services (Wheat Ridge, CO): Linda Barringer and Eva 

Rivera 

Ayuda (Washington, DC): Soraya Fata 

Domestic Violence Resource Project (Washington, DC): Srijana Chettri, Anjali Nagpaul, 

Jane Hwang, and Stella Choi. 

Legal Aid Society of Minneapolis (Minneapolis, MN): Kirsten Olson 

Legal Assistance Corporation of Central Massachusetts (Worcester, MA): Arose Nielsen 

Florida Immigrant Advocacy Center (Miami, FL): Maria Jose Fletcher 

COSMOS Corporation, November 10, 2006 ii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Manavi (New Brunswick, NJ): Soma Dixit 

Tapestri, Inc. (Atlanta, GA): Aparna Bhattacharyya, Aisha Deshmukh, Aleksandra Lissowska, 

Juana Perez, Julia Perilla, and Danuta Przadka. 

The authors gratefully acknowledge the hundreds of immigrant women who shared their 

personal experiences with protection orders and intimate partner violence with the study team. 

Their contribution is the cornerstone of this study. 

The authors would also like to thank other persons who contributed to the completion of the 

project and the report. From COSMOS Corporation: Katherine Page and Alissa Fujimoto. 

From Legal Momentum: Joyce Noche, Ericka Echavarria, Olivia Garcia, Msia Clark, and 

Satayam Barakoti. From Kent State University: Robert Weaver, Ph.D. 

This project was supported by Grant Number 2003-WG-BX-1004 awarded by the National 

Institute of Justice, Office of Justice Programs, U.S. Department of Justice. Points of view in 

this document are those of the authors and do not necessarily represent the official position or 

policies of the U.S. Department of Justice. 

COSMOS Corporation, November 10, 2006 iii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ABSTRACT

Based on a summary by the World Health Organization of a multicountry large-scale study 

on women’s health and domestic violence against women in both industrialized and developing 

countries, the proportion of ever-partnered women who had ever experienced physical or sexual 

violence, or both, by an intimate partner in their lifetime, ranged from 15 to 71 percent, with 

most study sites reporting between 29 and 62 percent (WHO, 2005). Increasingly, a growing 

body of research indicates that large numbers of immigrant women experience intimate partner 

violence after they come to the United States (Ammar, 2000; Ammar, Orloff, Dutton, & Hass, 

2005; Abraham, 2000a & b; Ahmad et al., 2004; Hass, Dutton, & Orloff, 2000; Dutton, Orloff, & 

Hass, 2000; Orloff, Dutton, Hass, & Ammar, 2003; Raj & Silverman, 2002). 

The overall goal of the study was to examine the decision-making factors, accessibility, and 

effectiveness of civil protection orders for immigrant women abused by their intimate partners. 

The study included a total of 153 predominately low-income study participants, 21-46 years of 

age (M = 31 years, SD = 6.52), who were recruited from 14 partner organizations that offer 

advocacy services to battered immigrant women. Women served by these partner organizations 

spoke 19 different languages and represent nine geographic regions. The immigration status of 

most participants was undocumented (43.85%). The COSMOS Study Questionnaire was used in 

face-to-face structured interviews to assess the specific domains of demographic information, 

acculturation, intimate partner violence, protection orders, depression, and posttraumatic stress 

disorder. 

Results reported in this final technical report indicate that overall, the level of violence 

experienced by this sample of immigrant women seeking services related to intimate partner 

violence (IPV) was reportedly high. Most women reported being worried about their own or 

their children’s safety. Before seeking help from the agency from which they were recruited, 

most women (60.9%) in the sample had no prior knowledge of protection orders. Most of the 

sample had filed a protection order against their abusive partner (n = 104, 68%). Most women 

who had filed for a protection order reported them to be helpful (22.7%) or very helpful (65.2%), 

although a substantial proportion of women (36.8%) reported that they felt the protection order 

would increase their danger. A significant proportion of participants reported experiencing 

symptoms of posttraumatic stress disorder, a condition associated with exposure to traumatic 

events or experiences (American Psychiatric Association, 2000). Women in the sample reported 

high levels of exposure to violence in addition to IPV with an average of three prior trauma 

exposures. Results of the study suggest that protection orders are effective in reducing acts that 

would constitute violations of protection orders, which include not only violent and abusive 

behaviors, but also other types of violations. Lastly, participants in the sample who obtained 

protection orders reported greater appraisal of IPV-related risk and were more likely not to be 

undocumented. 

COSMOS Corporation, November 10, 2006 iv 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
EXECUTIVE SUMMARY

Introduction 

Violence against women, including intimate partner violence (IPV), has been recognized as 

a major issue in the justice system, a violation of human rights, and a problem leading to ill 

health among women. Based on a summary by the World Health Organization of a multicountry 

large-scale study on women's health and domestic violence against women in both industrialized 

and developing countries, the proportion of ever-partnered women who had ever experienced 

physical or sexual violence, or both, by an intimate partner in their lifetime, ranged from 15 to 71 

percent, with most study sites reporting between 29 and 62 percent (WHO, 2005). 

Increasingly, a growing body of research indicates that large numbers of immigrant women 

experience intimate partner violence after they come to the United States (Ammar, 2000; 

Ammar, Orloff, Dutton, & Hass, 2005; Abraham, 2000a & b; Ahmad et al., 2004; Hass, Dutton, 

& Orloff, 2000; Dutton, Orloff, & Hass, 2000; Orloff, Dutton, Hass, & Ammar, 2003; Raj & 

Silverman, 2002). Immigrant women face unique dynamics of violence. Four significant 

barriers have been highlighted by research (Abu Ras, 2003; Dutton et al., 2000; Hass et al., 

2000; Ammar, 2000; Abraham, 2000a; Peeks, 2002; Srinivasan & Ivey, 1999; Rodriguez, 1999) 

that impede battered women’s ability to either leave their abuser or stop the abuse. These 

barriers include: 1) fear of deportation/immigration as a tool of abuse, 2) severity of the abuse, 

3) fear of losing custody, and 4) language access. 

In particular, research studies have found that abusers of immigrant domestic violence 

victims often use their power to control their wife’s and children’s immigration status and threats 

of deportation to lock their partners in the abusive relationship (American Bar Association, 1994; 

Ammar, Orloff, Dutton, & Hass, 2005; Natarajan, 2003; Orloff, Dutton, Hass, & Ammar, 2003; 

Raj & Silverman, 2003; Ramos & Runner, 1999; Raj, Silverman, McCleary-Sills, & Liu, 2005). 

Additionally, immigrant women often suffer higher and severer rates of battering than U.S. 

citizens (Orloff et al., 1995). For example, a general population study of Latina immigrant 

women (Hass, Dutton, & Orloff, 2000) found that 49.3 percent of 280 immigrant women 

reported some type of physical IPV and 42.1 percent reported severe physical IPV from a current 

or former intimate partner during their lifetime, figures which are consistent with other studies of 

Latina immigrant populations (Coalition for Immigrant and Refugee Rights and Service 

(CIRRS), 1990; Perilla, Bakerman, & Norris, 1994; Rodriguez, 1995). Another study found a 61 

to 80 percent lifetime prevalence of IPV among immigrant and U.S. born women of Japanese 

decent in the U.S. (Yoshihama, 1999; Yoshihama & Sorenson, 1994). A study in New York 

City found that 51 percent of intimate partner homicide victims were foreign-born, while 45 

percent were born in the United States (New York City Department of Health Bureau of Injury 

Epidemiology, 2003). IPV can rise to almost three times the national average when a citizen’s 

inmate partner is foreign born (Hass, Ammar, & Orloff, 2006). Taken together, studies of 

intimate partner violence prevalence and severity among immigrant women in Latina, South 

Asian, and Korean communities report abuse rates that range from 30 to 50 percent (Dutton, 

Orloff, & Hass, 2000; Raj & Silverman, 2003; Rodriguez, 1995; Song, 1996). These rates are 

COSMOS Corporation, November 10, 2006 v 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
higher than the lifetime prevalence of domestic violence in the U.S. general population, which is 

estimated at 22.1 percent (Tjaden & Thoennes, 2000). 

Changes in demographics and legislation have identified the need for research on how to 

best improve services for immigrant women facing IPV. In the past decade a number of studies 

have been conducted in a variety of immigrant communities to ascertain the prevalence and 

severity of IPV, the unique domestic violence and power and control dynamics facing immigrant 

women who experience IPV, barriers to seeking services and justice system protection, help 

seeking among battered immigrant women, and difficulties immigrant victims have in accessing 

the relief created in the VAWA legislation (Abraham, 2000a & b; Ahmad et al., 2004; Ayyub, 

2000; Haas et al., 2000; Hass et al., 2006; Pendleton & Block, 2001; Orloff, & Kaguyutan, 2002; 

Orloff & Sullivan, 2004; Natarajan, 2003; Raj et al., 2005; Rodriguez, 1999, Warrier, 2002; 

Yoshihama, 1999). However, little research has been conducted on the experiences of battered 

immigrant women seeking help from the civil or criminal justice systems (Ammar, 2000, Ammar 

et al., 2005; Orloff et al., 2003; McFarlane et al., 2003). This study contributes to this area of 

research and is the first research to focus entirely on immigrant women’s experiences in 

obtaining civil protection orders in the United States. 

The overall goal of the study was to examine the decision-making factors, accessibility, and 

effectiveness of civil protection orders for immigrant women abused by their intimate partners. 

Specific objectives of the study were: 

1. To examine the factors (e.g., level of acculturation, level of IPV, immigration 

status, intent to end the abusive relationship, lifetime exposure to traumatic 

events, symptoms of posttraumatic stress and depression) that affect the 

decision to file a petition for a civil protection order among battered 

immigrant women seeking help for IPV; 

2. To examine the systemic (representation by an attorney, language access to 

the courts, permission for an advocate to speak in court, requirement to 

provide tangible evidence of physical abuse), community (level of perceived 

social support for the battered woman), and individual (woman’s appraisal of 

IPV-related threat) factors that affect whether a woman who petitions 

actually obtains a full protection order; and 

3. Compare the outcomes for women who obtain a full protection order; who 

file for, but do not obtain a full protection order; and who do not file for a 

protection order. 

COSMOS Corporation, November 10, 2006 vi 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Method 

A total of 153 study participants were recruited from 14 partner organizations that offer 

advocacy services to battered immigrant women. Women served by these partner organizations 

represent the Asian, Latino, African, Middle Eastern, and European communities. 

COSMOS Study Questionnaire 

Measurement of the relevant constructs was obtained via face-to-face structured interviews 

using specific measures that comprise the COSMOS Study Questionnaire. The measures that 

comprise the COSMOS Study Questionnaire were reviewed and revised for use with a diverse 

immigrant population. The Study Questionnaire included the following domains: 

demographics, acculturation, intimate partner violence, protection orders, depression, and 

posttraumatic stress disorder. 

The demographic measure included items to assess the subjects’ age, number of children, 

immigration status (naturalized citizen/lawful permanent residency, temporary legal immigration 

status, undocumented immigration status), country of origin, ethnicity, marital relationship status 

with abusive or “index” partner for whom participant is seeking services, intent regarding 

“index” relationship (remain in, leave, or return to relationship), and other demographics. The 

Stephenson Multigroup Acculturation Scale (SMAS) (Stephenson, 2000) was used to assess 

acculturation. The Conflict Tactics Scale (CTS-2) (Straus, Hamby, Boney-McCoy, & 

Sugarman, 1995), a revision of the original Conflict Tactics Scale (Straus & Gelles, 1990), was 

used to measure the frequency of physical violence, injury, and sexual coercion by the “index” 

partner. The Psychological Maltreatment of Women Inventory-Short Form (PMWI) 

(Tolman, 1989, 1999) is a 14-item measure of dominance/isolation and verbal/emotional types of 

psychological abuse. The IPV Threat Appraisal Scale (Dutton, 2001) is a 16-item scale that 

was used to assess subjects’ expectation that IPV will occur within the next 12 months. 

Information pertaining to the subjects’ experience with protection orders was assessed 

quantitatively using a set of items that ask the subject whether: 1) the subject filed for an ex 

parte protection order; 2) the subject returned to obtain the temporary full order, and if so, how 

many times before obtaining the order or deciding to stop trying; 3) the subject was represented 

by an attorney; 4) the court permitted the advocate to speak in court; and 5) tangible evidence of 

physical abuse was required. Qualitative questions were also included to capture each subject’s 

experience in pursuing a protection order, any decisions to drop the petition or have the 

protection order rescinded, specific remedies requested and obtained, and level of satisfaction 

with the protection order process. Two scales, the Posttraumatic Stress Disorder Checklist 

(PCL) (Weathers, Litz, Herman, Huska, & Keane, 1993) and Center for Epidemiological 

Studies–Depression Scale (CES-D) (Radloff, 1977) were used to assess the subjects’ mental 

health symptoms associated with IPV/trauma exposure. Ten items from the Lifetime Trauma 

and Victimization History (Widom, Dutton, Czaja, & DuMont, in press) were used to assess 

the subjects’ exposure to traumatic events during their lifetime. Perceived social support was 

assessed with the Interpersonal Support Evaluation List (ISEL) (Cohen, Mermelstein, 

Kamarack, & Hoberman, 1985). 

COSMOS Corporation, November 10, 2006 vii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
A number of multilingual/multicultural committees were involved in developing the 

questionnaire. An initial committee comprised of persons bilingual in English and Arabic 

(multiple dialects), French, Hebrew, Spanish, Tagalog, and Urdu formulated the central 

questionnaire. Committee members included social scientists, lawyers, and direct-service 

advocates. The study team followed three types of equivalences often cited in the literature 

regarding translation of questionnaires (Behling & Law, 2000; Bloch, 2004; and Pan & de la 

Puente, 2005). The first kind of equivalency is Semantic, which refers to literal meaning in the 

translation (Pan & de la Puente, 2005, p.5). The second kind of equivalency is Conceptual and 

refers to “the degree to which a given concept is present in both the U.S. and the various 

immigrant languages and cultures” (Pan & de la Puente, 2005, p.5). The final equivalency is 

Normative and refers to the “extent to which the translated text successfully addresses the 

difficulties created by differences in societal rules between English and other languages” (Pan & 

de la Puente, 2005, p.6). A number of norms were brought into question. These ranged from 

gender roles, to the role of women, to how to define marital rape across cultures. 

The Study Team 

The study team was comprised of academic researchers and battered immigrant women’s 

advocates spanning the disciplines of psychology, anthropology, and law situated within a 

private research firm, in partnership with two universities and a women’s public policy 

organization. The study team brought together skills in qualitative and quantitative research, 

law, public policy, cultural diversity, and research methodology, as well as expertise in the areas 

of domestic violence, immigration, acculturation, and criminal justice. The study team was 

assisted by a host of partner organizations that were responsible for recruiting and consenting 

study subjects, and administering the study instrument. 

Questionnaire Administration 

The COSMOS Study Questionnaire was administered between June 2004 and May 2006 

(initial and follow-up interviews). The questionnaires were administered by staff from 14 

partner organizations (described above). A total 153 initial questionnaires and 36 follow-up 

questionnaires were completed. An $85 incentive was provided per recruited subject for the 

partner organizations to schedule and conduct the initial and follow-up interviews. Study 

subjects received $15 for completion of the initial questionnaire and $25 for completion of the 

follow-up questionnaire. 

COSMOS Corporation, November 10, 2006 viii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Results 

1. Demographic description of sample of battered immigrant women, 

including country of origin, family constellation, and immigration status: 

– Most (58.6%) of the sample reported being involved with the agency from 

which they were recruited for the first time; 

– The 153 women in the study reported living in the U.S. for an average of 

9.0 years (SD = 6.14), with a range of 1-30 years. Most women (67.3%) 

had lived in the U.S. for 10 years or less; 

– Mean age was 31 years (SD 6.52) with a range of 21-46 years; 

– Most (86.7%) women had children with a range of 0-10 children and a 

mean number of 2.4 (SD 1.8) children; 

– The total family income of the sample reflected a relatively low income: 

44 percent reported an annual income of less than $10,000; 67 percent less 

than $15,000; and 85 percent less than $25,000; 

– The sample represented nine geographic regions of origin; 

– The women in the sample spoke 19 different first languages; 

– Immigration status of the sample was as follows: 

i. Citizen, n = 12 (5.9%) 

ii. Lawful permanent resident, n = 36 (23.5%) 

iii. Undocumented, n = 67 (43.8%) 

iv. Temporary, n = 33 (21.6%) 

v. Refugee, n = 3 (2%) 

vi. Don’t know, n = 2 (1.3%) 

2. Type and level of IPV exposure: 

Overall, the level of violence experienced by this sample of immigrant women seeking 

services related to IPV was high (see Exhibit 1). Most women reported being “somewhat” or 

“very” worried about their own or their children’s safety (see Exhibit 2). The level of 

psychological abuse was also high, including both emotional/verbal abuse and 

dominance/isolation. Further, participants reported forms of psychological abuse that included 

abused related to her immigration status (e.g., threatened or actually withdrew immigration 

papers, 39.5% sometimes, often, or very often; threatened or actually turned participant into 

immigration officials, 51% sometimes, often, or very often) (see Exhibit 3). 

3. Knowledge and use of protection orders: 

– Before seeking help from the agency from which they were recruited, 60.9 

percent of the sample had no prior knowledge of protection orders. 

– Most of the sample had filed a protection order against their abusive 

partner (n = 104, 68%), although a substantial minority had not (n = 49, 

32%). 44.9 percent of those who filed had filed within the past six months. 

COSMOS Corporation, November 10, 2006 ix 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 1 

PERCENTAGE OF WOMEN WHO REPORTED VIOLENCE IN THE LAST YEAR 

Percentage of Women Reporting, 

by Frequency Categories 

Yes, but 

not in last 

Question: In the last year... 0 1-2 3-10 10+ year 

1. S/He grabbed me. 12.4 18.3 30.1 29.4 9.8 

2. S/He pushed or shoved me. 12.4 15.0 37.9 26.1 8.5 

3. S/He threw something at me that could hurt. 28.8 8.5 26.8 20.9 15.0 

4. S/He slapped me. 32.0 15.0 21.2 17.6 11.1

5. S/He twisted my arm 32.2 24.3 18.4 14.5 10.5 

6. Pulled my hair 37.5 27.4 20.4 13.2 6.6 

7. S/He kicked me. 39.7 21.9 17.2 11.3 9.9 

8. S/He punched or hit me with something that could hurt. 34.6 21.6 19.6 12.4 11.8 

9. S/He slammed me against a wall. 31.6 20.4 27.0 12.5 8.6 

10. S/He choked me. 39.9 30.1 11.8 7.2 11.1 

11. S/He burned or scalded me on purpose. 90.8 5.9 1.3 0 2.0 

12. S/He beat me up. 30.1 20.3 18.3 17.6 13.7 

13. S/He used or threatened to use a knife or gun. 47.4 21.7 15.1 8.6 7.2 

14. S/He forced me to have sex. 35.5 14.5 13.8 23.0 13.2 

15. S/He refused to wear a condom during sex. 50.0 11.8 11.2 19.1 7.9 

16. S/He used physical force when pregnant 52.4 13.1 10.3 5.5 18.6 

17. I had sex with him because I was afraid of what s/he would do if I 34.0 13.1 16.3 27.5 9.2 

didn’t. 

18. I felt physical pain that still hurt the next day because of his 17.8 23.7 23.0 23.0 12.5

abuse. 

19. I had a sprain, bruise, or small cut because of his abuse. 25.8 24.5 19.9 19.2 10.6 

20. I passed out from being hit on the head by him. 72.2 14.6 4.6 3.3 5.3 

21. I had a broken bone from his abuse. 92.1 3.9 .7 0 3.3 

22. I went to a doctor because of his abuse. 62.2 21.2 4.0 0 8.6 

Exhibit 2 

TYPE AND LEVEL OF SUBJECTIVE APPRAISAL OF WORRY RELATED TO IPV 

Percentage of Women Reporting 

Not A Little Some-what Very 

Worries About Safety Worried Worried Worried Worried 

23. Worried about keeping self safe 13.8 24.3 25.7 36.2 

24. Worried about keeping children safe 22.4 15.4 16.1 26.2 

COSMOS Corporation, November 10, 2006 x 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 3 

PERCENTAGE OF WOMEN WHO REPORTED PSYCHOLOGICAL 

ABUSE WITHIN FREQUENCY CATEGORIES 

Frequency Categories 

Some Very 

Question: In the last year... Never Times Often Often 

1. S/he called you a bad name, swore, yelled or screamed at you 8.5 20.3 26.1 45.1 

2. S/he treated you like less than s/he was 9.9 16.4 17.8 55.9 

3. S/he watched over your activities or insisted you tell him/her 11.8 11.8 14.5 61.8 

where you were 

4. S/he used your money or made financial decisions without talking 26.1 13.7 11.1 49.0

to you 

5. S/he was jealous or suspicious of you friends 15.8 14.5 15.1 54.6 

6. S/he accused you of having an affair with another man/woman 22.4 17.8 21.7 38.2 

7. S/he interfered with your relationships with family or community 22.2 20.9 17.0 39.9 

members 

8. S/he tried to keep you from doing things to help yourself 23.5 16.3 13.1 47.1 

9. S/he controlled your use of the telephone 24.8 18.3 15.7 41.2 

10. S/he told you that your feelings were crazy 17.0 17.6 17.0 48.4 

11. S/he blamed you for his/her problems 15.0 15.0 11.1 58.8 

12. S/he told you s/he would or actually took your children away 40.6 15.4 11.2 32.9 

13. S/he told you s/he would or actually threw or locked you out of 32.9 25.0 12.5 29.6 

the house 

14. S/he told you s/he would or actually locked you in the house or a 61.2 16.4 10.5 11.8 

room 

15. S/he told you s/he would take away or not give you money 30.3 11.8 15.1 42.8 

16. S/he told you s/he would or actually turned you in to immigration 49.0 11.3 10.6 29.1

officials 

17. S/he told you s/he would or actually failed to file or withdrew 61.5 5.4 11.5 21.6

immigration papers 

18. S/he told you s/he would hurt you or your unborn child when you 66.9 11.7 7.6 13.8

were pregnant 

19. S/he destroyed your property 47.7 17.0 11.1 24.2

COSMOS Corporation, November 10, 2006 xi 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
4. Subjective experience of involvement in court process to seek protection 

order: 

– Most women who had filed for a protection order reported it to be helpful 

(22.7%) or very helpful (65.2%), although a substantial proportion of 

women (36.8%) reported that they felt the protection order would increase 

their danger. Nevertheless, the vast majority of women (98.1%) stated 

that they would recommend another woman that they knew to get a 

protection order, if needed. 

5. Level of posttraumatic responses associated with IPV: 

A significant proportion of participants reported experiencing symptoms of posttraumatic 

stress disorder, a condition associated with exposure to traumatic events or experiences 

(American Psychiatric Association, 2000) (see Exhibit 4). 

6. Prior trauma exposure other than IPV: 

Women in the sample reported high levels of exposure to violence in addition to IPV with 

an average of three prior trauma exposures (see Exhibit 5). Half of the women had three or more 

prior traumatic exposures. Only 14 percent of the sample reported previously experiencing none 

of the traumatic events listed below. 

7. Acts within the last six months that constitute violation of a protection order: 

Participants were asked if they had experienced a range of behaviors from their abusive 

intimate partners within the previous six months. Results indicate that some behaviors occurred 

at relatively high rates (e.g., 43.8% abuse; 54.9% unwanted contact). However, most often those 

behaviors occurred when there was no protection order in place, suggesting that protection 

orders may have been effective in reducing these behaviors for some abusive partners. 

8. Correlates of protection order status: 

Comparison of participants with and without protection orders on covariates produced the 

following results: 

– Undocumented participants were less likely to obtain a protection order 

compared to all other participants; 

– Participants with a protection order perceived their risk of future intimate 

partner violence to be greater than those without a protection order; and 

– Participants with a protection order report having been exposed to a 

greater number of previous traumatic events (non-IPV) compared to those 

without a protection order. 

COSMOS Corporation, November 10, 2006 xii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 4 

PROPORTION OF WOMEN REPORTING POSTTRAUMATIC SYMPTOMS 

Posttraumatic Symptom 

1. Had repeated, disturbing memories, thoughts, or images of the abuse? 

2. Had repeated disturbing dreams about the abuse? 

3. Suddenly acted or felt as if the abuse was happening again (as if you were reliving it)? 

4. Felt very upset when something reminded you of the abuse? 

5. Had physical reactions (e.g., heart pounding, trouble breathing, sweating) when something 

reminded you of the abuse? 

6. Avoided thinking about or talking about the abuse? 

7. Avoided activities or situations because they reminded you of the abuse? 

8. Had trouble remembering important parts of the abuse? 

9. Felt a loss of interest in activities that you used to enjoy? 

10. Experienced feeling distant or cut off from other people? 

11. Felt unable to have loving feelings for those close to you? 

12. Been upset by things that usually don't bother you? 

Exhibit 5 

Percentage Of 

Women Reporting 

Symptom 

80 

61 

84 

55 

67 

25 

70 

47 

61 

69 

50 

56 

TRAUMATIC EXPOSURE FROM SOMEONE OTHER THAN AN ABUSIVE PARTNER 

Type of Traumatic Event 

Beaten 

Hit 

Forced sex 

Natural disaster 

Lived in war zone 

Serious accident 

Threatened with weapon 

Held captive 

Was present when another was raped, 

beaten, or killed 

Witnessed physical violence between adults 

in the home 

Number and 

(Percentage) of 

Women Reporting 

52 (34.4) 

66 (43.4) 

52 (34.4) 

48 (31.4) 

33 (21.6) 

33 (21.6) 

56 (36.8) 

30 (19.9) 

34 (22.4) 

66 (43.1) 

COSMOS Corporation, November 10, 2006 xiii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Conclusions 

This Final Technical Report describes the process of conducting a study of battered 

immigrant women’s experience with protection orders. Substantive results will appear in 

subsequent journals and other publications and dissemination channels. Conclusions include the 

following: 

z Conducting research in the immigrant community requires members of the 

research team to be imbedded and respected in that community. That is a 

necessary, but not sufficient, condition for a successful research endeavor. 

Beyond compensation to participants and to agency staff for their time, 

successful involvement of community partners requires dedication and 

commitment by either someone within a community agency who has the 

power and authority to ensure that the research activity is completed or by 

advocates, attorneys, or agency volunteers who as individuals are committed 

to completing the work and who often choose to conduct interviews by 

devoting additional time above and beyond what is required by their agency. 

 Involvement of community advocates who have a trusted relationship with 

the target population was essential to the successful recruitment and 

interviewing of the study participants. 

z A research team representing a broad range of methodological skills, 

substantive areas of expertise, and experience is necessary to conduct 

community-based research involving the complex issues represented by 

immigrant women’s exposure to domestic violence and their use of the 

justice system – specifically protection orders – as a remedy. Access to the 

many individuals who provided formal and informal consultation throughout 

the course of the project was invaluable to its successful completion. 

z A strong capacity for project coordination and administration is essential for 

successfully completing the complex process of involvement of many 

community partners across diverse ethnic communities and geographic 

locations. Successful project completion would not be possible without this 

infrastructure. 

z Partnership with funding agency and research team is essential for adapting 

to the inevitable adjustments and modifications that are required to respond 

to unexpected contingencies in research design and implementation. 

Flexibility allows for midcourse adjustments that maximize the productivity 

of the research endeavor. 

COSMOS Corporation, November 10, 2006 xiv 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
z Substantive results offer several conclusions: 

– Immigrant women seeking help within community agencies for domestic 

violence report an extremely high level of domestic violence exposure. 

Compounding the situation, most women also report a prior history of 

trauma exposure. Chronic trauma exposure increases the battered 

woman’s vulnerability to adverse health, economic, and social outcomes. 

– Immigrant women seeking help for IPV report an ongoing concern for the 

safety of themselves and their children. 

– Knowledge of civil protection orders is not something most immigrant 

women reported prior to contact with the community agency where they 

were seeking services. Confirming that immigrant victims lack 

information about what legal options are available to help them, and 

indicating the need for greater public awareness among immigrant women 

and their female support providers of options for responding to domestic 

violence within communities. 

– Battered immigrant women’s experience in the civil court process is 

perceived as positive for most women, although a substantial minority was 

not satisfied with this process. Importantly, a sizeable proportion 

perceived that the protection order increased their danger related to 

domestic violence. 

– The level of posttraumatic symptomatology is extremely high among this 

sample of battered immigrant women, indicating an immense mental 

health burden to the woman, her family and extended community, and to 

society. The need for integrated services to address these needs within the 

justice system is clear. 

– Many immigrant battered women who participated in the survey reported 

forms of posttraumatic symptomatology that could directly interfere with 

an immigrant victim’s ability to present testimony and evidence in a court 

proceeding or in an affidavit submitted to the Department of Homeland 

Security in an immigration case. They reported having trouble 

remembering important parts of the abuse (47%), avoided thinking about 

the abuse (25%), and felt very upset when something reminded them 

about the abuse (55%). These findings confirm that immigrant victims are 

very unlikely to be able to obtain protection orders or immigration relief 

on their own without the assistance of trained advocates and attorneys. 

Advocates and attorneys working with immigrant victims need to be 

trained how to support victims with posttraumatic symptomatology and 

need to develop resources in their communities to provide linguistically 

accessible and culturally sensitive mental health treatment to immigrant 

COSMOS Corporation, November 10, 2006 xv 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
victims. Additionally, judicial officers and government agency 

adjudicators need to be trained to be sensitive to and understand that 

mental health effects of domestic violence and multiple lifetime 

victimization can affect how immigrant victims present testimonial 

evidence in domestic violence cases. 

– Protection orders may be associated with fewer acts that would constitute 

violations of protection orders. This would suggest that protection orders 

are effective in reducing these acts, which include not only violent and 

abusive behaviors, but also other types of violations. 

– Participants who obtain protection orders report greater appraisal of IPVrelated risk, are more likely not to be undocumented, and report fewer 

prior exposures to non-IPV traumatic events. Each of these represents a 

potential barrier to obtaining protection orders for intimate partner 

violence. 

Study Limitations 

The study was limited by several considerations: 

z Potential participant bias; 

Participants in this study were recruited from agencies providing immigrant 

services, including but not limited to legal services. This study may not 

represent battered immigrant women who do not seek similar services. 

Thus, generalization to all battered immigrant women may be limited. 

z No comparison groups; 

This study included only women who were both born outside the U.S. and 

who had experienced violence from an intimate partner. We did not 

include a comparison group of non-immigrant women exposed to intimate 

partner violence nor did we include a comparison group of immigrant 

women who had never been exposed to intimate partner violence. 

Comparisons to each of these groups are important for furthering our 

understanding of battered immigrant women. 

z Sampling methods. 

This study utilized convenience sampling as a method for obtaining study subjects. 

This method may result in study bias since it is does not systematically sample 

potential participants from the population. Alternate methods of representative 

sampling from the population were too expensive to consider. Another potential 

method, cluster sampling, was not feasible since we were unable to systematically 

sample all agencies providing services to immigrant women. Thus, our sample 

may be biased by our sampling method and not represent all battered immigrant 

women. 

COSMOS Corporation, November 10, 2006 xvi 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
CONTENTS

Page 

Section 

Acknowledgements ................................................................................................................. ii 

Abstract................................................................................................................................... iv 

Executive Summary.................................................................................................................v 

1. Introduction to the Study ...................................................................................................1 

1.1 Description of the Problem ................................................................................................1 

Prevalence of IPV Among Immigrant Women in the U.S. ................................................1 

The Civil Protection Order as a Remedy for IPV ..............................................................4 

Effectiveness of Protection Orders for IPV........................................................................5 

Predicting Who Gets Protection Orders .............................................................................6 

1.2 Factors Relevant to the Study: Research Design Variables..............................................7 

Acculturation......................................................................................................................7 

Unique Patterns of Intimate Partner Violence Among Immigrant Women .......................8 

 Immigration Status .............................................................................................................8 

Intent to Leave an Abusive Relationship ...........................................................................8 

 Social Support ....................................................................................................................9 

Immigrant Women and Court-Related Issues ....................................................................9 

1.3 Purpose, Goals, and Objectives of the Study...................................................................11 

2. Study Design and Methodology .......................................................................................12 

2.1 Study Design....................................................................................................................12 

 Theoretical Framework ....................................................................................................12 

 Study Hypotheses .............................................................................................................12 

Sample and Subject Selection Criteria .............................................................................14 

2.2 Development of the COSMOS Study Questionnaire .......................................................15 

Description of the Measures in the COSMOS Study Questionnaire ................................15 

Demographic Characteristics ..................................................................................15 

Acculturation...........................................................................................................16 

Intimate Partner Violence........................................................................................16 

Protection Order Information ..................................................................................17 

Symptoms of Posttraumatic Stress and Depression ................................................17 

Exposure to Traumatic Events ................................................................................17 

Social Support .........................................................................................................18 

COSMOS Corporation, November 10, 2006 xvii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Item Development for the COSMOS Study Questionnaire ..............................................18

Multilingual/Multicultural Committee....................................................................19 

Establishing Clear Criteria for Cross-cultural Comparisons/Translations..............19 

Pilot Testing of the COSMOS Study Questionnaire................................................21 

Development of Subject Consent Form and Administrative Tracking Forms.................21 

2.3 The Study Team .......................................................................................................21 

Recruitment of Partner Organizations.....................................................................22 

Original Partner Organization: Tapestri, Inc....................................................22 

Recruitment and Training of First Wave of New Partner Organizations..........23 

Recruitment and Training of Second Wave of Partner Organizations..............26 

Lessons Learned......................................................................................................28 

2.4 Administration of the COSMOS Study Questionnaire .............................................30 

Management of Risks to Subjects ...........................................................................30 

Consent Form and Process ................................................................................30 

Safety Protocol ..................................................................................................32 

Institutional Review Board Review of the Data Collection Procedures ...........33 

Unique Identifiers..............................................................................................33 

Training for Questionnaire Administrators .............................................................33 

Subject Recruitment and Screening ........................................................................34 

Administration of the Initial and Follow-up Questionnaires ..................................35 

Tracking and Processing Completed Questionnaires and 

Administrative Forms........................................................................................37 

Electronic Data Scanning ........................................................................................38 

2.5 Data Analysis ...........................................................................................................38 

3. Results of the Study ..........................................................................................................40 

4. Conclusions........................................................................................................................50

5. References..........................................................................................................................54

COSMOS Corporation, November 10, 2006 xviii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibits 

1. Subject Selection and Disqualification Criteria ............................................................14 

2. Examples of Semantic Equivalency Edits to Items in the 

COSMOS Study Questionnaire .....................................................................................20

3. Examples of Concept Equivalency Edits to the COSMOS Study Questionnaire..........20 

4. Examples of Normative Equivalency Edits to the COSMOS Study Questionnaire ......21 

5. Subject Recruitment by the First Wave of New Partner Organizations........................26 

6. Subject Recruitment by the Second Wave of New Partner Organizations ...................29 

7. Total Subject Recruitment by the First and Second Waves of New 

 Partner Organizations....................................................................................................29 

8. Procedures for Electronically Scanning Questionnaire Data via TeleForm .................39 

9. Percentage of Women Who Reported Violence in the Last Year.................................42 

10. Percentage of Women Who Reported Psychological Abuse Within Frequency 

Categories......................................................................................................................43 

11. Type and Level of Subjective Appraisal of Worry Related to IPV...............................43 

12. Proportion of Women Reporting Posttraumatic Symptoms..........................................44 

13. Traumatic Exposure from Someone Other than an Abusive Partner ............................45 

14. Acts Within the Previous Six Months that Constitute Violations of a 

 Protection Order ............................................................................................................45

15. Comparing Those with Protection Order vs. Those with No Protection Order...........48 

Appendices 

A. COSMOS Study Questionnaire and Visual Aids (Initial Questionnaire) .................. A-1 

B. COSMOS Study Questionnaire and Visual Aids (Follow-up Questionnaire) ............B-1 

C. Consent Form ..............................................................................................................C-1 

D. Administrative Forms................................................................................................. D-1 

E. E-mail Letter to Recruit Second Wave Partner Organizations....................................E-1 

F. Training Manual for Questionnaire Administration ....................................................F-1 

G. Screening Checklist.................................................................................................... G-1 

COSMOS Corporation, November 10, 2006 xix 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
1. INTRODUCTION TO THE STUDY 

1.1 DESCRIPTION OF THE PROBLEM 

Prevalence of Intimate Partner Violence (IPV) Among Immigrant Women in the U.S. 

Violence against women, including IPV, has been recognized as a major issue in the justice 

system, a violation of human rights, and a problem leading to ill health among women. Based on 

a summary by the World Health Organization of a multicountry large-scale study on women's 

health and domestic violence against women in both industrialized and developing countries, the 

proportion of ever-partnered women who had ever experienced physical or sexual violence, or 

both, by an intimate partner in their lifetime, ranged from 15 to 71 percent, with most study sites 

reporting between 29 and 62 percent (WHO, 2005). A United Nations Children Fund study 

(2000) estimated that up to half of all women and girls studied had experienced physical 

violence at the hands of an intimate partner or family member. 

Increasingly, a growing body of research indicates that large numbers of immigrant women 

experience intimate partner violence after they come to the United States (Ammar, 2000; 

Ammar, Orloff, Dutton, & Hass, 2005; Abraham, 2000a & b; Ahmad et al., 2004; Hass, Dutton, 

& Orloff, 2000; Dutton, Orloff, & Hass, 2000; Orloff, Dutton, Hass, & Ammar, 2003; Raj & 

Silverman, 2002). Immigrant women face unique dynamics of violence. Four significant 

barriers have been highlighted by research (Abu Ras, 2003; Dutton et al., 2000; Hass et al., 

2000; Ammar, 2000; Abraham, 2000a; Peeks, 2002; Srinivasan and Ivey, 1999; Rodriguez, 

1999) that impede battered women’s ability to either leave their abuser or stop the abuse. These 

barriers include: 1) fear of deportation/immigration as a tool of abuse, 2) severity of the abuse, 

3) fear of losing custody, and 4) language access. 

In particular, research studies have found that abusers of immigrant domestic violence 

victims often use their power to control their wife’s and children’s immigration status and threats 

of deportation to lock their partners in the abusive relationship (American Bar Association, 1994; 

Ammar, Orloff, Dutton, & Hass, 2005; Natarajan, 2003; Orloff, Dutton, Hass, & Ammar, 2003; 

Raj & Silverman, 2003; Ramos & Runner, 1999; Raj, Silverman, McCleary-Sills, & Liu, 2005). 

Additionally, immigrant women often suffer higher and severer rates of battering than U.S. 

citizens (Orloff et al., 1995). For example, a general population study of Latina immigrant 

women (Hass et al., 2000) found that 49.3 percent of 280 immigrant women reported some type 

of physical IPV and 42.1 percent reported severe physical IPV from a current or former intimate 

partner during their lifetime, figures which are consistent with other studies of Latina immigrant 

populations (Coalition for Immigrant and Refugee Rights and Service (CIRRS), 1990; Perilla et 

al., 1994; Rodriguez, 1995). Another study found a 61 to 80 percent lifetime prevalence of IPV 

among immigrant and U.S. born women of Japanese decent in the U.S. (Yoshihama, 1999; 

Yoshihama & Sorenson, 1994). A study in New York City found that 51 percent of intimate 

partner homicide victims were foreign-born, while 45 percent were born in the United States 

(New York City Department of Health Bureau of Injury Epidemiology, 2003). IPV can rise to 

COSMOS Corporation, November10, 2006 1 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
almost three times the national average when a citizen’s inmate partner is foreign-born (Hass, 

Ammar, & Orloff, 2006). Taken together, studies of intimate partner violence prevalence and 

severity among immigrant women in Latina, South Asian, and Korean communities report abuse 

rates that range from 30 to 50 percent (Dutton, Orloff, & Hass, 2000; Raj & Silverman, 2003; 

Rodriguez, 1995; Song, 1996). These rates are higher than the lifetime prevalence of domestic 

violence in the U.S. general population, which is estimated at 22.1 percent (Tjaden & Thoennes, 

2000). 

Concerns about children and their safety are factors that complicate immigrant women’s 

experience with IPV (Dutton et al., 2000; Hass et al., 2000; Ammar et al., 2004). Abusers of 

immigrant women often intimidate them by threatening to take the children if the immigrant 

victim leaves the marriage (Ammar, Orloff, Hass, & Dutton, 2004). The fear that abusers will 

redirect the violence towards the children is a legitimate concern since in 60 percent of 

households where women face abuse, children are also abused (Ammar & Orloff, 2006; 

Pendleton & Maher, 2000). 

New National Institute of Justice-funded research published by the National Center for 

State Courts (NCSC) was released in July of 2006, documenting the need for language access to 

protection order courts by Limited English Proficient (LEP) battered immigrant women. It is 

clear from the countries of origin of immigrant women (Greico, 2003), the NCSC study (Uekert, 

2006), and the experiences of victim advocates over the last two decades that most immigrant 

women in the United States are not fluent in English. Research published by Ammar, Orloff, 

Dutton, and Hass (2005) shows that the overwhelming majority (75.6%) of the battered 

immigrants participating in their study of 280 Latina women spoke little or no English. This 

inability to speak English creates a linguistic barrier that prevents immigrant victims from 

learning about their legal rights in the United States and from seeking help that is available to 

victims. Very often an immigrant woman’s spouse serves as her translator or her language 

teacher (Ammar, 2000; Orloff et al., 2003). Seeking assistance from shelters, victim service 

programs, legal service offices, police departments, prosecutor’s offices, and courts is difficult 

for battered immigrant women whose spoken English is not fluent. When victim services 

programs do not have employees who can understand an immigrant woman’s native language 

and do not provide interpreters, these programs effectively shut their doors to immigrant victims 

in their communities (Ammar and Orloff, 2006). These linguistic limitations can also seriously 

impede immigrant women’s potential to escape the harms of intimate partner violence (Orloff et 

al., 2003; Abraham, 2000a and b; Ammar, 2000; Ammar and Orloff, 2006). 

The need for programs to expand services to immigrant victims of intimate partner violence 

has become more urgent in recent years for two major reasons. The first lays in the demographic 

changes in the U.S. population during the last quarter of a century and the dramatic changes in 

immigrant settlement patterns since 1990. The population of the United States is diverse, 

composed of a great variety of cultures, races, ethnic groups, and religious and linguistic 

communities. Eighteen percent of the U.S. population age five and over speak a language other 

than English at home (Shin, H.B. and Bruno, R. 2003). The United States experienced a steady 

rise in the absolute number of immigrants living in the United States during each decade over the 

past 65 years (Nowak, 2004). Since the 1990s more females than males have immigrated to the 

COSMOS Corporation, November 10, 2006 2 

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been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
United States (Greico, 2002). This immigration pattern, combined with a persistent annual rate 

of natural increase (births minus deaths), has led to the estimation that 60 percent of the 

population increase in the United States between 1994 and 2050 will be attributed to 

immigration (Nowak, 2004). According to the U.S. Census Bureau, by 2005, 25 percent of the 

U.S. population were themselves foreign-born or had at least one foreign-born parent (Ewing, 

2005). 

 Secondly, the Violence Against Women Act (1994, 2000, and 2005) creates an imperative 

that justice, social service, health care, and victim services programs are fully accessible to offer 

help to immigrant and non-English speaking victims. The Violence Against Women Act (VAWA) 

is the first piece of ground-breaking legislation mandating expanded legal protection and 

services to all victims of violence against women. First passed in 1994, VAWA was the first 

piece of federal legislation designed to involve all three branches of federal government 

(Congress, the courts, and federal government agencies) in curbing domestic violence in the 

United States (Orloff and Kaguyutan, 2002; Hass, Ammar, and Orloff, 2006). VAWA explicitly 

required that the full range of legal protections and victim’s services be open to all immigrant 

victims without regard to their immigration or citizenship status in the United States (Section 

40002(a)(32) of the Violence Against Women Act of 1994).

 The Violence Against Women Act of 1994, 2000, and 2005 EACH contained several 

provisions designed to prevent abusers from using immigration as a tool to control their victims. 

Specifically, VAWA 1994 made it possible for battered immigrants to obtain lawful permanent 

residency (green cards) without the cooperation of their abusive spouse (Ammar and Orloff, 

2006). VAWA self-petitions and VAWA cancellation of removal are two such forms of relief 

(Pendleton and Block, 2001). On October 28, 2000, VAWA was reauthorized to expand the 

protections for victims of domestic violence, sexual assault, stalking, trafficking, and other 

violent crimes. VAWA 2000 made it easier for many more battered immigrant women to leave 

their abusers, receive culturally competent services, and to help prosecute their abusers. It 

created special rules to allow non-citizen battered women and children to remain in the United 

States, expanding immigration protections to immigrant victims of sexual assault, trafficking, 

and immigrant victims of domestic violence left out of VAWA 1994 protections (Orloff and 

Kaguyutan, 2002; Ammar and Orloff, 2006). 

On January 5, 2006, VAWA was authorized once again (VAWA 2005) enhancing relief to 

victims of violence against women including immigrant women and children. VAWA 2005 

extends VAWA immigration protection to immigrant victims of elder abuse and improves 

protections for immigrant victims of child abuse and incest. VAWA stops the deportation of 

immigrant victims and assures that Department of Homeland Security enforcement officers can 

no longer arrest immigrant victims at shelters, rape crisis centers, or at courthouses when the 

immigrant victims have come there seeking protection orders and custody of their children. 

Additionally, VAWA 2005 guarantees that all immigrant victims of domestic violence, sexual 

assault, and trafficking can access legal services and receive legal work authorization at a much 

earlier point in the process of filing for and receiving legal immigration relief. (Lin and Orloff, 

2006). 

COSMOS Corporation, November 10, 2006 3 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
The above changes in demographics and legislation have identified the need for research on 

how to best improve services for immigrant women facing IPV. In the past decade a number of 

studies have been conducted in a variety of immigrant communities to ascertain the prevalence 

and severity of IPV, the unique domestic violence and power and control dynamics facing 

immigrant women who experience IPV, barriers to seeking services and justice system 

protection, help seeking among battered immigrant women, and difficulties immigrant victims 

have in accessing the relief created in the VAWA legislation (Abraham, 2000a and b; Ahmad et 

al., 2004; Ayyub, 2000; Haas et al., 2000; Hass et al., 2006; Pendleton and Block, 2001; Orloff, 

and Kaguyutan, 2002; Orloff and Sullivan, 2004; Natarajan, 2003; Raj et al., 2005; Rodriguez, 

1999, Warrier, 2002; Yoshihama, 1999). However, little research has been conducted on the 

experiences of battered immigrant women seeking help from the civil or criminal justice systems 

(Ammar, 2000, Ammar et al., 2005; Orloff et al., 2003; McFarlane et al., 2003). This study 

contributes to this area of research, and is the first research to focus entirely on immigrant 

women’s experiences in obtaining civil protection orders in the United States. 

The Civil Protection Order as a Remedy for IPV 

Civil protection orders were developed to provide a justice system option for victims of 

domestic violence, separate from the criminal court system, in which the victim could seek court 

intervention to stop ongoing abuse and to provide a broad range of victim-controlled remedies 

and protections (Klein and Orloff, 1993). Civil protection orders serve as a future deterrent to 

violence, do not require criminal prosecution of the abuser (Malecha et al., 2003), and are often 

used by IPV victims for protection from ongoing abuse (Gist et al., 2001; Weisz et al., 1998). 

Protection orders allow women to decide on the remedies according to their needs, which may 

include: ordering the batterer to refrain from further abuse, evicting the abuser from the 

residence, awarding the victim custody and child support, stay away orders, property allocation, 

court costs, and any other relief that could help reduce future violence and tension in the 

relationship including ordering the abuser not to contact immigration authorities regarding the 

victim (Klein and Orloff, 1993). Research has shown that broader, comprehensive relief 

provisions in protection orders “increase the likelihood of reducing the man’s abuse and 

promoting the woman’s autonomy” (Finn, 1991; Hart, 1992). 

Most jurisdictions have a two-tiered civil protection order system in which the victim 

petitioner first petitions the court on an ex parte basis and receives a temporary protection order 

(Klein and Orloff, 1993). The abuser respondent is served with the pleadings in the protection 

order case and is given notice and opportunity to appear at a hearing before the court issues a full 

protection order. The petitioner and respondent must both return to the court anywhere between 

10 and 30 days after a temporary protection order has been issued for a full protection order 

hearing, at which the court will decide whether or not to issue a permanent protection order. At 

this point the judge can amplify any temporary protection order issued and grant a permanent 

order for any length of time up to the statutory maximum which varies from state to state 

(Chaudhuri and Daly, 1992; De-Jong and Burgess-Proctor, 2006). Permanent orders last 

anywhere between one to five years, or they can be indefinite. Most state statues require that the 

petitioner establish a legally recognized relationship (Grau et al., 1985; De-Jong and BurgessCOSMOS Corporation, November 10, 2006 4 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Proctor, 2006). Violation of the terms of a protection order can lead to a civil or criminal 

contempt proceeding or a criminal prosecution (Klein and Orloff, 1993). Violation of a civil 

protection order is a criminal offense, even when the acts committed in violation of the order are 

not in and of themselves separate crimes (De-Jong and Burgess-Proctor, 2006). 

VAWA included provisions to facilitate the use of protection orders including “a full faith 

and credit” provision to ensure law enforcement protection in any state or U.S. jurisdiction, 

regardless of the state in which the protection order was issued. VAWA also made crossing state 

lines to continue abuse a federal offense (Malecha et al., 2003; De-Jong and Burgess-Proctor, 

2006). The Model Code on Domestic and Family Violence (National Council of Juvenile and 

Family Court Judges, 1993) and recent statutory reforms have improved on some important 

aspects of the protection order and are designed to help all battered women. These 

improvements include the waiver of filing fees, increasing forms of relief that are listed as 

available remedies in the civil protection order, and increasing the length of the order. However, 

access to protection orders remains difficult for battered immigrant women due to language 

access issues (Uekert et al., 2006), lack of knowledge about the U.S. legal system (Orloff and 

Sullivan, 2004), and the practical impossibility of LEP battered immigrant women navigating the 

U.S. court system on their own – pro se – without bilingual and bicultural lawyers and advocates 

to assist them. 

Effectiveness of Protection Orders for IPV 

The emerging body of research examining the effectiveness of protection orders for 

reducing the risk to victims of IPV (Gist et al., 2001; Kaci, 1994; Keilitz, Hannaford and 

Efkeman, 1997; Holt et al., 2003; Malecha et al., 2003; Ptacek, 1999) agrees generally that 

women report a lower level of IPV for up to two years after obtaining a protection order. Studies 

of protection orders that examine only pre- and postcomparisons (Carlson, Harris, and Holden, 

1999), without inclusion of a control group, do not account for potential confounding factors, 

such as time. A study by Harrell and colleagues (Harrell and Smith, 1996) found that permanent 

protection orders were effective in reducing recurrent psychological, but not physical, IPV. 

The effectiveness of protection orders may be impeded when police do not respond 

appropriately to reported protection order violations. Research has found that victims benefit 

from protection orders upon issuance (Dutton et al., 2000). Women should be able to choose 

when, how, and whether they can safely enforce their protection order, and women will often 

explore alternative approaches before calling the police. A victim must weigh whether calling 

the police to enforce her protection order will enhance safety or danger in her particular case. 

When victims do call the police for help to enforce their protection order, police should take 

such calls seriously. Police response to calls for help following the issuance of a protection 

order can often be unsatisfactory. A study of Canadian police officers found that they reported 

making an arrest in only 21 percent of cases following a protection order violation (Rigakos, 

1997). A recent study of battered immigrant women involving the investigators of this study 

(Orloff, Dutton, Hass, and Ammar, 2003) found that police were more likely to make an arrest 

COSMOS Corporation, November 10, 2006 5 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
following a domestic violence call when the woman had a protection order, further supporting 

the important role of protection orders. 

There is only one published paper about immigrant women seeking protection orders 

(McFarlane et al., 2004), which reports on 42 women of whom 40 were born in Spanishspeaking countries. This study found that when immigrant women succeeded in accessing the 

justice system and obtaining protection orders, levels of violence fell significantly in a way 

comparable to U.S.-born women. Significantly, this study also found that immigrant women 

experience “double jeopardy”: while they report a level of postprotection order violence that 

was similar to that of the U.S. women in the sample, immigrant women do not have the 

“proficiency of English, income, or education to deal with the abuse” (McFarlane et al., 2002, p. 

248). A recent study by the National Center for State Courts found that protection order courts 

across the country were not fully accessible to LEP battered women due to lack of interpreters, 

sparse information on protection orders in languages other than English, lack of outreach to LEP 

communities, and lack of relationships with community-based organizations serving LEP 

communities (Uekert et al., 2006). 

Predicting Who Gets Protection Orders 

Understanding who among battered immigrant women gets protection orders is important 

for reducing barriers to legal protections. According to Logan, Shannon, Walker and Faragher 

(2006), studies of IPV victims seeking protection orders do not report consistent data on 

race/ethnicity and employment. On the one hand some studies (Carlson, Harris, and Holden, 

1999; Gist et al., 2001, McFarlane et al., 2004) report an equal number of African American, 

white, and Latina women filing for protection orders; on the other hand, some studies 

(Chaudhuri and Daly, 1992; Keilitz et al., 1997) identify that African Americans file at a higher 

rate. Further, these race/ethnicity studies do not focus on immigration status. In terms of 

employment, some studies show that between 40 to 50 percent of those filing for protection 

orders were employed (Gondolf et al., 1994), while other studies report that about 90 percent of 

women petitioning for protection orders were employed (part-time or full-time) (Chaudhuri and 

Day, 1992; McFarlane et al., 2004; Wolf, Holt, Kernic, and Rivara, 2000). 

The majority of studies agree on a range of other demographic indicators that are helpful to 

predict which victims are more likely to seek protection orders. These include education, 

relationship with the perpetrator, number of children, place of residence at time of filing, 

victimization history, and help-seeking patterns (Logan, et al., 2006, pp. 186-191). Women 

filing for protection orders were more likely to have high school education, be in a relationship 

that has lasted on average between four to nine years, be married (77% of the time), have on 

average one to two children, and be living with the partner at the time of filing. Women filing 

for protection orders also were more likely to have severe histories of violence, and pursued help 

from multiple sources including the police, family and friends, health care services, counseling, 

religious services, shelters, and legal services (Logan et al., 2006, p. 190). 

COSMOS Corporation, November 10, 2006 6 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
There is no comparable data for understanding battered immigrant women’s use of 

protection orders. The current study provides data on the socio-demographic characteristics of 

battered immigrant women who seek protection orders, examines immigrant women’s decisionmaking regarding whether to seek a protection order, and explores the effectiveness of protection 

orders for battered immigrant women. 

Following is a brief review of factors relevant to this study on battered immigrant women’s 

use and outcomes of protection orders. 

1.2 FACTORS RELEVANT TO THE STUDY: RESEARCH DESIGN VARIABLES 

Acculturation 

Acculturation has been defined as the process of psychological and behavioral change that 

individuals and groups undergo as a result of long-term contact with another culture (Zea, AsnerSelf, Birman, and Buki, 2003). Contemporary views of acculturation recognize the 

multidimensional and bilateral process through which individuals are transformed (Berry and 

Sam, 1997; Stephenson, 2000). 

Acculturation is an important construct for understanding battered immigrant women’s use 

of civil protection orders. Filing a petition for a protection order and returning to obtain a full 

order involves accessing an institution within a mainstream culture to address a problem that 

may be considered to be private and within the domain of the family or ethnic community. To 

do so may require adaptations from one’s original culture in terms of knowledge, language, and 

behavior. Thus, greater acculturation would be expected to play a role in battered immigrant 

women’s decision to utilize protection orders as a means of addressing IPV. 

Specifically, the woman’s level of acculturation often determines her English speaking 

ability, her knowledge of her legal rights and the resources available to assist her, and her ability 

to navigate the justice and service systems. The greater her level of acculturation, the more 

likely she is to know that domestic violence is a crime in the U.S. and that there are civil and 

criminal remedies available to victims. She also is more likely to know of available resources, or 

at least know how to find the services she needs, and more likely to feel comfortable in accessing 

these services for assistance. Knowing how the system works helps reduce her anxiety over the 

legal procedures and makes her more willing to file. 

COSMOS Corporation, November 10, 2006 7 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Unique Patterns of Intimate Partner Violence Among Immigrant Women 

Previous research has shown that greater severity of IPV is associated with greater use of 

all types of strategies for dealing with IPV, including protection orders (Dutton, Goodman, and 

Bennett, 1999; Goodman, Dutton, Weinfurt, and Cook, 2003). However, a recent study suggests 

that physical assault to family members may be even more relevant to women’s decisions to seek 

an order than physical assault or injury to themselves (Wolf, Holt, Kernic, and Rivara, 2000). 

Further, it may be that it is not merely the level or type of prior IPV, but the level or type of IPV 

expected in the future, that determines a victim’s decision concerning protection orders. 

Immigration Status 

Fear of deportation is a major factor that keeps immigrant victims of domestic violence 

from seeking any form of justice system assistance to stop abuse. Immigration status has been 

found to play a role in the victim’s treatment by the justice system (Pogrebin and Poole, 1990; 

Russell, 1998) and in women’s strategic responses to IPV (Yoshihama, 2002). Prior research 

involving immigrant Latinas (Orloff et al., 2003) found that battered immigrant women’s 

willingness to call the police for help is significantly related to the stability of their immigration 

or citizenship status. Immigrant women with more stable immigration status (naturalized 

citizens or lawful permanent residents) were more likely than immigrant victims with temporary 

legal immigration status (e.g., student, work or spouse dependent visas) or undocumented 

victims (lacking legal immigration status) to seek help from the social service and justice 

systems for domestic violence. Further, a victim’s immigration status may affect whether she 

will choose to separate from her abuser. Accordingly, she may need a full-contact, rather than a 

no-contact, protection order that requires her abuser to stop his violent acts against her, but does 

not necessitate that the parties separate. 

Intent to Leave an Abusive Relationship 

Women in many cultures struggle with the decision to leave, return to, or remain in an 

abusive relationship. Anecdotal evidence suggests women who are not prepared to leave an 

abusive relationship may not file for protection orders or return to obtain the full order. Yet, 

little empirical evidence exists to address this issue—especially among immigrant women. 

Cultural influences that consider divorce and separation as shameful pressure women to remain 

in marriages, and ostracize women from their communities when they separate—even from 

abusive partners (Ayyub, 2000; Maglizza, 1985). Cultural concerns also discourage women 

from using available justice system resources. Further, if an IPV victim believes that protection 

orders are available only to women who leave, she will be deprived of the remedies that a 

protection order potentially may provide. When an abuser commits repeat acts of IPV, a 

protection order can offer recourse that is not available if no order is in effect, even for victims 

who remain with or return to live with their abusive partner. Understanding more about the 

relationship between a woman’s intent to remain in an abusive relationship and her decision to 

COSMOS Corporation, November 10, 2006 8 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
seek a protection order would inform the ability of advocates and others in offering domestic 

violence services to IPV victims. 

Social Support 

Emotional and tangible support are central factors in women’s ability to protect themselves 

and their children from IPV and to address the emotional aftermath of abuse (Barnett, 2001; 

Dutton, Hohnecker, Halle, Burghardt, and et al., 1994; Fraser, McNutt, Clark, WilliamsMuhammed, and Lee, 2002; Rose, Campbell, and Kub, 2000; Thompson et al., 2000). Studies of 

battered immigrant Latinas found that battered women tended to speak about domestic violence 

to female friends or relatives, but not to other members of the community, including helping 

professionals (Dutton, Orloff, and Hass, 2000). Fewer than half of the women in these studies 

reported receiving emotional support related to IPV from the first person with whom they spoke. 

 Battered immigrant women are particularly vulnerable because of: 1) cultural perceptions 

regarding domestic violence which call on them to subsume their individual needs to the 

interests of family or the community; 2) their limited access to the outside world; and 3) systems 

and services that do not provide language access or outreach to immigrant communities and 

effectively silence immigrant victims (Ammar et al., 2005; Orloff and Kaguyutan, 2002; Raj and 

Silverman, 2002; Dutton et al., 2000; Orloff and Sullivan, 2004; Uekert, et al., 2006). 

Strategies for how to provide effective services and care to recent immigrant victims have 

only recently been studied and understood (Rodriquez, 1995; Ammar and Orloff, 2006). Most 

service providers are not knowledgeable about basic information on immigrant victims’ legal 

rights. They do not understand the available remedies and cultural tools to completely serve 

non-English speaking clients and often do not address culturally based needs. This has become 

more problematic, especially in the new destination states that have seen an increase in 

immigrant populations by 90 percent or more between 1990 and 2000 (Fix, Passel, and Sucher, 

2003). Many service providers and justice system personnel in these states have had limited 

previous experience serving immigrant victims. 

Immigrant Women and Court-Related Issues 

Institutional barriers can prevent IPV victims from obtaining the resources they need to 

protect themselves and their children from further abuse. Barriers that are particularly relevant 

for battered immigrant women often include several of the following: 1) lack of access to 

qualified interpreters to help them throughout the protection order process–from filing through 

receipt and enforcement of their protection order; 2) the inability to obtain representation by an 

attorney; 3) court-imposed requirements for the submission of corroborating evidence of abuse; 

and 4) failure to allow advocates to speak in court. Generally, among battered women in the 

United States, lack of representation by an attorney is one barrier that can influence whether a 

woman is successful in her attempt to obtain a protection order, since women are more likely to 

obtain an order if they are legally represented (Murphy, 2002, in press). 

COSMOS Corporation, November 10, 2006 9 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Although a woman may be accompanied by a domestic violence advocate in court, some 

courtrooms do not allow advocates to speak in court as a support to the battered woman. 

Battered immigrant women are more likely to be able to secure assistance of a battered women’s 

advocate to accompany them to the protection order hearing than she is to obtain representation 

from an attorney, particularly one with experience helping victims in domestic violence cases. 

In the case of unrepresented battered immigrant women, an advocate can often serve as a 

facilitator to help the court understand the needs of the woman seeking the protection order. A 

battered immigrant woman who is not represented by an attorney and whose advocate is not 

allowed to speak on her behalf in court must face an unfamiliar legal system alone. 

The extent to which a petitioner is required to present tangible evidence of physical abuse 

(vs. verbal report) also hampers the ability of battered immigrant women to access protection 

orders because the women may not have reported the abuse to police, sought medical help for 

violence, or sought help from victim’s services programs due to fear of deportation, language 

access, cultural barriers, or lack of information about these services. The fear, safety, and 

cultural issues may have even deterred immigrant victims from telling family members or 

members of her cultural community about the abuse. Other factors that can influence a battered 

immigrant woman’s willingness to obtain a protection order or access other forms of legal 

protection include: variations in a battered immigrant woman’s ability to articulate in English or 

through a qualified interpreter her experiences and needs, information the immigrant victim has 

heard from other women about a victim’s ability to access legal immigration status without the 

cooperation of her abuser, or the willingness of the court to grant custody of the children to 

immigrant women particularly when the abuser is a citizen. These factors are important to 

consider in terms of their role in understanding battered immigrant women’s efforts to 

successfully obtain relief through civil protection orders. 

Finally, the dramatic growth of the immigrant population in new destination states has 

created a critical need for interpretation (into languages other than English) for bilingual social 

services, health care, and justice system personnel (Orloff et al., 2003). According to the U.S. 

Census Bureau, in 2000, almost 45 million people, or 18 percent of the U.S. population, who are 

5 years and older speak a language other than English at home. Of those, 10.5 million either 

speak English “not well” or “not at all” (Pan and de la Puente, 2005). Access to someone with 

whom an immigrant woman can communicate in their own language either directly or through a 

qualified interpreter who is sensitive to domestic violence issues and also is knowledgeable 

about VAWA’s protections for immigrant victims and immigrant victims’ legal rights poses a 

major barrier that the justice and services systems must redress in delivering services to help 

battered immigrant secure their safety. 

COSMOS Corporation, November 10, 2006 10 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
1.3 PURPOSE, GOALS, AND OBJECTIVES OF THE STUDY 

On September 29, 2003, COSMOS Corporation was awarded a grant from the National 

Institute of Justice, U.S. Department of Justice, to conduct the study “Use and Outcomes of 

Protection Orders by Battered Immigrant Women.” The study was led by Dr. Mary Ann Dutton, 

Georgetown University Medical Center (Principal Investigator), Dr. Nawal Ammar, Kent State 

University (Co-Principal Investigator), Leslye Orloff, Legal Momentum (Co-Principal 

Investigator), and a team of researchers from COSMOS, Kent State University, and Legal 

Momentum (formerly NOW Legal Defense and Education Fund). 

The overall goal of the study was to examine the decision-making factors, accessibility, and 

effectiveness of civil protection orders for immigrant women who are abused by their intimate 

partners. Specific objectives of the study were: 

1. To examine the factors (e.g., level of acculturation, level of IPV, immigration 

status, intent to end the abusive relationship, lifetime exposure to traumatic 

events, symptoms of posttraumatic stress and depression) that affect the 

decision to file a petition for a civil protection order among battered 

immigrant women seeking help for IPV; 

2. To examine the systemic (representation by an attorney, language access to 

the courts, permission for an advocate to speak in court, requirement to 

provide tangible evidence of physical abuse), community (level of perceived 

social support for the battered woman), and individual (woman’s appraisal of 

IPV-related threat) factors that affect whether a woman who petitions 

actually obtains a full protection order; and 

3. Compare the outcomes for women who obtain a full protection order; who 

file for, but do not obtain a full protection order; and who do not file for a 

protection order. 

The study objectives are detailed in the next section, Study Design and Methodology. 

COSMOS Corporation, November 10, 2006 11 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
2. STUDY DESIGN AND METHODOLOGY 

2.1 STUDY DESIGN 

Theoretical Framework 

The number of immigrants entering the United States since the 1970s has increased threefold, with the largest influx taking place during the 1990s (Fix and Passel, 2001). In addition to 

the increase in numbers of immigrants arriving in the United States, there also has been a 

significant demographic shift where immigrant families are settling once they arrive in the 

United States. The recent research on immigration distribution patterns shows that immigrants 

are settling in new states–many of which have not seen this level of immigrant population 

growth for over 100 years (Saenz, 2004; Fix, Passel, and Sucher, 2003). Among the top 

immigrant-receiving states are North Carolina, Georgia, Nevada, Arkansas, Utah, and Tennessee 

(Saenz, 2004; Fix, Passel and Sucher, 2003). The shift in settlement patterns among immigrants 

has galvanized an upsurge in greater interest in research on immigrant victims. Often the influx 

of immigrants to the United States has contributed to a conceptual formulation that too easily 

blames domestic violence on cultural differences (Jiwani, 2005; Narayan, 1997). As Jiwani 

notes (2005, p. 852) “the focus on culture quickly becomes one of implicitly or explicitly 

comparing a seemingly backward, traditional, and oppressive cultural system to the modern, 

progressive, and egalitarian culture of the U.S.” Hence, instead of using a cultural argument, this 

study explores the experiences of battered immigrant women with civil protection orders within 

a structural analysis. This study’s general theoretical framework is nested in the ecological 

model of social behavior (Bronfenbrenner, 1986, 1992), which recognizes the importance of 

context and various structural conditions such as ethnicity, gender, and poverty in understanding 

behavior. The theory has been adapted for understanding battered women’s response to IPV 

(Dutton, 1996) in recognition of the many different factors that influence how women respond to 

IPV, such as varying experiences in the host country, economic resources, institutional barriers, 

social networks involving community and family ties, social norms, and individual variables. 

This study examines factors within several of these contextual layers and their intersectionality 

to understand battered immigrant women’s involvement with protection orders. 

Study Hypotheses 

The original study hypotheses were modified in accordance with study design changes (see 

below). Original study hypotheses and revisions follow. 

1. Among women seeking help for IPV, we expect that the decision to seek a 

protection order will be predicted from: 1) higher levels of acculturation, 

2) higher levels of IPV, 3) greater permanence in legal immigration status, 

4) the intent to leave an abusive relationship, and 5) having children who 

witnessed IPV. (Revised hypothesis unchanged from original hypothesis); 

COSMOS Corporation, November 10, 2006 12 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
2. Among women who file for a protection order, we predict that actually 

obtaining a protection order will be predicted from: 1) representation by an 

attorney (systemic), 2) permission for advocate to speak in court (systemic), 

3) requirement to provide tangible evidence of physical abuse (systemic), 

4) low levels of community support for the woman (community), and 5) high 

levels of the woman’s appraisal of IPV-related threats. (This hypothesis was 

dropped as a formal hypothesis since small follow-up sample size resulted in 

insufficient statistical power to detect significant differences. However, beta 

weights will be examined to estimate effect sizes for planning future research 

to address this hypothesis); and 

3. Women who obtain a protection order will report: 1) lower levels of IPV, 

2) lower levels of IPV-related injury, 3) lower levels of IPV-related threat 

appraisal, and 4) higher quality of life at follow-up compared to women who 

either filed for but did not obtain an order or women who did not file for an 

order. (This hypothesis was dropped as a formal hypothesis since small 

follow-up sample size resulted in insufficient statistical power to detect 

significant differences. However, beta weights will be examined to estimate 

effect sizes for planning future research to address this hypothesis). 

Additional descriptive research questions that will provide important direction to the field can 

also be answered with the data collected during the study. The domains of these questions 

include: 

1. Demographic description of this convenience sample of battered immigrant 

women, including country of origin, family constellation, and immigration 

status, among other variables; 

2. Level of acculturation and its relation to other study variables; 

3. Type and level of IPV exposure including psychological abuse, physical 

violence, and sexual abuse and its relation to other study variables; 

4. Type and level of subjective appraisal of IPV threat and fear; 

5. When and from whom participants first learned about protection orders; 

6. Positive and negative expectations related to obtaining a protection order; 

7. Immigrant victim’s decision-making about whether to obtain a protection 

order; 

8. Description of the process of obtaining a protection order and current 

protection order status; 

9. Specific remedies included in obtained protection orders; 

10. Subjective experience of involvement in the court process to seek a 

protection order; 

11. Injury reduction as reported by victims in cases of those who sought 

protection orders compared with those who did not; 

12. Violations of protection orders as reported by respondents; 

13. Women’s behavioral response to protection order violations and related 

outcomes; 

COSMOS Corporation, November 10, 2006 13 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
14. Level of posttraumatic responses (PTSD, depression) associated with IPV; 

15. Prior trauma exposure other than IPV; and 

16. Level of current appraised social support. 

Sample and Subject Selection Criteria 

A total of 153 study subjects were recruited. Study subjects were drawn from 14 partner 

organizations that offer advocacy services to battered immigrant women. Women served by 

these partner organizations represent the Asian, Latino, African, Middle Eastern, and European 

communities. 

Formal subject selection and disqualification criteria were developed by the study team. 

Each potential subject must have met ALL the selection criteria in order to be eligible to 

participate in the study, AND the subject did not qualify for the study if they met any one of the 

disqualification criteria. The selection and disqualification criteria are outlined in Exhibit 1. 

Exhibit 1 

SUBJECT SELECTION AND DISQUALIFICATION CRITERIA 

Subject Selection Criteria: 

1) female status; 

2) age 18 years or older; 

3) born outside the U.S.; 

4) seeking help due to IPV from one of the partner organizations within the 

 previous six months; and 

5) the most recent IPV incident having occurred within the past 12 months. 

Subject Disqualification Criteria: 

1) subject was not physically or sexually abused in the U.S.; 

2) subject does not –by law- meet the qualification to receive a protection 

 order (e.g., women who were emotionally abused only); 

3) subject has a current serious mental illness (includes women who are 

acutely suicidal); 

4) subject has serious mental retardation; 

5) subject has serious hearing impairment that would prevent verbal 

 administration of the questionnaire; 

6) subject has acute intent to harm others; and 

7) subject has alcohol or other substance intoxication. 

The rationale for limiting recruitment to those women who have experienced IPV within 

the previous 12 months and seeking help related to IPV from the collaborating organizations 

COSMOS Corporation, November 10, 2006 14 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
within the previous six months was to increase the likelihood that the protection order and nonprotection order samples would be comparable in terms of IPV recency. Female status was 

included as a recruitment criterion since the study team expected that issues involving IPV 

against male immigrants would be qualitatively different and, thus, would deserve a separate 

focus. Inclusion of women 18 years and older ensured that participants were legal adults in 

order to provide consent to participate in the study and in order to ensure that both the protection 

order and non-protection order samples were comparable in terms of age. Finally, the 

recruitment criterion of having been born outside the U.S. is intended to operationalize the term 

“immigrant” as used in the study. 

The rationale for disqualifying women with serious mental illness, mental retardation, and 

hearing impairment was to ensure that subjects were able to fully understand and consider first 

and foremost, the consent discussion, but also the myriad of items on the study questionnaire. 

Women with hearing impairment who had access to resources that would enable them to fully 

understand and consider both the consent discussion and the study questionnaire (e.g., through 

an interpreter) were not disqualified from participation in the study. The rationale for 

disqualifying women who exhibited an acute intent to harm others was to prevent the possibility 

of exacerbating any existing tendencies towards violence that might be caused by discussing the 

sensitive topics (e.g., history of interpersonal violence and lifetime trauma) included in the study 

questionnaire. Women exhibiting substance intoxication were temporally disqualified and 

invited to reschedule the survey administration. Lastly, women who were not abused in the U.S. 

or who, by law, were not eligible (for any other reason) to receive a protection order were 

disqualified to ensure that the study sample included only women who were eligible to receive a 

protection order in the U.S. 

2.2 DEVELOPMENT OF THE COSMOS STUDY QUESTIONNAIRE 

Description of the Measures in the COSMOS Study Questionnaire 

Measurement of the relevant constructs was obtained via face-to-face structured interviews 

using specific measures that comprise the COSMOS Study Questionnaire. The measures that 

comprise the COSMOS Study Questionnaire were reviewed and revised for use with a diverse 

immigrant population. Each measure in the questionnaire is described below. 

Demographic Characteristics 

The questionnaire included items to assess the subjects’ age, number of children, 

immigration status (naturalized citizen/lawful permanent residency, temporary legal immigration 

status, undocumented immigration status), country of origin, ethnicity, marital relationship status 

with abusive or “index” partner for whom participant is seeking services, intent regarding 

“index” relationship (remain in, leave, or return to relationship), and other demographics. (The 

“index” partner is defined for this study as the person the subject was seeking protection from, at 

the time of the interview, from the partner organization.) Demographic items were included at 

COSMOS Corporation, November 10, 2006 15 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
the initial interview and selected items (items with potential variance) were updated at the 

follow-up interview. 

Acculturation

 The Stephenson Multigroup Acculturation Scale (SMAS) (Stephenson, 2000) was used 

to assess acculturation. The measure was developed and validated on a multiethnic sample of 

first to fourth generation immigrants from both community (62%) and student (38%) groups. 

The advantage of the SMAS is that it is the only acculturation scale that has been developed and 

validated for use with a multiethnic group. The SMAS provides scores for two subscales: 

dominant society immersion (DSI) and ethnic society immersion (ESI). Each scale was to be 

examined in the analyses, although the hypotheses are focused on DSI. The scale was crossvalidated with an independent multiethnic sample. Cronbach alpha coefficients for the ESI and 

DSI are .94 and .75, respectively. The SMAS was administered at the initial interview only. 

Intimate Partner Violence (Prevalence, Severity, Types, Risk, and Lethality)

 The Conflict Tactics Scale (CTS-2) (Straus et al., 1995), a revision of the original Conflict 

Tactics Scale (Straus and Gelles, 1990), was used to measure the frequency of physical violence, 

injury, and sexual coercion by the “index” partner. In a recent study, Cronbach alpha 

coefficients using the CTS-2 for low income, urban, predominately African American women 

ranged from .75 for the injury subscale to .90 for the physical assault subscale (Goodman, 

Bennett, and Dutton, 1999). The CTS-2 was administered at the initial and the follow-up 

interviews. 

The Psychological Maltreatment of Women Inventory-Short Form (PMWI) (Tolman, 

1989, 1999) is a 14-item measure of dominance/isolation and verbal/emotional types of 

psychological abuse. Participants indicated the frequency of each event on a Likert-type scale 

ranging from “never” to “very often.” The reliability of the two subscales of the PMWI form is 

quite good (Cronbach’s alpha = .88 for dominance/isolation and .92 for verbal/emotional). The 

factor loadings of the short from have been found to be comparable to the longer, 58-item form 

(Tolman, 1999). The PMWI was administered at the initial and the follow-up interviews. 

The IPV Threat Appraisal Scale (Dutton, 2001) is a 16-item scale that was used to assess 

participants’ expectation that IPV will occur within the next 12 months. The scale was modified 

to capture a 12-month timeframe. Participants were asked to rate the likelihood of risk in their 

present situation based on seven dimensions of batterer-generated risks. These include 1) 

physical injury, 2) death threat, 3) psychological harm, 4) child-related risks, 5) financial risks, 

6) risks to family and friends, and 7) risks involving arrest and legal status (Davies, Lyon, and 

Monti-Catania, 1998). Ratings are made using a Likert-type scale ranging from “not at all 

[likely]” to “definitely [likely].” Reliability analyses yielded coefficient alphas of .91 for the 

total score; .81 for child-related threat, .85 for violent threat, and .85 for nonviolent threat 

subscales. The IPV Threat Appraisal Scale was administered at the initial and at the follow-up 

interviews. 

COSMOS Corporation, November 10, 2006 16 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Protection Order Information 

Information pertaining to the subjects’ experience with protection orders was assessed 

quantitatively using a set of items that ask whether: 1) the subject filed for an ex parte protection 

order; 2) the subject returned to obtain the temporary full order, and if so, how many times 

before obtaining the order or deciding to stop trying; 3) the subject was represented by an 

attorney; 4) the court permitted the advocate to speak in court; and 5) tangible evidence of 

physical abuse was required. Qualitative questions also were included to capture each subject’s 

experience in pursuing a protection order, any decisions to drop the petition or have the 

protection order rescinded, specific remedies requested and obtained, and level of satisfaction 

with the protection order process. The protection order information was collected at the initial 

and selected items (items with potential variance) were updated at the follow-up interview. 

Symptoms of Posttraumatic Stress and Depression 

Two scales, the Posttraumatic Stress Disorder Checklist (PCL) and Center for 

Epidemiological Studies – Depression Scale (CES-D) were used to assess the subjects’ mental 

health symptoms associated with IPV/trauma exposure. The PCL (Weathers et al., 1993) 

requires participants to indicate on a 4-point scale the degree of distress they have experienced 

for each of the posttraumatic stress disorder (PTSD) symptoms included in the DSM-IV 

diagnosis. For the purposes of establishing a diagnosis, symptoms that are rated as moderately 

severe or greater are classified as present. The PCL has good reliability with structured 

interviews for PTSD (Blanchard, Jones-Alexander, Buckley, and Forneris, 1996). An NIJfunded longitudinal study that involved low-SES battered women found Cronbach’s alpha to be 

.94. Self-reported, current depressive symptomatology were assessed using the CES-D (Radloff, 

1977). Respondents reported the number of times they have experienced each of 20 depressive 

symptoms over the week before the interview. The total score reflects severity of depression. 

Preliminary research with low income, urban, battered women in the court system found 

Cronbach’s alpha to be .91 (Dutton, 1998; Goodman, Bennett, and Dutton, 1999). The PCL and 

CES-D scales were administered at the initial and follow-up interviews. 

Exposure to Traumatic Events 

Ten items from the Lifetime Trauma and Victimization History (Widom, Dutton, Czaja, 

and DuMont, in press) were used to assess the subjects’ exposure to traumatic events during their 

lifetime (the full scale was not given in order to reduce participant burden). Items assess 

exposure to specific traumatic experiences, age of first and last exposure, and frequency of 

exposure. This measure was administered at the initial interview and selected items (items with 

potential variance) were updated at the follow-up interview. 

COSMOS Corporation, November 10, 2006 17 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Social Support 

Perceived social support was assessed with the Interpersonal Support Evaluation List 

(ISEL) (Cohen et al., 1985). The ISEL measures the perceived availability of social resources. 

The ISEL was modified in a preliminary research study by the PI and colleagues (Dutton, 1998; 

Goodman et al., 1999) for use with a low income population by simplifying the language and 

using more appropriate references. Alpha coefficients in the study ranged from .71 (self-esteem) 

to .87 (belong). For the current study, scales were combined to yield total scores for two scale 

scores (tangible and emotional support), a procedure based on high intercorrelations between 

three scales (appraisal, belonging, self-esteem) (House and Kahn, 1985). The ISEL was 

administered at the initial and the follow-up interviews. 

The measures above were compiled to create an instrument to use in collecting data for the 

current study. The instrument was named the COSMOS Study Questionnaire (the generic name 

for the instrument was purposefully selected for safety reasons—i.e., to allow subjects and team 

members to conceal the nature of the study, if necessary). An “introduction script” was 

developed and included as part of the instrument to remind and guide administrators in 

reiterating: 1) the purpose of study, 2) confidentiality of information and data, and 3) potential 

risks of participating in the study (these and other issues–including the full consent discussion– 

were discussed with the subject prior to the administration of the questionnaire, and are 

discussed in detail in Section 2.4). The COSMOS Study Questionnaire (both the initial and 

follow-up versions) also included a “debriefing script,” which included an offer of assistance in 

the event that the subject was distressed as a result of the interview (“assistance” would have 

included counseling by the administrator (if qualified) or referral to other resources within or 

outside of the partner organization), a reminder that the subject would be contacted to schedule 

the follow-up interview (at the initial interview only), and an offer to ask the administrator any 

questions about the questionnaire, the study, or anything else. Also, both the initial and followup Questionnaires allowed the administrators to note their impressions of the interview, 

including the level of subject engagement, subject demeanor, unusual or unique subject 

circumstances, special considerations for follow-up, or other issues that might be noteworthy 

(Appendices A and B contain the initial and follow-up versions of the COSMOS Study 

Questionnaire). Lastly, the team developed a series of slides to use as visual aids to assist the 

subject in understanding certain questions with potentially confusing concepts or response 

options (Appendices A and B also contain copies of the visual aids for each questionnaire). 

Item Development for the COSMOS Study Questionnaire 

The grant budget did not allow for translation to the multiple languages that were spoken 

by study subjects. However, there was extensive debate among the study team members and the 

partner organizations over translating the questionnaires to Spanish (since Spanish speaking 

immigrants in the U.S. comprise the majority of the population of non-English speakers (60 

percent of the 45 million individuals who reported speaking a language other than English at 

home, Pan and de la Puente, 2005)). However, three issues convinced the team to adapt the 

instrument conceptually to a variety of immigrant communities and to seek the use of 

COSMOS Corporation, November 10, 2006 18 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
interpreters and translators–if necessary– in the interview interaction. These issues were: 1) the 

necessity of accessing immigrants who speak languages other than Spanish, 2) the results of the 

Spanish language American Community Survey that specified that even some well-translated 

questions still pose conceptual problems as well as other concern for Spanish-speaking 

respondents (Lornea, 2003), and 3) a variety of human resource and budgetary limitations. 

Temple (2002, p.847) notes that researchers often disregard the “linguistic imperialism 

central to an unquestioning use of English as a baseline language.” The study team was very 

aware of such problems and followed a method that required a focus on the meaning of the 

questions across languages and cultures, rather than simple translation (Behling and Law, 2000; 

Bloch, 2004). Additionally, the numerous languages the respondents speak made using English 

a practical issue since it was the only common language to all those involved in the research 

project. To ensure cultural equity in using English questionnaires, the approach required the use 

of a number of procedures listed in the literature about questionnaire translation (Harkness, 

2003; Lehman-Winzig, 2001; Link et al., 2006; Peters and Passchier, 2005; Tran, Ngo, and 

Conway, 2003) including preparing the questionnaires by multilingual/multicultural committee, 

establishing clear criteria for cross-cultural comparisons/translation, and pretesting/piloting the 

questionnaire with a variety of linguistic groups. 

Multilingual/Multicultural Committee 

The study utilized an initial questionnaire and then a follow-up questionnaire (which was 

an abbreviated version of the initial questionnaire). A number of multilingual/multicultural 

committees were involved in developing the questionnaire. An initial committee comprised of 

persons bilingual in English and Arabic (multiple dialects), French, Hebrew, Spanish, Tagalog, 

and Urdu formulated the questions of the central questionnaire. The initial committee members 

included social scientists, lawyers, and direct-service advocates. The questionnaire developed 

by this committee was then reviewed and pretested by bilingual persons in a number of 

languages including Polish, a variety of Indian languages, and Spanish. After these initial 

revisions, the first questionnaire was pretested again and revised. Finally during the training of 

the initial groups of questionnaire administrators (who spoke a variety of the above languages, in 

addition to Iranian) feedback was received and the questionnaire was revised a final time. 

Establishing Clear Criteria for Cross-cultural Comparisons/Translation 

The study team followed three types of equivalences often cited in the literature regarding 

translation of questionnaires (Behling and Law, 2000; Bloch, 2004; and Pan and de la Puente, 

2005). The first kind of equivalency is Semantic and it refers to literal meaning in the translation 

(Pan and de la Puente, 2005, p.5). During the development of the questionnaire the study team 

focused on the possibility of literally translating certain terms and statements. For all questions, 

the team used English words that would easily translate to other languages (see Exhibit 2 for 

examples). 

COSMOS Corporation, November 10, 2006 19 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 2 

EXAMPLES OF SEMANTIC EQUIVALENCY EDITS TO ITEMS 

IN THE COSMOS STUDY QUESTIONNAIRE

Initial Questionnaire – Demographics 

In Question 22, the term “your/his place” was used to denote residential arrangements because it is an easier term to 

translate in an interview interaction. 

Initial Questionnaire - Stephenson Multigroup Acculturation Scale (SMAS) 

In Question 3, the term “social circle” was used rather than only one term such friends, or co-workers, or neighbors to 

make it easier to translate across languages. 

Initial and Follow-up Questionnaires - Psychological Maltreatment of Women Inventory 

In Question 1 and subsequent questions the term “called me a bad name” was used to enable translation across 

languages. 

Initial and Follow-up Questionnaires - Conflict Tactics Scale 

In Question 12, the statement “I had sex with him/her because I was afraid of what he/she would do if I didn’t,” was 

used instead of using marital rape statements. 

The second kind of equivalency is Conceptual and refers to “the degree to which a given 

concept is present in both the U.S. and the various immigrant languages and cultures” (Pan and 

de la Puente, 2005, p.5). The committee developing the questionnaire was very aware of these 

problems in translation. In all questions, the study team used English words that would 

conceptually translate to most cultures (see Exhibit 3 for examples). 

Exhibit 3 

EXAMPLES OF CONCEPT EQUIVALENCY EDITS TO THE 

COSMOS STUDY QUESTIONNAIRE 

Use of visual aids to help the respondents answer questions on the Likert scale and to graphically demonstrate other 

complex response categories. 

Provided definitions of complex concepts, such as “immigration status,” to the respondents clearly for them to 

choose an answer. 

To assess country of origin, two different questions were asked (place of birth and home country) since in many 

instances those are not the same. 

In the Conflict Tactics Scale, Question 12, the statement “I had sex with him/her because I was afraid of what he/she 

would do if I didn’t,” was used instead of using marital rape statements. 

The final equivalency is Normative and refers to the “extent to which the translated text 

successfully addresses the difficulties created by differences in societal rules between English 

and other languages” (Pan and de la Puente, 2005, p.6). A number of norms were brought into 

question. These ranged from gender roles, to the role of women, to how to define marital rape 

across cultures (see Exhibit 4 for examples). 

COSMOS Corporation, November 10, 2006 20 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 4 

EXAMPLES OF NORMATIVE EQUIVALENCY EDITS TO THE 

COSMOS STUDY QUESTIONNAIRE 

Question 15 in Stephenson Multigroup Acculturation Scale (SMAS) required defining the meaning of women’s 

role in the United States. Hence it was reworded as following, “I am comfortable with the role of women in the 

United States as equal partners with men and as having more rights than women in my country.” 

Question 13 in Stephenson Multigroup Acculturation Scale (SMAS) inquired about a concept that cannot be 

translated normatively across cultures. Hence, to many immigrants the idea of “American food” is not translatable, 

so the team opted for “foods that Americans eat.” 

Pilot Testing of the COSMOS Study Questionnaire

 The COSMOS Study Questionnaire was pilot tested by staff at the study’s first partner 

organization, Tapestri, Inc.—the Immigrant and Refugee Coalition Challenging Gender Based 

Oppression. Tapestri members are refugee and immigrant advocates and survivors that represent 

and serve a multitude of refugee and immigrant communities in metro Atlanta, Georgia. 

Tapestri staff administered the draft questionnaire staff person-to-staff person and to several of 

their clients. In addition to piloting the draft instrument, the pilot test included a mock screening 

interview and consent discussion. Extensive feedback was received from Tapestri and included 

suggestions to shorten the questionnaire and suggestions to reword or delete specific items. 

Development of Subject Consent Forms and Administrative Tracking Forms 

A consent form was developed which outlined the purpose of the study, the number of 

respondents, general plan of the research, benefits and risks of participation, inclusion criteria, 

confidentiality of data, and rights as a research subject (a copy of the consent form can be found 

in Appendix C). The team also developed a wide array of forms required for the tracking and 

administration of the COSMOS Study Questionnaire, including tracking logs, a fee 

acknowledgement form, and a screening checklist (copies of these administrative forms can be 

found in Appendix D). The forms are discussed in detail below in Section 2.4. 

2.3 THE STUDY TEAM 

The study team was comprised of academic researchers and battered immigrant women’s 

advocates spanning the disciplines of psychology, anthropology, and law situated within a 

private research firm, in partnership with two universities and a women’s public policy 

organization. The study team brought together skills in qualitative and quantitative research, 

law, public policy, cultural diversity, and research methodology, as well as expertise in the areas 

of domestic violence, immigration, acculturation, and criminal justice. The study team was 

COSMOS Corporation, November 10, 2006 21 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
assisted by a host of partner organizations that were responsible for recruiting and consenting 

study subjects, and administering the study instrument. 

Recruitment of Partner Organizations 

Original Partner Organization: Tapestri, Inc. 

The original grant proposal for the study included Tapestri, Inc., as the sole partner 

organization who would be responsible for recruiting study subjects and administering the study 

questionnaires (in addition to assisting in developing and pilot testing the questionnaires). 

Tapestri is a coalition of community-based service providers based in metro Atlanta, Georgia. 

Tapestri member organizations (Tapestri, Raksha, Caminar Latino, and Refugee Family 

Services) include refugee and immigrant advocates and survivors that represent and serve a 

myriad of refugee and immigrant communities in and around Atlanta. 

The original budget plan provided for nearly 2,500 hours for research assistants (unnamed 

and unnumbered) at Tapestri to recruit and administer the study questionnaire. It was anticipated 

that these interviewers would be bilingual in a number of languages, particularly those spoken by 

the proposed study participants. Based on estimates from Tapestri, we anticipated 428 subjects 

to be recruited over a period of 12 months. Bilingual interviewers would conduct interviews in 

the language of the women participating in the study who were seeking services from one of 

Tapestri’s member organizations. The goal was to hire a multilingual group of interviewers that 

would include staff from Tapestri’s member organizations and other paid volunteers. By 

working with a group of interviewers who were bilingual, interpreters would not be required for 

questionnaire administration. In addition to the interviewers, a senior program director at 

Tapestri was slated to provide overall supervision at Tapestri (for a total of 240 hours), including 

serving as the study’s primary contact at Tapestri, supervising the bilingual interviewers, 

assisting with coordinating Tapestri’s recruitment efforts, and assisting in management of other 

day-to-day activities. Tapestri’s original budget was $46,288. 

During February and March 2004, the study team negotiated a new budget and 

modifications to the work plan with Tapestri to accommodate their assertion that their proposed 

budget was insufficient. Based on Tapestri’s new projections of level of effort and the 

associated budgetary implications, the estimated sample size was reduced to 306. The new 

project budget, which was accepted by Tapestri, accommodated Tapestri’s request to increase 

their budget by reducing the remaining study partners’ efforts by 5 percent. On March 15, 2004, 

the revised project budget and modifications to the workplan were submitted to the NIJ project 

officer, and approval was received on March 19, 2004. 

In April 2004, the study team was informed by Tapestri that, after additional review, the 

revised project budget and work plan that they had agreed to (and was submitted to NIJ) would 

not be acceptable. The study team worked with Tapestri during April, May, and June 2004 to 

arrive at a plan that would accommodate the overall project budget and not compromise the 

project work plan. However, the team was unable to arrive at a compromise or resolution. The 

COSMOS Corporation, November 10, 2006 22 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
primary issues that remained unresolved included: 1) the project could not meet Tapestri’s 

proposed budget of $107,440 (a 132% increase over the original grant amount of $46,288), 

requested in January 2004 and restated in June 2004; and 2) the project budget did not allow for 

either written translation of the questionnaire into 12 languages or use of professional 

interpreters (as requested by Tapestri). 

Despite the lack of a compromise on the working relationship between the study team and 

Tapestri, it should be noted that from November 2003 (the beginning of the study) through 

March 2004, Tapestri staff made a significant contribution to the study by assisting with the 

development of the questionnaire and pilot testing the questionnaire. In addition, several 

Tapestri staff members (representing a variety of cultural, racial, and ethnic backgrounds) 

reviewed the draft questionnaire and provided substantial input regarding semantic, normative, 

and concept equivalency (described above under “Item Development for the COSMOS Study 

Questionnaire”). 

In July 2004, the study’s Principal Investigator informed the NIJ Project Officer of the 

impasse with Tapestri, and that the team had begun to contact other agencies to ascertain their 

interest in serving as partner organizations. On October 5, 2004, a meeting was held with the 

NIJ Project Officer, study team members, and staff from Tapestri to discuss the impasse. At that 

time, the study team confirmed that they had been successful in recruiting new partner 

organizations and would be glad to pay Tapestri for the services rendered to the study. On 

December 31, 2004, the study team submitted payment for the services of one interviewer and 

the project supervisor for the period December 2003 through April 2004, effectively closing 

Tapestri’s involvement in the study. 

Recruitment and Training of First Wave of New Partner Organizations 

Beginning in May 2004, the study team began to investigate other potential partners to 

replace Tapestri’s role in the study. The study team undertook a different recruiting strategy for 

this new effort to recruit partner organizations. Co-Principal Investigator Leslye Orloff is a cofounder and co-director of the National Network to End Violence Against Immigrant Women, 

which is an organization with over 3,000 members across the country, most of whom are 

agencies that provide advocacy or legal services to battered immigrant women (Co-Principal 

Investigator Nawal Ammar serves on the advisory committee of the National Network). The 

study team decided to reach out to specific Network member organizations from geographically 

distinct locations across the country. Organizations were sought that worked with different 

population groups of immigrant women in an effort to ensure that participants included 

immigrant victims from Latino, Asian, African, Middle Eastern, and Eastern European 

immigrant communities. Each of the new partner organizations had significant experience 

working with battered immigrant women to provide advocacy services and assistance in 

obtaining civil protection orders. Additionally, each new partner organization had a staff 

member or a program director who had worked for many years on collaborative projects with 

Legal Momentum’s Immigrant Women Program, directed by Leslye Orloff (one of the study’s 

co-Principal Investigators). The goal was to identify new partners who understood the 

COSMOS Corporation, November 10, 2006 23 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
importance of the research study and who had a track record for following through on 

collaborative projects. 

By December 2004, the study team had identified six agencies that agreed to sign 

Statements of Work formalizing their participation in the study. These six new partner 

organizations included: 1) Texas Rio Grande Legal Aid (Texas), 2) Iowa Coalition Against 

Domestic Violence (Iowa), 3) Ayuda (District of Columbia), 4) Asian Pacific Islander Domestic 

Violence Resource Project (District of Columbia), 5) Manavi (New Jersey) and 6) The Legal Aid 

Foundation of Los Angeles (California). The study team believed that this new multisite 

configuration would produce study findings that were more representative of the overall 

experience of battered immigrant women throughout the U.S. The inclusion and exclusion 

criteria for study subjects remained the same (see Exhibit 1). The partner organizations agreed 

to reimbursement at the rate of $85.00 per recruited subject. This amount covered all costs 

related to: 

z Training for their staff on administration procedures and survey content; 

z Recruiting and consenting the subject; 

z Conducting the initial interview; 

z Maintaining interim contact with the participant to ensure ability to conduct a 

second interview at a 3-4 month interval and to schedule the follow-up 

interview; 

z Conducting the follow-up interview; 

z Providing the completed original study instruments to the project team for 

data entry when and where instructed; and 

z Providing biweekly email updates to the project team on the progress of 

recruitment, and initial and follow-up questionnaire administration. 

In order to provide an incentive for the partner organizations to schedule and conduct the 

follow-up interview, the $85 per subject fee was prorated as follows: $30 paid to the 

organization after the completion of the initial interview and submission of the completed study 

instrument to the study team; and the remaining $55 after the completion of the follow-up 

interview and submission of the completed study instrument. 

The first training was conducted simultaneously with two partner organizations, Ayuda and 

the Domestic Violence Resource Project (DVRP), at COSMOS’s offices in Bethesda, MD, on 

January 24, 2005. Both Ayuda and DVRP are located in the Washington metropolitan area, and 

thus no funds were required for travel or related expenses. The next three organizations were 

trained via teleconference as follows: Manavi and Texas Rio Grande Legal Aide on April 26, 

2005; and Iowa Coalition Against Domestic Violence on May 17 and May 26, 2005. These 

trainings were conducted by the Principal Investigator or a Co-Principal Investigator, and at least 

one other person from the study team. The training for the sixth project partner the Legal Aid 

Foundation of Los Angeles was never scheduled, because after agreeing to participate in the 

study and signing the Statement of Work the Executive Director of that organization decided to 

not allow agency staff to participate in the study. 

COSMOS Corporation, November 10, 2006 24 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Members of the study team were in regular contact (by telephone and e-mail) with the new 

partner organizations following the trainings to gauge progress in administering the 

questionnaire and to provide technical assistance. The new partner organizations had varying 

degrees of success in meeting their recruitment goals (see Exhibit 5). 

The first wave of new partner organizations reported several recruitment barriers and 

challenges to recruitment of study participants and conducting the surveys. Some programs did 

not have as many eligible clients seeking services from their program as they had anticipated. 

Others found that women who were eligible to participate in the survey chose not to participate 

out of fear about discussing their domestic violence history because they feared that their abuser 

would find out. However, the most significant barrier was lack of time. Agency staff who 

committed to conduct interviews had difficulty clearing time in busy advocacy and client 

representation schedules to conduct interviews. By February 2006 (three months prior to the end 

of the data collection period), only 47 subjects had been recruited by the first wave of partner 

organizations (the figures noted in Exhibit 5 below represent the final recruitment figures). 

It was clear however, that at least one program partner–the Iowa Coalition Against 

Domestic Violence (ICADV)–was more successful in following through on their projected 

recruitment of study participants than the other program partners. Co-Principal Investigator 

Leslye Orloff interviewed the lead staff members at two of the first wave partner organizations to 

gain insight into what was working, what was not working, and why. Following those 

discussions she also contacted another National Network-affiliated organization, the Florida 

Immigrant Advocacy Center (FIAC), for assistance in developing future recruitment strategies 

that were likely to be more successful. 

It was determined that there were significant differences between partner organizations that 

were able to successfully complete the questionnaires and those who had not. The most 

important factor was that at the successful organization (ICADV), a staff member with 

management responsibilities over staff members who were administering the questionnaires 

made a management-level commitment to making survey completion a priority. In comparison, 

at other partner organizations, when the lead person interested in moving the project forward was 

a staff member who had to rely upon other co-equal staff members at the agency to fit this work 

into their work schedules–project work kept stalling and agency management did not take steps 

to ensure completion. Client services work took precedent over completion of the agency’s 

commitment to complete questionnaires for the study. 

COSMOS Corporation, November 10, 2006 25 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 5 

SUBJECT RECRUITMENT BY THE FIRST WAVE OF 

NEW PARTNER ORGANIZATIONS 

Partner Organization 

Anticipated 

Recruitment (as 

stated in their SOW) 

Actual Recruitment 

Initial 

Questionnaire 

Follow-Up 

Questionnaire 

1. Iowa Coalition Against Domestic 

Violence (Des Moines, IA) 

50 46 35 

2. Texas Rio Grande Legal Aid 

(Austin, TX) 

20 18 1 

3. Ayuda (Washington, DC) 50 9 0 

4. Asian Pacific Islander Domestic 

Violence Resource Project (DVRP) 

(Washington, DC) 

15 5 0 

5. Manavi (New Brunswick, NJ) 15 2 0 

Totals 150 80 36 

Discussions between Legal Momentum, ICADV, FIAC, and Texas Rio Grande Legal Aid 

staff led to a new suggested approach to recruiting survey participants that would build on the 

commitment of individual staff members at agencies serving immigrant victims that would 

hopefully avoid many of the agency related bureaucratic issues that had undermined partner 

success to date. Instead of requiring that individual agencies commit to administering the 

questionnaires, the study team would recruit individual professionals (advocates, attorneys) who 

work with battered immigrants in these agencies. These individuals would administer 

questionnaires to their eligible clients and the individual interviewers would be paid $50 per 

survey. The individual and their agency could choose whether the $50 fee for the completed 

interview would be paid to the advocate/attorney interviewer or to their organization. For at 

least one original partner organization this approach resolved most of the previous roadblocks to 

survey completion. Texas Rio Grande Legal Aid was able to recruit their organization’s 

volunteers who would be paid $50 per completed questionnaire. In the end, this strategy enabled 

Texas Rio Grande Legal Aid to administer most of their questionnaires. 

Following these discussions, the study team decided to recruit a wide range of new project 

partners through the National Network to End Violence Against Immigrant Women and its 

listservs. The goal was to recruit advocates and attorneys who were Network members from 

across the country to individually commit to administering questionnaires for the project. 

Recruitment and Training of Second Wave of Partner Organizations 

In a meeting with the NIJ Project Officer on February 27, 2006, a new plan was agreed to 

in which a second wave of new partner organizations would be recruited in order to maximize 

the number of completed initial questionnaires before the end of the data collection period on 

COSMOS Corporation, November 10, 2006 26 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
April 30, 2006. The new subject recruitment goal was set at 100, and the data collection period 

was extended one month to May 31, 2006. The goal was to work through the National Network 

to End Violence Against Immigrant Women (which is co-directed by the study’s co-Principal 

Investigator at the Immigrant Women Program at Legal Momentum) to recruit new project 

partner interviewers. The outreach would be specifically directed to individual professionals 

(advocates/lawyers/social services providers) who work in agencies serving a broad range of 

immigrant victims. Interviewers would have the option of administering the questionnaire on 

their own time or as part of their work for their agency. Interviewers were asked to interview 

clients of their agency. The decision was made to focus on completing only the initial interview 

per subject, and the payment made to the interviewers (or organizations) was restructured and 

increased from $30 to $50 as payment for completion of the initial questionnaire. The incentive 

fee for the subject remained at $15 for completion of the initial questionnaire. Existing partner 

agencies were encouraged to persuade their staff and volunteers to conduct interviews after 

regular work hours for which they would receive payment directly. This helped at least one 

current partner, Texas Rio Grande Legal Aid, increase the numbers of questionnaires they were 

able to complete. 

The second wave of new partner organizations were recruited via an invitation letter (see 

Appendix E) from Leslye Orloff, a Co-Principal Investigator and a founder of the National 

Network to End Violence Against Immigrant Women who used her relationships and reputation 

with allies involved in the Network and made a personal appeal for their assistance. This letter 

explained the importance of the project, what the study team was asking interviewers to do, and 

the timeline for completion of the work. The invitation letter was distributed to all of the 

Network’s active listservs on March 22, 2006. These listservs were: VAWA updates (1231 

participants); VAWA experts (255 participants); Public Benefits (199 participants); Family Law 

(259 participants); and the Network Advisory Committee Listserv (45 participants). Persons 

receiving the invitation were encouraged to share it with others they thought might be interested 

in participating in the study. Only the initial interview was to be conducted; no follow-up 

interview was required. 

The invitation letter provided a description of the study and the data collection methods, the 

screening and consent requirements, and appealed to organizations that were interested and 

could agree to administer a minimum of 10 questionnaires. The inclusion and exclusion criteria 

for study subjects remained the same (see Exhibit 1). Individual interviewers had to be affiliated 

with an organization to which battered immigrant victims turned for help so that study subjects 

could be recruited from that agency’s clients. The new partner organizations were required to 

complete, sign, and return to the study team a Statement of Work, which requested information 

about the organization, contact person, number of subjects that the organization expected to 

recruit for the study, and a general description of the ethnic composition of the target population 

from which the subjects would be recruited. 

Outreach through the National Network proved to be an extremely successful recruitment 

approach. The study team received over 70 responses to the invitation via e-mail and telephone 

from organizations interested in assisting with subject recruitment and questionnaire 

administration. The study team set a cut-off date of April 30, 2006, for recruitment of new 

COSMOS Corporation, November 10, 2006 27 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
organizations. By May 1, 2006, 10 new organizations had completed, signed, and returned their 

Statements of Work, and were approved by the study team to serve as new partner organizations. 

Each new partner organization received individual orientation and training via conference call. 

The study team maintained weekly contact with each new organization to provide technical 

assistance. 

Of the 10 new partner organizations recruited during wave 2, only one organization was not 

able to recruit any subjects or administer the questionnaire. Four of the remaining nine partner 

organizations met or exceeded the minimum of 10 initial interviews, and the other five 

organizations completed between three and nine initial questionnaires. The new partner 

organizations recruited during wave 2 completed a total of 73 initial questionnaires (See Exhibit 

6). The new method instituted for administering questionnaires also helped the first wave of 

partner organizations reach their recruitment goals. As a result, in three months the study team 

exceeded the target of 100 initial questionnaires by over 50 percent. This approach led to 

completion of 153 initial surveys and 36 follow up surveys. Exhibit 7 shows the total number of 

questionnaires completed during waves 1 and 2. 

Lessons Learned 

This research study provided an opportunity to learn many valuable lessons that shed light 

on how research among battered immigrant women subjects can be successfully conducted. 

Partnering with Agencies vs. Hiring Agency Staff and Volunteers as Interviewers. The 

study team learned that the best approach is to work with agencies that serve battered immigrant 

clients in identifying interviewers willing to work as independent contractors. This strategy 

worked because it provided a mechanism through which individual staff members or agency 

volunteers who were bilingual and who had access to and relationships with battered immigrant 

clients could choose to work additional hours to administer the questionnaires, without taking 

time away from their regular job duties. The problem that arose in virtually all agencies was that 

the demands of direct service work combined with shifting management priorities undermined 

the ability of agencies to deliver on their commitment to completion of the numbers of 

questionnaires as promised. Only when a management supervisor was herself invested in and 

pushing the project, and was able to control competing demands, did contracting with the agency 

produce expected results. Working through individual interviewers rather than agencies 

appeared to be more effective as well because individuals were better at predicting the numbers 

of interviews they would be able to conduct within the specified time frame than the agencies. 

Further, increasing the compensation rate to $50 for each completed interview, requiring only 

one interview, and paying interviewers directly made the process of conducting the interview 

simpler, faster, and more efficient. 

COSMOS Corporation, November 10, 2006 28 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 6 

SUBJECT RECRUITMENT BY THE SECOND WAVE OF 

NEW PARTNER ORGANIZATIONS 

Partner Organization 

Anticipated Recruitment 

(as stated in their SOW) 

Actual Recruitment (Initial 

Questionnaire Only) 

1. A Woman’s Place of Merced 

County (Merced, CA) 

15 15 

2. Alliance for Battered and Abused 

International Women (Cincinnati, 

OH) 

10 10 

3. The Bridge – A Refuge for 

Women (Pasadena, TX) 

10 10 

4. Shelter for Abused Women and 

Children (Naples, FL) 

10 10 

5. Task Force on Family Violence 

(Milwaukee, WI) 

10 9 

6. Family Tree – Housing and 

Family Services (Wheat Ridge, CO) 

10 9 

7. Legal Aid Society of 

Minneapolis (Minneapolis, MN) 

10 4 

8. Legal Assistance Corporation of 

Central Massachusetts (Worcester, 

MA) 

10 3 

9. Florida Immigrant Advocacy 

Center (Miami, FL) 

30 3 

Totals 115 73 

Exhibit 7 

TOTAL SUBJECT RECRUITMENT BY THE FIRST AND SECOND WAVES OF 

NEW PARTNER ORGANIZATIONS 

Wave Number 

Wave 1 (5 partners) 

Wave 2 (9 partners) 

Totals 

Number of 

Initial 

Questionnaires 

80 

73 

153 

Number of 

Follow-up 

Questionnaires 

36 

0 

36 

COSMOS Corporation, November 10, 2006 29 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Hiring Bilingual Interviewers Worked, Interpreters Were Not Needed. A second 

important lesson is that there are growing numbers of bilingual and bicultural advocates and 

attorneys working in agencies that serve immigrant victims across the country. These bilingual 

service providers can be trained to use an English language survey tool to administer an oral 

interview to victims who speak multiple languages. Working through agencies who are already 

providing services to immigrant victims in a variety of languages and who had developed the 

language expertise in their agency among their staff and volunteers was key. Hiring of 

additional interpreters was not needed. 

Outreach Recruitment of Interviewers and Subjects Using the National Network to End 

Violence Against Immigrant Women Listservs Works. Outreach to potential partner agency 

staff through listservs run by Legal Momentum and the National Network to End Violence 

Against Immigrant Women produced extraordinary results in a very short time frame. The study 

team received affirmative responses from many more organizations than could have been 

partnered with to complete the project. The use of listservs as an avenue for contacting potential 

partner organizations provided significant diversity from which the research project benefited. 

Participants included shelters, legal aid offices, housing and social services agencies, and 

immigrant rights advocacy groups. There was geographic diversity in the location of the 

agencies and demographic diversity in the populations of battered immigrant women they 

served. Importantly, this method of recruitment produced positive results very swiftly. 

2.4 ADMINISTRATION OF THE COSMOS STUDY QUESTIONNAIRE 

The COSMOS Study Questionnaire was administered between June 2004 and May 2006 

(initial and follow-up interviews). The questionnaires were administered by staff from 14 

partner organizations (described above). A total 153 initial questionnaires and 36 follow-up 

questionnaires were completed. 

Management of Risks to Subjects 

Safety concerns were paramount in all project procedures and in all contacts with research 

subjects. Subject safety was maximized by utilizing informed consent, individualized safety 

protocols for contacts with subjects, Institutional Review Board (IRB) review of the data 

collection procedures, and unique identifiers for each participant. These safety mechanisms are 

described below. 

Consent Form and Process 

An informed consent document (see Appendix C) was developed to ensure that subjects 

understood the purpose of the study, the nature of participation in the study, study procedures, 

potential risks and benefits to them, and persons who they could contact to inquire further about 

their participation. Once a person agreed to participate in the study and was deemed eligible, the 

next step was to introduce the consent process and consent form. 

COSMOS Corporation, November 10, 2006 30 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
The interviewer presented a brief overview of the consent process to the participant to 

explain why they must read the consent form and why they must sign it if they wished to 

participate in the study. The interviewer did not assume that the participant would be familiar 

with consent forms, the issue of confidentiality, or their rights as research participants. A script 

was developed to assist interviewers in introducing the consent process to participants. This 

“consent presentation” is provided below. 

Consent Presentation: 

“In order for you to participate in the study, you must read a 

consent form that explains: 

• What this study is about; 

• What you will be asked to do; 

• The risks and benefits of participating in the study; and 

• The steps the researchers will take to protect (or keep 

 private) the information that you give us. 

I will be happy to explain any part of the form or answer any 

questions you may have. Once you read the consent form, you 

will be asked to sign the form. By signing the form, you are 

saying that you read the form, that anything you didn’t 

understand was explained to you, and that you agree to 

participate in the study. 

I would like to remind you that your participation in the study is 

voluntary, which means you do not have to participate if you 

don’t want to. 

If you would like, I can read the form to you. Would you like to 

read the form yourself or would you like me to read the form to 

you? If you choose, you may take the unsigned consent form 

home to read more carefully and return at a later time to 

complete the consent process. Upon signing the form, you will 

receive a copy of the form, unless you prefer not to. The original 

form will be kept in a locked drawer and will be destroyed at the 

end of the study. 

The research team will combine all the information that 

participants tell us; we will not report information for individual 

participants, but for all participants as a whole. We will not write 

your name on the questionnaire, only an ID number. The only 

people that can connect names to ID numbers are the principal 

investigator and the project coordinator. Results of this study may 

COSMOS Corporation, November 10, 2006 31 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
be reported in meetings or publications; however, the identity of 

specific study participants will not be disclosed. In other words, 

the results of the study will be reported overall, not about specific 

people. 

In order to finalize the consent process, both the subject and the interviewer were required to 

sign the consent form. 

Safety Protocol 

A detailed safety protocol was developed and included in the Training Manual for 

Questionnaire Administrators (discussed below) to codify the procedures for minimizing the 

risks to the study’s subjects and others, as follows: 

z If at any point, the interviewer or the subject herself believes that the subject 

might be in increased danger due to her participation in the study, their 

involvement will be terminated immediately, until such time as the increased 

danger is no longer present. 

z If the subject tells the interviewer of their intent to harm someone else or 

themselves, the interviewer should probe to determine if the intent is 

legitimate, and if so, should terminate the interview immediately. The 

interviewer should then contact their organizational supervisor and follow 

their organization’s guidelines for mandatory reporting. The interviewer 

should then contact the principal investigator (Dr. Mary Ann Dutton, 301­

526-0658) to discuss the incident. If the principal investigator is not 

available, the interview should contact the project coordinator (Darci Terrell, 

301-215-9100). Additional contact information for the principal investigator 

and project coordinator can be found in Section 1 of this Manual. 

z If the subject begins to tell of a child that is being abused, the interviewer 

should remind the subject of the mandatory reporting requirements. If the 

subject tells of a child that is being abused, the interviewer should terminate 

the interview immediately. The interviewer should then contact their 

organizational supervisor and follow their organization’s guidelines for 

mandatory reporting. The interviewer should then contact the principal 

investigator (Dr. Mary Ann Dutton, 301-526-0658) to discuss the incident. If 

the principal investigator is not available, the interview should contact the 

project coordinator (Darci Terrell, 301-215-9100). Additional contact 

information for the principal investigator and project coordinator can be 

found in Section 1 of this Manual. 

z All interviews will be conducted in private. 

z A careful debriefing will be conducted following each interview to ensure 

that participants have not been upset by the nature of the interview, and to 

provide appropriate referrals if appropriate. 

z All participants will be given referrals to community agencies that can 

provide emergency service or other assistance. 

COSMOS Corporation, November 10, 2006 32 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
z When calling the subject to schedule the follow-up interview, use caution 

when leaving a message and refer only to the “COSMOS Study.” 

Institutional Review Board (IRB) Review of the Data Collection Procedures 

The Georgetown University’s Institutional Review Board (IRB) served as the IRB of record 

for the study (the Principal Investigator is employed by Georgetown University). In addition, the 

study was reviewed by the IRB at Kent State University (the employer of one of the Co-Principal 

Investigators) as a requirement of her participation in the study. Initial applications were 

submitted to each IRB along with all required documentation including the study protocols, 

consent forms, etc., and the study received approval from both IRBs to conduct data collection 

(Georgetown University IRB #03-302 and Kent State IRB #4-135). Annual review reports were 

required and submitted each year to the IRBs to provide updates on subject recruitment and 

progression of the study. 

Unique Identifiers 

Each subject was assigned a unique identification (ID) number. The ID number appeared 

only on the consent form, the questionnaire, and the master tracking log (maintained by the study 

coordinator). The ID number is the only identifying information that appeared on the 

questionnaire, and all questionnaires and consent forms were stored in separate locked drawers 

within COSMOS’s locked office. Only the Principal Investigator and the Study Coordinator 

have access to these documents. 

Training for Questionnaire Administrators 

A training manual (Appendix F) was developed, and formal training was conducted with all 

questionnaire administrators prior to the administration of the questionnaires (two organizations 

received in-person training, the remaining partners received training via conference call). The 

training was conducted by at least one of the Principal Investigators and consisted of two phases. 

The first phase of the training consisted of an overview of the project, and details about 

administering the questionnaire. The first phase of the training included the following modules: 

1) Introduction to the Project; 2) Screening Potential Participants; 3) Informed Consent and 

Confidentiality; 4) Logistics for Initial Questionnaire Administration; 5) Logistics for Follow-up 

Questionnaire Administration; and 6) Team Collaboration and Information Sharing. The second 

phase of the training consisted of a detailed review and discussion of the study questionnaire. 

The entire training (both phases) lasted approximately four hours. 

COSMOS Corporation, November 10, 2006 33 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Subject Recruitment and Screening 

The partner organizations recruited subjects from their current roster of clients and, 

according to the study’s eligibility criteria, were also allowed to recruit former clients that sought 

help from their agency within the previous six months. Two recruitment incentives were 

implemented: 1) Subjects were paid a total of $40 for their participation in the study. This 

amount was prorated so that subjects received $15 for completion of the initial interview and $25 

for completion of the follow-up interview; and 2) a limited amount of funds were available to 

compensate subjects for transportation. When partner organizations only administered the initial 

questionnaire, the subject only received $15. 

A potential subject was first approached with a request to determine their interest in hearing 

more about the study. The following script was utilized: 

Request To Conduct Screening: 

[Name of Organization] is working on a study to find out if 

immigrant women use protection orders, and if so, if the protection 

orders were helpful. We will be interviewing a lot of women, like 

yourself, to find out about their decisions and experiences with 

protection orders. I would like to ask you a few questions to see if 

you would qualify to participate in the project. Everything you tell 

me will be kept private. It is okay if I ask you a few questions? 

If the client agreed to answer the screening questions, the interviewer next determined if the 

client met the study’s selection and disqualification criteria (see Section 2.1, Sample and 

Selection Criteria). The interviewer completed a Screening Checklist (see Appendix G) for each 

client that was screened to document the screening’s findings. 

If the client met the selection criteria for the study, AND was not disqualified from 

participation, the interviewer then determined if the client was still interested in participating in 

the study. The following script was utilized: 

Request To Participate In The Study: 

You are eligible to participate in the study. If you choose to 

participate, we will interview you two times, now and again in 

about 3-4 months. Each interview will take about 1 1⁄2 hours to 

complete. We will pay you $40 total to complete both interviews; 

you will receive $15 in cash to complete the first interview, and we 

will pay you $25 in cash when you complete the last interview in 3­

4 months. In the interviews, we will ask questions about you and 

your family, how you have adapted to living in the U.S., how happy 

you are with your life, the threat of danger you feel from your 

partner, your experience with protection orders, and other related 

COSMOS Corporation, November 10, 2006 34 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
questions. You do not have to participate in the study if you don’t 

want to and this will not affect your eligibility to receive services 

from [agency]. If you would like to participate, we would ask you 

to sign a consent form that explains what the study is about, what 

you will be asked to do, the risks and benefits of being in the study, 

and the steps we will take to protect (or keep private) all the 

information that you give us. Are you interested in reading the 

consent form? 

If the client expressed interest in reading the consent form, the interviewer proceeded with the 

consent discussion (detailed above). 

Administration of the Initial and Follow-up Questionnaires 

The questionnaires were administered by trained staff from 14 partner organizations 

(described above under Section 2.3) to eligible and consented subjects. Prior to administration 

of the questionnaire, subjects were offered the opportunity to ask any questions about the study, 

the consent form, the questionnaire, etc. Questionnaire administration proceeded as a structured 

interview. The interview was conducted one-on-one by the interviewer and, if necessary, an 

interpreter (from the partner organization) was present to provide translation and interpretation 

(note: the partner organizations all serve immigrant women in some capacity, and therefore, all 

have staff that speak the languages of the clients they serve). Interviews were required to be 

completed in a private room, where the subject could be assured of their privacy. A limited 

number of interviews (less than five) were conducted over the telephone in cases where the 

subjects were not able to acquire transportation. In these cases, the interviewer alerted the 

subject to additional safety concerns (primarily that the interviewer could not assure the subject 

that other persons hearing the interview on the subject’s end of phone line would keep the 

information confidential). Interviewers utilized visual aids to assist with specific questions 

dealing with complicated concepts or response categories like Likert scales. The visual aids 

consisted of a series of laminated 8”x11” slides (Appendices A and B contain copies of the 

visual aids for each questionnaire). Subjects were allowed to skip any question that they did not 

want to answer. At the conclusion of the interview, a debriefing was conducted with subject to 

offer resources in the event that the subject was in any way distressed and to allow the subject to 

ask any questions. Subjects were asked to sign or initial a fee acknowledgement form (see 

Appendix D for a copy of this form) to indicate that the recruitment incentive payment was 

provided. At the conclusion of the initial interview, subjects were also asked for contact 

information (see Appendix D for a copy of this form) where they could be reached to schedule 

the follow-up interview. Completion of the screening and consent discussions and the initial 

interview required approximately 1.5 hours. 

The interviewers were instructed to contact the subject approximately two months after the 

initial interview for the purpose of scheduling the follow-up interview (the follow-up interview 

was slated for 3-4 months following the initial interview). The interviewers contacted the 

subjects an average of 4.4 months following the initial interview (SD = 2.74). Most participants 

COSMOS Corporation, November 10, 2006 35 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
(72%) were contacted more than one month following the initial interview. The variability in 

length of time between the initial and follow-up interviews was reported by the questionnaire 

administrators to be due to several conditions: 

1. The bulk of the initial interviews were conducted towards the end of the data collection 

period, and the administrators attempted to conduct the follow-up questionnaire 

even though it was prior to the three-month follow-up mark; 

2. The subjects’ conditions changed before three months, and since the subjects were often 

difficult to contact, the administrators went ahead and conducted the follow-up 

when the women came back to get the protection order; and 

3. Related to the above, since the subjects were sometimes difficult to contact, the 

administrators went ahead and conducted the follow-up if the woman happened to 

be in the office. 

Administration of the follow-up interview was similar to that of the initial interview, 

though the follow-up interview had significantly fewer questions. Subjects were rescreened and 

interviewers again conducted the consent discussion. Similar to the process described for the 

initial interview, at the conclusion of the follow-up interview the subject again signed or initialed 

the fee acknowledgment form after receiving the recruitment incentive payment of $25, and a 

debriefing was conducted to ascertain if the subject showed any signs of distress. Completion of 

the rescreening, consent discussion, and the follow-up interview required approximately one 

hour. 

The interviewers encountered some challenges in administering the COSMOS Study 

Questionnaire, including: 

z When using an interpreter, the interview took longer to complete; 

z Despite assurances from the interviewer, some subjects were reluctant to or 

did not answer specific questions (because of fear and/or reluctance to 

recount traumatic events); 

z A common response of both administrators and subjects was that the 

interviews were lengthy and required considerable emotional effort and time 

to complete. During the questionnaire development phase, the study team 

endeavored to find the balance between participant burden and maximizing 

the information obtained; 

z The questionnaire section titled “Pathway to Services and Experiences with 

Protective Orders” (section VI in the initial questionnaire; section V in the 

follow-up questionnaire) was the most difficult section for administrators due 

to the complexity of the skip patterns, the large number of follow-up 

questions, and the large number of response options. For these reasons, this 

section was particularly difficult for administrators to navigate once in the 

midst of the interview; and 

z Keeping both the initial and follow-up interviews focused on the “index 

partner” (defined as the person the subject was seeking protection from at 

that time) was challenging particularly if the subject had been involved and 

COSMOS Corporation, November 10, 2006 36 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
abused by more than one partner. In order to ensure that the questions were 

answered about the index partner, a reminder was added to the instructions at 

the beginning of each section that reiterated that all questions about their 

“partner” referred to the index partner. 

Tracking and Processing Completed Questionnaires and Administrative Forms 

Questionnaire administrators were responsible for managing a wide variety of forms and 

materials, including the questionnaire, consent form, screening checklist, fee acknowledgement 

receipts, domestic violence resource lists, cash money for subject incentive fees, and various logs 

for tracking the forms and fees. A coordinator was appointed at each site to be responsible for 

compiling, tracking, and distributing the materials and funds to questionnaire administrators; 

tracking, logging, and conducting quality reviews of completed questionnaires; tracking subject 

incentive fees and receipts; and transmitting all materials to COSMOS for processing. 

The procedures for tracking and processing completed questionnaire materials coming from 

the field involved a series of quality checks to ensure that all questionnaires, subject incentive 

funds, tracking logs, consent forms, screening checklists, and other forms were accounted for 

and recorded for tracking purposes. The following quality checks were completed and recorded 

at COSMOS for incoming questionnaires materials from each site: 

z Count the number of completed questionnaires; 

z Review each questionnaire to ensure that the instrument is complete; 

z Ensure that all associated materials are present for each questionnaire (i.e., 

consent form, screening checklist, fee acknowledgement form); 

z Match the incoming questionnaire ID numbers with the Master Tracking Log 

(see Appendix D), which tracks the outcome for each ID number (i.e., 

questionnaire complete, questionnaire incomplete, questionnaire not 

completed for that ID number) and records the screening results for each ID 

number (i.e., subject eligibility and consent); and 

z Complete a thorough reckoning of subject incentive fees and organization 

payment fees, and process payments to the partner sites. 

COSMOS Corporation, November 10, 2006 37 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Electronic Data Scanning 

Both the initial and follow-up version of the COSMOS Study Questionnaire were formatted 

using TeleForm1

 software to enable electronic scanning of the questionnaire data, thus avoiding 

the entry errors and extensive labor associated with manual data entry. The study team also 

developed the underlying databases that would house the scanned data and conducted internal 

testing of the scanning process using “dummy” questionnaires to ensure that the database 

structure and scannable format functioned properly. 

All electronic data scanning was conducted by a study team member at COSMOS. After 

processing and tracking all of the incoming questionnaire materials, the questionnaires were 

electronically scanned to an Access database via TeleForm software. The procedures for 

transferring data from paper surveys to the Access database are outlined in Exhibit 8. 

2.5 DATA ANALYSIS 

Both the baseline (initial) and follow-up data were read from Microsoft Access into SPSS 

(version 14.0) and were analyzed separately, as well as together. The SPSS data files included 

baseline survey data for 153 respondents, and follow-up survey data for 36 respondents. 

Initial data validation procedures began with assigning variable labels and value labels in 

adherence to the respective questionnaires. After establishing meaning to the data, responses 

were examined for completeness and correctness. In addition to scrutinizing the data, logic 

checks were developed and conducted for confirmation of skip patterns and assurance of inrange values that reflect response validity. Data were cleaned, so that data for respondents who 

did not espouse proper data compositions were removed from the data file. The final data file 

included 153 respondents and the resultant follow-up survey data included 36 respondents. 

Scales were calculated from items to measure the components outlined in the conceptual 

framework. In the baseline data, eight main scales and their subscales were computed: 

1) SMAS (Acculturation) Scale, 2) PMWI (Psychological Abuse) Scale, 3) CTS (Violence) 

Scale, 4) IPV (Threat Appraisal) Scale, 5) PCL (Post Traumatic Stress Disorder) Scale, 6) CESD (Depression) Scale, 7) Prior Trauma (Summary Exposure Score) Scale, and 8) Social Support 

Scale. The follow-up data had the same scales and subscales computed as the baseline data, but 

did not include the SMAS (Acculturation) Scale. 

1

The questionnaire framework was constructed using Verity software’s TeleForm Elite (Designer module). 

TeleForm Designer is a powerful application that creates forms for collecting data via facsimile, mail, by hand , or 

the Internet. Completed forms can be retrieved via facsimile, scanner, modem, or Internet, and then are read 

automatically by TeleForm. 

COSMOS Corporation, November 10, 2006 38 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 8 

PROCEDURES FOR ELECTRONICALLY SCANNING 

QUESTIONNAIRE DATA VIA TELEFORM 

TeleForm Processing Steps 

1. Scan surveys 

2. Batch creation 

3. Batch reading 

4. Batch identification 

5. Batch evaluation 

6. Batch correction 

7. Batch committal 

Description of Processing Steps 

• Scan completed surveys into PDF format 

• Save scanned surveys in a centralized folder on COSMOS’s network 

• Compile scanned surveys into small batches (5-10 surveys) 

• Process surveys by batches using TeleForm 

• Review created batches 

• Reject or accept the individual batches 

• Batch matched with correct form template for purposes of correction and 

data entry 

• Remove duplicates, blank pages, and miscellaneous error pages 

• Conduct manual correction of TeleForm’s reading of the data, where 

necessary: 

- Ex. Correction of misread numbers 

- Ex. Clarification of unreadable responses due to stray marks, illegible 

writing, and scratched-out responses 

• Conduct data cleaning: if multiple responses were checked in a field 

requiring only one response, all responses for that question were 

removed in order to continue batch processing, resulting in a blank 

response. 

• Following evaluation and correction, transfer batches to Microsoft Access 

database 

Data analysis methods primarily included running descriptives and frequencies on all the 

variables, scales, and subscales in the baseline and follow-up data. These procedures allowed for 

an overview of the results from the data’s respective questionnaires. Additional analyses will be 

conducted for inclusion in follow-up manuscripts for publication. 

The data analytic plan for subsequent analyses will include linear and logistic regression 

analyses for predicting relevant outcomes (e.g. filing for a protection order, obtaining a final 

order, reabuse). Prediction models incorporate appropriate numbers of predictors to 

accommodate the final sample size. These analyses will be conducted using SPSS v. 14 and 

MPlus v. 4.1 in order to address missing data. 

COSMOS Corporation, November 10, 2006 39 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
3. RESULTS OF THE STUDY 

Preliminary results are presented here. Further results will be presented in subsequent 

manuscripts submitted to professional journals (citations and links to these manuscripts will be 

posted on COSMOS’s website at http://www.cosmoscorp.com/publications.html). 

1. Demographic description of sample of battered immigrant women, 

including country of origin, family constellation, and immigration status: 

– Most (58.6%) of the sample reported being involved with the agency from 

which they were recruited for the first time; 

– The 153 women in the study reported living in the U.S. for an average of 

9.0 years (SD = 6.14), with a range of 1-30 years. Most women (67.3%) 

had lived in the U.S. for 10 years or less; 

– Mean age was 31 years (SD 6.52) with a range of 21-46 years; 

– Most (86.7%) women had children with a range of 0-10 children and a 

mean number of 2.4 (SD 1.8) children; 

– The total family income of the sample reflected a relatively low income: 

44 percent reported an annual income of less than $10,000; 67 percent less 

than $15,000; and 85 percent less than $25,000; and 

– The sample represented nine geographic regions of origin, including: 

1. Mexico 

2. Central America 

3. South America 

4. Europe 

5. Africa 

6. North America 

7. Japan 

8. India 

9. Asia 

– The women in the sample spoke 19 different first languages, including: 

1. 104 Spanish 

2. 12 Hmong 

3. 7 English 

4. 5 Russian 

5. 2 Japanese 

6. 2 Mandarin/Chinese 

7. 2 Romanian (one person speaks both Romanian and Hungarian) 

8. 1 Albanian 

9. 1 Arabic 

10. 1 Assamese 

11. 1 Cantonese 

12. 1 Czech 

13. 1 Dutch 

14. 1 Hungarian (this person also speaks Romanian) 

15. 1 Ibo 

16. 1 Igbo 

17. 1 Kejia 

18. 1 Mienh 

19. 1 Vietnamese 

– Immigration status of the sample was as follows: 

COSMOS Corporation, November 10, 2006 40 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
vii. Citizen, n = 2 (5.9%) 

viii. Lawful permanent resident, n = 36 (23.5%) 

ix. Undocumented, n = 67 (43.8%) 

x. Temporary, n = 33 (21.6%) 

xi. Refugee, n = 3 (2%) 

xii. Don’t know, n = 2 (1.3%) 

2. Type and level of IPV exposure: 

Overall, the level of violence experienced by this sample of immigrant women seeking 

services related to IPV was high (see Exhibit 9). The level of psychological abuse was also high, 

including both emotional/verbal abuse and dominance/isolation. Further, participants reported 

forms of psychological abuse that included abuse related to her immigration status (e.g., 

threatened or actually withdrew immigration papers, 39.5 percent sometimes, often, or very 

often; threatened or actually turned participant into immigration officials, 51 percent sometimes, 

often, or very often) (see Exhibit 10). Most women reported being “somewhat” or “very” 

worried about their own or their children’s safety (see Exhibit 11). 

3. Knowledge and use of protection orders: 

– Before seeking help from the agency from which they were recruited, 60.9 

percent of the sample had no prior knowledge of protection orders. 

– Most of the sample had filed a protection order against their abusive 

partner (n = 104, 68%), although a substantial minority had not (n = 49, 

32%). 44.9 percent of those who filed had filed within the past six 

months. 

4. Subjective experience of involvement in court process to seek protection 

order: 

– Most women who had filed for a protection order reported it to be helpful 

(22.7%) or very helpful (65.2%), although a substantial proportion of 

women (36.8%) reported that they felt the protection order would increase 

their danger. Nevertheless, the vast majority of women (98.1%) stated 

that they would recommend another woman that they knew to get a 

protection order, if needed. 

5. Level of posttraumatic responses associated with IPV: 

A significant proportion of women reported experiencing symptoms of posttraumatic stress 

disorder, a condition associated with exposure to traumatic events or experiences (American 

Psychiatric Association, 2000) (see Exhibit 12). 

COSMOS Corporation, November 10, 2006 41 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 9 

PERCENTAGE OF WOMEN WHO REPORTED VIOLENCE IN THE LAST YEAR 

Percentage of Women Reporting, 

by Frequency Categories 

Yes, but 

not in last 

Question: In the last year... 0 1-2 3-10 10+ year 

25. S/He grabbed me. 12.4 18.3 30.1 29.4 9.8 

26. S/He pushed or shoved me. 12.4 15.0 37.9 26.1 8.5 

27. S/He threw something at me that could hurt. 28.8 8.5 26.8 20.9 15.0 

28. S/He slapped me. 32.0 15.0 21.2 17.6 11.1 

29. S/He twisted my arm 32.2 24.3 18.4 14.5 10.5 

30. Pulled my hair 37.5 27.4 20.4 13.2 6.6 

31. S/He kicked me. 39.7 21.9 17.2 11.3 9.9 

32. S/He punched or hit me with something that could hurt. 34.6 21.6 19.6 12.4 11.8 

33. S/He slammed me against a wall. 31.6 20.4 27.0 12.5 8.6 

34. S/He choked me. 39.9 30.1 11.8 7.2 11.1 

35. S/He burned or scalded me on purpose. 90.8 5.9 1.3 0 2.0 

36. S/He beat me up. 30.1 20.3 18.3 17.6 13.7 

37. S/He used or threatened to use a knife or gun. 47.4 21.7 15.1 8.6 7.2 

38. S/He forced me to have sex. 35.5 14.5 13.8 23.0 13.2 

39. S/He refused to wear a condom during sex. 50.0 11.8 11.2 19.1 7.9

40. S/He used physical force when pregnant 52.4 13.1 10.3 5.5 18.6

41. I had sex with him because I was afraid of what s/he would do if I 34.0 13.1 16.3 27.5 9.2

didn’t. 

42. I felt physical pain that still hurt the next day because of his 17.8 23.7 23.0 23.0 12.5 

abuse. 

43. I had a sprain, bruise, or small cut because of his abuse. 25.8 24.5 19.9 19.2 10.6

44. I passed out from being hit on the head by him. 72.2 14.6 4.6 3.3 5.3

45. I had a broken bone from his abuse. 92.1 3.9 .7 0 3.3

46. I went to a doctor because of his abuse. 62.2 21.2 4.0 0 8.6

COSMOS Corporation, November 10, 2006 42 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 10 

PERCENTAGE OF WOMEN WHO REPORTED PSYCHOLOGICAL 

ABUSE WITHIN FREQUENCY CATEGORIES 

Frequency Categories 

Some Very 

Question: In the last year... Never Times Often Often 

1. S/he called you a bad name, swore, yelled or screamed at you 8.5 20.3 26.1 45.1 

2. S/he treated you like less than s/he was 9.9 16.4 17.8 55.9 

3. S/he watched over your activities or insisted you tell him/her 11.8 11.8 14.5 61.8 

where you were 

4. S/he used your money or made financial decisions without talking 26.1 13.7 11.1 49.0

to you 

5. S/he was jealous or suspicious of you friends 15.8 14.5 15.1 54.6 

6. S/he accused you of having an affair with another man/woman 22.4 17.8 21.7 38.2 

7. S/he interfered with your relationships with family or community 22.2 20.9 17.0 39.9 

members 

8. S/he tried to keep you from doing things to help yourself 23.5 16.3 13.1 47.1 

9. S/he controlled your use of the telephone 24.8 18.3 15.7 41.2 

10. S/he told you that your feelings were crazy 17.0 17.6 17.0 48.4 

11. S/he blamed you for his/her problems 15.0 15.0 11.1 58.8 

12. S/he told you s/he would or actually took your children away 40.6 15.4 11.2 32.9 

13. S/he told you s/he would or actually threw or locked you out of 32.9 25.0 12.5 29.6 

the house 

14. S/he told you s/he would or actually locked you in the house or a 61.2 16.4 10.5 11.8 

room 

15. S/he told you s/he would take away or not give you money 30.3 11.8 15.1 42.8 

16. S/he told you s/he would or actually turned you in to immigration 49.0 11.3 10.6 29.1

officials 

17. S/he told you s/he would or actually failed to file or withdrew 61.5 5.4 11.5 21.6

immigration papers 

18. S/he told you s/he would hurt you or your unborn child when you 66.9 11.7 7.6 13.8

were pregnant 

19. S/he destroyed your property 47.7 17.0 11.1 24.2

Exhibit 11 

TYPE AND LEVEL OF SUBJECTIVE APPRAISAL OF WORRY RELATED TO IPV 

Percentage of Women Reporting 

Not A Little Some-what Very 

Worries About Safety Worried Worried Worried Worried 

47. Worried about keeping self safe 13.8 24.3 25.7 36.2 

48. Worried about keeping children safe 22.4 15.4 16.1 26.2 

COSMOS Corporation, November 10, 2006 43 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 12 

PROPORTION OF WOMEN REPORTING POSTTRAUMATIC SYMPTOMS 

Posttraumatic Symptom 

1. Had repeated, disturbing memories, thoughts, or images of the abuse? 

2. Had repeated disturbing dreams about the abuse? 

3. Suddenly acted or felt as if the abuse was happening again (as if you were reliving it)? 

4. Felt very upset when something reminded you of the abuse? 

5. Had physical reactions (e.g., heart pounding, trouble breathing, sweating) when something 

reminded you of the abuse? 

6. Avoided thinking about or talking about the abuse? 

7. Avoided activities or situations because they reminded you of the abuse? 

8. Had trouble remembering important parts of the abuse? 

9. Felt a loss of interest in activities that you used to enjoy? 

10. Experienced feeling distant or cut off from other people? 

11. Felt unable to have loving feelings for those close to you? 

12. Been upset by things that usually don't bother you? 

6. Prior trauma exposure other than IPV: 

Percentage Of 

Women Reporting 

Symptom 

80 

61 

84 

55 

67 

25 

70 

47 

61 

69 

50 

56 

Women in the sample reported high levels of exposure to violence in addition to IPV with 

an average of three prior trauma exposures (see Exhibit 13). Half of the women had three or 

more prior traumatic exposures. Only 14 percent of the sample reported previously experiencing 

none of the traumatic events listed in Exhibit 13. 

7. Acts within the last six months that constitute violation of a protection order: 

Participants were asked if they had experienced a range of behaviors from their abusive 

intimate partners within the previous six months. If they responded “yes,” they were asked if 

there was a protection order (any type) in effect during the period of time in which the act 

occurred. For only for those women who responded “yes” to the second question would there be 

a violation of a protection order. However, rates of occurrence of the acts provides a comparison 

so that we can estimate what proportion of the time when these behaviors occur do they occur 

when a protection order is in effect. Results indicate that some behaviors occurred at relatively 

high rates (e.g., 43.8% abuse; 54.9% unwanted contact). However, most often those behaviors 

occurred when there was no protection order in place, suggesting that protection orders may 

have been effective in reducing these behaviors for some abusive partners (see Exhibit 14). 

COSMOS Corporation, November 10, 2006 44 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 13 

TRAUMATIC EXPOSURE FROM SOMEONE OTHER THAN AN ABUSIVE PARTNER 

Type of Traumatic Event 

Beaten 

Hit 

Forced sex 

Natural disaster 

Lived in war zone 

Serious accident 

Threatened with weapon 

Held captive 

Was present when another was raped, 

beaten, or killed 

Witnessed physical violence between adults 

in the home 

Exhibit 14 

Number and 

(Percentage) of 

Women Reporting 

52 (34.4) 

66 (43.4) 

52 (34.4) 

48 (31.4) 

33 (21.6) 

33 (21.6) 

56 (36.8) 

30 (19.9) 

34 (22.4) 

66 (43.1) 

ACTS WITHIN THE PREVIOUS SIX MONTHS THAT 

CONSTITUTE VIOLATIONS OF A PROTECTION ORDER 

Acts that Constitute a Protection Order Violation 

Percentage of 

Respondents 

Reporting that the 

Act Occurred within 

Previous 6 Months 

Percentage of 

Respondents with a 

Protection Order 

1. Used physical abuse toward you 43.8 7.2 

2. Refused to stay away from you even though you 

asked him/her to or s/he was ordered to do so 47.1 19.0 

3. Had contact with you (in person or via phone, email, 

mail, or through other people) even though you asked 

him/her not to or s/he was ordered not to 

54.9 26.8 

4. Stayed at your home (even if you asked him/her to 

leave or s/he was ordered to leave) and you now share it 

with him/her 

24.8 8.5 

5. Returned to your home even though you asked 

him/her not to or s/he was ordered not to 29.4 12.4 

6. Kept personal property/documents when s/he was 

supposed to give them to you 32.7 15.7 

7. Refused to give you access to, or copies of, any 

documents supporting your immigration application even 

though you asked him/her to or s/he was ordered to 

19.6 9.2 

8. Continued to use the car or other possessions even 

though you asked him/her not to or s/he was ordered not 

to 

7.8 

3.9 

(Continued) 

COSMOS Corporation, November 10, 2006 45 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 14 (Continued) 

Acts that Constitute a Protection Order Violation 

Percentage of 

Respondents 

Reporting that the 

Act Occurred within 

Previous 6 Months 

Percentage of 

Respondents with a 

Protection Order 

9. Refused to give you access to your children even 

though you have custody 7.8 3.3 

10. Did not follow required supervision (or other 

conditions, e.g. return times, no contact with you during 

exchange of children) when visiting the children 

10.5 7.2 

11. Removed the children from the court’s jurisdiction 

when there was an order not to 1.3 1.3 

12. Removed the children from the United States when 

there was an order not to 1.3 1.3 

13. Did not turn over the children’s passports to you or 

the court even though ordered to do so 3.9 3.9 

14. Sought a visitor’s visa or any other visas for the 

children from an embassy or consulate 1.3 1.3 

15. Did not provide financial support for the children 

even though you asked or s/he was ordered to do so 19.6 8.5 

16. Did not provide you with financial support even 

though you asked or s/he was ordered to do so 24.2 7.2 

17. Did not pay your (or your children’s) medical 

expenses or health insurance costs even though you 

asked or s/he was ordered to do so 

13.7 4.6 

18. Did not pay for repair of property s/he damaged 

(e.g., broken door, window) even though you asked or 

s/he was ordered to do so 

11.8 3.9 

19. Did not attend batterer treatment or treatment for 

anger management program, even though ordered to 7.8 5.9 

20. Did not attend drug or alcohol counseling, even 

though ordered to 7.2 5.2 

21. Did not give up his/her gun(s) or other weapons from 

his or her possession, even though ordered to 1.3 1.3 

22. Withdrew your application for permanent residency, 

which had been filed on your behalf 5.2 2.0 

23. Interfered in some other way with your application for 

permanent residency being approved 17.6 7.8 

24. Did not pay fees associated with your or children’s 

immigration cases, even though ordered to 3.9 2.6 

25. Called the immigration authorities to report you 8.5 4.6 

26. Contacted the U.S. Consulate, or the Embassy about 

your immigration status 3.9 3.9 

27. Did not sign a form to help obtain his/her birth 

certificate even though ordered to 2.0 2.0 

28. Did not sign a form to request information from an 

immigration case s/he filed, even though ordered to 4.6 2.0 

29. Did not turn over copies of documents about 

previous marriages and divorces, including where each 

occurred, even though ordered to 

2.6 2.0 

30. Was there anything else s/he was ordered to do that 

s/he did not do? If yes, specify 11.1 5.9 

COSMOS Corporation, November 10, 2006 46 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
8. Correlates of protection order status: 

Comparison of participants with and without protection orders on covariates produced the 

following results (see Exhibit 15): 

• Undocumented participants were less likely to obtain a protection order compared to 

all other participants. 

This finding suggests that undocumented status may be associated with greater 

barriers to seeking a protection order, even among those who have made contact with 

an agency that can provide help to petition for such orders. 

• Participants with a protection order perceived their risk of future intimate partner 

violence to be greater than those without a protection order. 

These data do not allow us to determine whether the increase appraisal of risk 

occurred prior or subsequent to obtaining a protection order. However, this finding 

suggests those with protection orders report the greater level of perceived risk – yet it 

is unclear whether this is the case before, after, or both before and after obtaining a 

protection order. 

• Participants with a protection order report having been exposed to a greater number 

of previous traumatic events (non-IPV) compared to those without a protection order. 

This finding suggests that prior exposure to non-IPV related traumatic events 

creates a barrier to obtaining a protection order. 

COSMOS Corporation, November 10, 2006 47 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 15 

COMPARING THOSE WITH PROTECTION ORDER VS. THOSE WITH NO 

PROTECTION ORDER 

(UNIVARIATE ANALYSIS OF VARIANCE) 

ACCULTURATION – ETHNIC SOCIETY CULTURE (SMAS ESI SUBSCALE) 

IV n Mean SD F df p 

No 43 29.40 5.98 3.64 1 .058 

Yes 110 31.18 4.88 

ACCULTURATION – DOMINANT CULTURE (SMAS DSI SUBSCALE) 

IV n Mean SD F df p 

No 43 25.33 4.26 .003 1 .958 

Yes 110 25.36 3.98 

PSYCHOLOGICAL ABUSE (PMWI) SCALE 

IV n Mean SD F df p 

No 43 49.44 12.56 .01 1 .935 

Yes 110 49.23 15.24 

PHYSICAL IPV (CTS) SCALE 

IV n Mean SD F df p 

No 43 35.26 19.36 .50 1 .480 

Yes 110 37.91 21.41 

IPV THREAT APPRAISAL SCALE 

IV n Mean SD F df p 

No 42 30.52 10.04 5.04 1 .026* 

Yes 109 35.38 12.53 

IMMIGRATION STATUS: UNDOCUMENTS VS. SOME LEGAL STATUS 

IV n % with PO χ

2 df p 

Other 41 62.7 5.86 1 .017* 

Undocumented 108 80.5 

FREQUENCY OF PRIOR TRAUMA SCALE 

IV n Mean SD F df p 

No 34 6.65 6.54 .49 1 .484 

Yes 85 8.49 14.75 

(Continued) 

COSMOS Corporation, November 10, 2006 48 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 15 (Continued) 

EXPOSURE PRIOR TRAUMA SCALE 

IV n Mean SD F df p 

No 43 3.84 2.17 7.20 1 .008* 

Yes 110 2.77 2.22 

POSTTRAUMATIC SYMPTOMS (PCLS) SCALE 

IV n Mean SD F df p 

No 43 31.05 6.37 3.30 1 .071 

Yes 109 28.60 7.88 

DEPRESSION (CESD) SCALE 

IV n Mean SD F df p 

No 43 55.49 8.89 .33 1 .569 

Yes 110 54.44 10.72 

SOCIAL SUPPORT SCALE (ISEL) 

IV n Mean SD F df p 

No 43 28.70 6.46 .000 1 .993 

Yes 110 28.71 6.93 

COSMOS Corporation, November 10, 2006 49 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
4. CONCLUSIONS 

This Final Technical Report describes the process of conducting a study of battered 

immigrant women’s experience with protection orders. Substantive results will appear in 

subsequent journals and other publications and dissemination channels. Conclusions include the 

following: 

z Conducting research in the immigrant community requires members of the 

research team to be imbedded and respected in that community. That is a 

necessary, but not sufficient, condition for a successful research endeavor. 

Beyond compensation to participants and to agency staff for their time, 

successful involvement of community partners requires dedication and 

commitment by either someone within a community agency who has the 

power and authority to ensure that the research activity is completed or by 

advocates, attorneys, or agency volunteers who as individuals are committed 

to completing the work and who often choose to conduct interviews by 

devoting additional time above and beyond what is required by their agency. 

 Involvement of community advocates who have a trusted relationship with 

the target population was essential to the successful recruitment and 

interviewing of the study participants. 

z A research team representing a broad range of methodological skills, 

substantive areas of expertise, and experience is necessary to conduct 

community-based research involving the complex issues represented by 

immigrant women’s exposure to domestic violence and their use of the 

justice system – specifically protection orders – as a remedy. Access to the 

many individuals who provided formal and informal consultation throughout 

the course of the project was invaluable to its successful completion. 

z A strong capacity for project coordination and administration is essential for 

successfully completing the complex process of involvement of many 

community partners across diverse ethnic communities and geographic 

locations. Successful project completion would not be possible without this 

infrastructure. 

z Partnership with funding agency and research team is essential for adapting 

to the inevitable adjustments and modifications that are required to respond 

to unexpected contingencies in research design and implementation. 

Flexibility allows for midcourse adjustments that maximize the productivity 

of the research endeavor. 

COSMOS Corporation, November 10, 2006 50 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
z Substantive results offer several conclusions: 

– Immigrant women seeking help within community agencies for domestic 

violence report an extremely high level of domestic violence exposure. 

Compounding the situation, most women also report a prior history of 

trauma exposure. Chronic trauma exposure increases the battered 

woman’s vulnerability to adverse health, economic, and social outcomes. 

– Immigrant women seeking help for IPV report an ongoing concern for the 

safety of themselves and their children. 

– Knowledge of civil protection orders is not something most immigrant 

women reported prior to contact with the community agency where they 

were seeking service. Confirming that immigrant victims lack 

information about what legal options are available to help her, and 

indicating the need for greater public awareness among immigrant women 

and their female support providers of options for responding to domestic 

violence within communities. 

– Battered immigrant women’s experience in the civil court process is 

perceived as positive for most women, although a substantial minority was 

not satisfied with this process. Importantly, a sizeable proportion 

perceived that the protection order increased their danger related to 

domestic violence. 

– The level of posttraumatic symptomatology is extremely high among this 

sample of battered immigrant women, indicating an immense mental 

health burden to the woman, her family and extended community, and to 

society. The need for integrated services to address these needs within the 

justice system is clear. 

– Many immigrant battered women who participated in the survey reported 

forms of posttraumatic symptomatology that could directly interfere with 

an immigrant victim’s ability to present testimony and evidence in a court 

proceeding or in an affidavit submitted to the Department of Homeland 

Security in an immigration case. They reported having trouble 

remembering important parts of the abuse (47%), avoided thinking about 

the abuse (25%) and felt very upset when something reminded them about 

the abuse (55%). These findings confirm that immigrant victims are very 

unlikely to be able to obtain protection orders or immigration relief on 

their own without the assistance of trained advocates and attorneys. 

Advocates and attorneys working with immigrant victims need to be 

trained how to support victims with posttraumatic symptomatology and 

need to develop resources in their communities to provide linguistically 

accessible and culturally sensitive mental health treatment to immigrant 

COSMOS Corporation, November 10, 2006 51 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
victims. Additionally, judicial officers and government agency 

adjudicators need to be trained to be sensitive to and understand that 

mental health effects of domestic violence and multiple lifetime 

victimization can affect how immigrant victims present testimonial 

evidence in domestic violence cases. 

– Protection orders may be associated with fewer acts that would constitute 

violations of protection orders. This would suggest that protection orders 

are effective in reducing these acts, which include not only violent and 

abusive behaviors, but also other types of violations. 

– Participants who obtain protection orders report greater appraisal of IPVrelated risk, are more likely not to be undocumented, and report fewer 

prior exposures to non-IPV traumatic events. Each of these represents a 

potential barrier to obtaining protection orders for intimate partner 

violence. 

Study Limitations 

The study was limited by several considerations. 

z Potential participant bias 

Participants in this study were recruited from agencies providing immigrant 

services, including but not limited to legal services. This study may not 

represent battered immigrant women who do not seek similar services. 

Thus, generalization to all battered immigrant women may be limited. 

z No comparison groups 

This study included only women who were both born outside the U.S. and 

who had experienced violence from an intimate partner. We did not 

include a comparison group of non-immigrant women exposed to intimate 

partner violence, nor did we include a comparison group of immigrant 

women who had never been exposed to intimate partner violence. 

Comparisons to each of these groups are important for furthering our 

understanding of battered immigrant women. 

z Sampling methods 

This study utilized convenience sampling as a method for obtaining study subjects. 

This method may result in study bias since it is does not systematically sample 

potential participants from the population. Alternate methods of representative 

sampling from the population were too expensive to consider. Another potential 

method, cluster sampling, was not feasible since we were unable to systematically 

COSMOS Corporation, November 10, 2006 52 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
sample all agencies providing services to immigrant women. Thus, our sample 

may be biased by our sampling method and not represent all battered immigrant 

women. 

COSMOS Corporation, November 10, 2006 53 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
5. REFERENCES 

Abraham, Margret (2000a). Speaking the unspeakable: Marital violence among south Asian 

immigrants in the United States. New Brunswick, NJ: Rutgers University Press. 

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APPENDIX A 

COSMOS Study Questionnaire and Visual Aids 

(Initial Questionnaire) 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
1

0 1

ID# 0 1

COSMOS STUDY QUESTIONNAIRE 

Introduction Script: I am a member of a research team that is conducting a study about how battered immigrant 

women use protection orders to protect themselves and their children from a partner. A partner may be your husband, 

boyfriend, girlfriend, dating partner, some one you are intimately involved with, or some one you have a child with. We 

are interested in understanding the barriers women face when trying to get protection orders, and whether or not 

protection orders work for the women. I'm going to ask you questions about you and your family, how you have adapted 

to living in the U.S., how happy you are with your life, the threat of danger you feel from your partner, and other related 

questions. We will ask several questions about your partner. These questions refer to the person you are seeking 

protection from right now with the help of {Agency}. What you tell me will be held in strict confidence, and this 

information will not be shared with the police, the immigration authorities, or any of your friends or family. Your name 

or other identifying information will be stored separately from the questionnaire under lock and key. If you do not feel 

comfortable answering a question, you do not have to give an answer; we can just skip to the next question. As a 

reminder, there are two possible risks to the confidentiality of the data collected during the study. First, if you tell us 

about a child who is being abused or about your intent to hurt someone, we may be required by law to report that 

information to the authorities. Second, if your partner finds out about your participation in the study you could be at 

increased risk of violence or other forms of retaliation from your partner. The first set of questions I'm going to ask are 

about you and your family. Do you have any questions before we begin? 

Instruction: Remind participant that all questions about their "partner" refer to the person they are seeking protection 

from right now. Ask what this partner's name is, and refer to this name when asking questions about the partner. This 

will help eliminate confusion about which person we are asking about when we refer to their "partner." 

Instruction: In most cases where questions have multiple response categories, the categories are NOT to be read to the 

participant. We have highlighted - in gray - the few cases where response categories are to be read to the participant. 

Date of Interview: 

I. Demographics 

1. How long have you lived in the U.S. years? (Instructions: note 01 year if less 

than 1 year). 

2. How many children do you have? 

2a. How many live in the U.S.? 

2b. How many were born in the U.S.? 

/ / 

[If no children, skip to 4] 

1 3822107306


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

3. What is the living arrangement of your children not living in your home? 

(Instruction: Do not read options to participant; probe until there are no further

responses. Mark only one answer and answer all applicable follow-up questions.) 

Child is an adult living out of the home (If yes, specify with whom and where) 

Child lives with relative (If yes, specify with whom and where) 

Child is in foster care

Child is deceased

No children living outside the home

4. Do any children currently live with you, either your own or children not born to you? 

Yes No 

5. What are the ages of the children currently living in your home? 

6. Who else-including non-family members-lives with you at home? 

(Instruction: Do not read options to participant; probe until there are no further 

responses. Mark all answers that apply.) 

Your husband/partner Your brothers or sisters 

Your Mother Your husband's/partner's brothers or sisters 

Your Father Your cousins 

Your husband's/partner's mother Your husband's/partner's cousins 

Your husband's/partner's father Others (specify below) 

7. Does any one else from your family (not including people in your household) live in

the United States? Yes No [if no, go to 8] 

7a. Who from your family lives the closest

 to you (e.g.,sister, cousin)? 

7b. How long does it take to get to this person? hours (Instruction: if less 

than 1 hour, note 01 hour) 

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This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

8. What is your Date of Birth: / /

8a. If you don't know date of birth, how old are you? 

9. Where were you born? 

10. What is your native (first) language? 

11. What is your ethnicity/race? 

12. What is your religious affiliation? 

13. How important is religion to you? (Instruction: Utilize Visual Card to show the scale to

 the subject; mark only one answer.) 

Not very important Very important 

Moderately important Extremely important 

14. What is your highest level of education? (Instruction: Do not read options to

 participant; mark only one answer.) 

Less than third grade 

Elementary school (primary school) 

Secondary school (middle or high school) 

Post-secondary school (preparatory school, A-level school) 

Community college, technical school, or other vocational training 

Some university education, no degree 

University degree (undergraduate) 

Some graduate school, no degree 

Master's degree 

Degree in medicine, veterinary median, dentistry, or law 

Doctoral degree

Other:

3 0804107303


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

15. What is your total family income? (i.e., income for everyone living in your

 household)? (Instruction: Utilize the Visual Card and have the subject select a range; do

 not read options to the participant; mark only one answer.) 

$0 to $9,999 

$10,000 to $14,999 

$15,000 to $24,999 

$25,000 to $34,999 

$35,000 to $49,999 

$50,000 to $64,999 

$65,000 and over 

16. How many people in the U.S. does your family income support? 

17. How many people abroad does your family income help support? 

18. What is your present personal income? (Instruction: Utilize the Visual Card and have

 the subject select a range; do not read options to the participant; mark only one answer.) 

$0 to $9,999 

$10,000 to $14,999 

$15,000 to $24,999 

$25,000 to $34,999 

$35,000 to $49,999 

$50,000 to $64,999 

$65,000 and over 

19. What is your present work situation? (Instruction: Do not read options to participant;

 mark only one answer.) 

Working full-time (one workplace) Unemployed 

Working full-time (multiple workplaces) On maternity/parental benefit 

Working part-time (one workplace) On social assistance 

Working part-time (multiple workplaces) Don't Know 

Self-employed or business owner Other 

4 1412107309


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

20. What is your relationship with your partner? (Instruction: This is different than living

 arrangement, which is addressed in No. 22; do not read options to participant; mark only one

legally married (i.e. common-law partner) 

answer.) 

Dating - not living together Never legally married (single) 

Child in common, but not dating or married Legally separated, but not divorced 

Legally married Separated from common-law partner 

Legally married but separated Divorced 

Consider yourself married, though not 

21. Is this person the father of at least one of your children? Yes No 

22. What is the current living arrangement with your partner? (Instruction: Do not read

 options to participant; probe until there are no further responses. Mark only one answer and

 answer follow-up questions.) 

Living together full time 

If yes: 

His/Her place 

Your place 

Your and His/Her place 

Other 

Living together part time or on/off: 

If yes: 

His/Her place 

Your place 

Your and His/Her place

Other

Not living together 

23. Has your living arrangement changed in the last month? Yes No [if no, go to 24] 

23a. If yes, how has it changed? 

5 4256107308


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

24. What do you plan to do regarding your relationship? (Instruction: Do not read options to

 participant; mark only one answer.) 

Plans to remain in the relationship Plans to return to the relationship 

Plans to leave the relationship Not sure 

25. What does your family or community expect you to do in terms of the relationship?

(Instruction: Do not read options to participant; mark only one answer.) 

Remain in the relationship No expectation 

Return to the relationship Not sure 

Leave the relationship 

26. What is your partner's present work situation? (Instruction: Do not read options to

 participant; mark only one answer.) 

Working full-time (one workplace) 

Working full-time (multiple workplaces) 

Working part-time (one workplace) 

Working part-time (multiple workplaces) 

Self-employed or business owner 

27. What are your current citizenship(s)? 

Unemployed 

On maternity/parental benefit 

On social assistance 

Don't Know 

Other 

28. I know I already asked you "where were you born?", but what do you consider to be

 your home country? 

6 1108107301


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

29. What is your immigration status? (Instruction: Utilize the Visual Card to assist the

 subject in selecting the correct response; do not read options to participant; mark only one

 answer.) 

Undocumented Persons without legal permission to be in the

United States either because they had entered

without inspection or because they had entered

lawfully and had overstayed or violated the

terms of their visa. 

e.g., student, work, tourist, temporary

protected status, fiancé visa. Have permission

from the immigration authorities to temporarily

live, work, or study in the U.S. Status is

limited as to length of time, is dependant upon

a specific familial or employment relationship,

or is designed to offer temporary relief to

persons due to conditions in their home

country. 

30. Why did you immigrate to the United States? (Instruction: Do not read options to

 participant; mark all answers that apply.) 

To be with your spouse/partner 

To join children who were already in the United States 

To escape violence or other persecution 

To improve economic conditions 

Other (specify) 

U.S. Born 

Foreign Born 

Permanent visa, green card 

Conditional resident, legal non-immigrant visa,

U.S. Citizen 

Naturalized Citizen 

Lawful permanent resident 

Temporary 

Refugee/Asylee 

Don't know 

7 3232107301


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

31. What is your partner's immigration status? (Instruction: Utilize the Visual Card to

 assist the subject in selecting the correct response; do not read options to participant; mark

 only one answer.) 

Undocumented Persons without legal permission to be in the

United States either because they had entered

without inspection or because they had entered

lawfully and had overstayed or violated the

terms of their visa. 

e.g., student, work, tourist, temporary

protected status, fiancé visa. Have permission

from the immigration authorities to temporarily

live, work, or study in the U.S. Status is

limited as to length of time, is dependant upon

a specific familial or employment relationship,

or is designed to offer temporary relief to

persons due to conditions in their home

country. 

32. What is your partner's native (first) language? 

Temporary 

Lawful permanent resident 

Naturalized Citizen 

U.S. Citizen U.S. Born 

Foreign Born 

Permanent visa, green card 

Conditional resident, legal non-immigrant visa,

Don't know 

Refugee/Asylee 

33. What is your partner's ethnicity/race? 

34. What is your partner's religious affiliation? 

8 0405107300


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

II. Stephenson Multigroup Acculturation Scale (SMAS) 

Script: The next set of statements I'm going to read to you are about how you have 

adapted to life in the U.S. For each statement, point to the place on the scale 

between "Not True" and "True" that shows how true the statement is for you. There are 

no right or wrong answers. Do you have any questions? 

Not Mostly Mostly True 

How true is the statement... True Not True 

True 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

Not 

True 

Mostly

Not 

True 

Mostly

True 

True 

1. I understand English. 

2. My spoken English is not fluent. 

3. I feel very comfortable with people from the United

 States as part of my social circle (as friends,

 neighbors, and co-workers). 

4. I regularly eat traditional foods from my native culture. 

5. I know how to read and write in my native language. 

6. I feel at home in the United States. 

7. I attend social functions with people from my native

 country. 

8. I regularly read magazines of my native/ethnic group. 

9. I only speak my native language at home. 

10. I like to listen to music of my native language/ethnic

 group. 

11. I attend social functions with people from the United

 States. 

12. I stay in close contact with family members and relatives

 in my native country. 

13. I like to eat the foods that Americans eat. 

14. I stay in close contact with family members in the U.S. 

15. I am comfortable with the role of women in the United

 States as equal partners with men and as having more

 rights than women in my country. 

16. I feel a responsibility to maintain my native culture in

 the U.S. 

 programs from my native country. 

9 2201107306 

17. I feel afraid of the U.S. police. 

18. I watch American TV programs more than I watch TV

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

III. Psychological Maltreatment of Women Inventory 

Script: Now, I'm going to read you statements about things your partner may have done 

to you in the last year. For each statement, point to the place on the scale that 

shows how often the event occurred in the last year. 

In the last year... Never Some Often Very

Times Often 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

Never Some 

Times 

Often Very

Often 

1. S/he called you a bad name, swore, yelled or screamed at

 you. 

2. S/he treated you like less than s/he was. 

3. S/he watched over your activities or insisted you tell

 him/her where you were at all times. 

4. S/he used your money or made important financial

 decisions without talking to you about it. 

5. S/he was jealous or suspicious of your friends. 

6. S/he accused you of having an affair with another

 man/woman. 

7. S/he interfered with your relationships with family or

 community members. 

8. S/he tried to keep you from doing things to help

 yourself (such as learning English, getting a job,

 exercising, etc.). 

9. S/he controlled your use of the telephone. 

10. S/he told you that your feelings were crazy. 

11. S/he blamed you for his/her problems. 

12. S/he told you s/he would or actually took your children

 away. 

13. S/he told you s/he would or actually threw or locked you

 out of the house. 

14. S/he told you s/he would or actually locked you in the

 house or in a room in the house. 

15. S/he told you s/he would take away or not give you money. 

16. S/he told you s/he would or actually turned you in to

 immigration officials. 

17. S/he told you s/he would or actually failed to file or

 withdrew immigration papers for you or your children. 

18. S/he told you s/he would hurt you or your unborn child

 when you were pregnant. 

19. S/he destroyed your property. 

10 4783107303


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

IV. Conflict Tactics Scale (CTS-2) 

Script: No matter how well a couple gets along, there are times when they disagree, 

get annoyed with each other, want different things from each other, or just have 

arguments or fights. I'm going to list some things that might happen when you have 

differences with your partner. For each thing, tell me how many times your partner 

did these things in the last year: 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct

response.)

Number of times in the last year 

Happened 

but not in Never In the last year... 1-2 3-10 10+ last year Happened 

1. S/he grabbed me. 

(Continued...) 

11 7900107307 

2. S/he pushed me. 

3. S/he threw something at me that could hurt. 

4. S/he slapped me. 

5. S/he twisted my arm. 

6. S/he pulled my hair. 

7. S/he kicked me. 

8. S/he beat me up. 

9. S/he punched or hit me with something that

 could hurt. 

10. S/he slammed me against a wall. 

11. S/he choked me. 

12. S/he burned me on purpose. 

13. S/he used or told you s/he would use a

 knife or gun. 

14. S/he used physical force against me when I

 was pregnant. 

15. S/he forced me to have sex. 

16. S/he refused to wear a condom during sex. 

17. I had sex with him/her because I was

 afraid of what s/he would do if I didn't. 

18. I felt physical pain that still hurt the

 next day because of his/her abuse. 

19. I had a bruise or cut because of his/her

 abuse. 

20. I passed out from being hit so hard by

 him/her. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

IV. Conflict Tactics Scale (CTS-2) (Continued...)

Number of times in the last year 

Happened 

but not in Never In the last year... 1-2 3-10 10+ last year Happened 

25. I have emotional problems now because of

 his/her abuse. 

21. I had a broken bone from his/her abuse. 

22. I went to the doctor because of his/her

 abuse. 

23. I have permanent scars because of his/her

 past abuse. 

24. I have physical health problems now because

 of his/her abuse. 

12 9565107306


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

V. IPV Threat Appraisal Scale and Fear Scale 

Script: I'm going to ask you how likely you think it is that your partner will do 

certain things in the next year. For each statement, point to the place on the scale 

between "Not At All" and "Definitely" that shows how likely you think it is that the 

event will happen. There is no right or wrong answer; just the way you feel. Do you 

have any questions before we begin? 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

High

Likelihood 

Some 

Likelihood 

Not At 

All Definitely 

In the next year, how likely do you Not Some High

think it is that your partner will... At All Likelihood Likelihood Definitely 

1. Threaten to harm you physically. 

2. Actually physically harm you. 

3. Force you to have sex against your will. 

4. Try to kill you. 

5. Control or dominate you. 

6. Embarrass you. 

7. Take away your money. 

8. Tell you s/he will physically harm someone you

know, such as friends, co-workers, parents,

 etc. 

9. Actually physically harm someone you know,

 such as friends, co-workers, parents, etc. 

10. Call immigration authorities to get you in

 trouble. 

11. Call police to get you in trouble. 

12. Throw or lock you out of the house or room. 

13. Destroy your property or important documents. 

14. Violate a protective order. 

15. Track you down or find you. 

16. Try to take away, get custody, or kidnap your

 child or children. 

17. Not sponsor petition for green card or visa

 for you or your children. 

13 0322107308


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

Script: For the next two questions, point to the place on the scale that indicates how

worried you are. 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

A Little 

Worried 

Somewhat 

Worried 

Very 

Worried 

Not 

Worried 

How worried are you... Not A Little Somewhat Very

Worried Worried Worried Worried 

18. How worried are you about keeping yourself safe? 

19. How worried are you about keeping your children

 safe? 

14 1848107302


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

VI. Pathway To Services And Experience With Protective Orders 

Script: The next set of questions I'm going to ask are about your experience with 

this agency, about your decision whether or not to file for a protection order, and 

how happy you are with the process for getting a protection order. There are no 

right or wrong answers; just what has been your experience. 

1. Is this your first time at this agency? Yes No 

2. How did you first learn about this agency? 

(Instruction: Do not read options to participant; probe until there are no further 

responses. Mark all that apply and answer all applicable follow-up questons.) 

Female Friend 

If yes, was she from your home country?................. 

If yes, does she speak your native language?............ 

Male Friend 

Yes 

Yes 

No 

No 

If yes, was he from your home country?.................. 

If yes, does he speak your native language?............. 

Mother 

Yes 

Yes 

No 

No 

Sister 

Father 

Brother 

Cousin 

If yes, was this cousin male or female?................. 

If yes, was s/he from your home country?................ 

If yes, does s/he speak your native language?........... 

Male 

Yes 

Yes 

Female 

No 

No 

Other family member (Specify) 

Someone at my place of work 

Advocate/Social Work/Community organization staff 

If yes, does s/he speak your native language?........... Yes No 

Attorney/Lawyer 

If yes, does s/he speak your native language?........... 

If yes, does s/he speak your native language?........... 

Yes 

Yes 

No 

No 

(Continued...) 

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This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

2. How did you first learn about this agency? (Continued...) 

Police

If yes, does s/he speak your native language?........... Yes No 

If yes, did the police provide interpretation for you?.. Yes No 

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

Court staff

If yes, does s/he speak your native language?........... Yes No 

If yes, did the court provide interpretation for you?.. Yes No 

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

Judge

If yes, does s/he speak your native language?........... Yes No 

If yes, did the judge provide interpretation for you?.. Yes No 

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

Health care provider (e.g., doctor, nurse)

If yes, does s/he speak your native language?........... Yes No 

Newspaper, brochure or something else in writing 

If yes, was it written in your native language?......... Yes No 

Radio 

If yes, was it in your native language?................. Yes No 

TV 

If yes, was it in your native language?................. Yes No 

Religious leader 

If yes, does this person speak your native language?.... Yes No 

Other (specify) 

If yes, did this person speak your native language?...... Yes No 

16 2756107301


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

3. What concerns led you to seek help at this agency? 

(Instruction: Do not read options to participant; probe until there are no further responses.

 Mark all that apply.) 

Problems with your current or former intimate partner (e.g.,

husband, boyfriend, or girlfriend) 

Immigration issues 

Shelter/transitional housing

Legal advocacy for immigration issues

Legal advocacy for civil issues (e.g., civil protection order,

housing, landlord/tenant, divorce, child custody)

Legal advocacy for criminal charges against your partner (e.g.,

domestic or other violence, child abuse, or other crimes)

Assistance securing medical and/or dental services

Securing food/clothing/furniture as needed

Filing public benefits

Transportation

Translation (written)

Translation (verbal)

ESL

Crisis counseling

Counseling

Support groups

After-school/youth programs

School liaison

Job training

Job placement

Assistance with relocation

Services for victims of trafficking

Other (specify) 

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This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

Yes No

If no, go to question 5.

If yes, how or from whom did you find out what a protection order was?

4. Before coming to this agency, did you know what a protection order was? 

(Instruction: Do not read options to participant; probe until there are no further 

responses. Mark all that apply and answer all applicable follow-up questons.) 

Female Friend

If yes, was she from your home country?................. Yes No 

If yes, does she speak your native language?............ Yes No 

Male Friend

If yes, was he from your home country?.................. Yes No 

If yes, does he speak your native language?............. Yes No 

Mother 

Sister 

Father 

Brother 

Cousin 

If yes, was this cousin male or female?................. Male Female 

If yes, was s/he from your home country?................ Yes No 

If yes, does s/he speak your native language?........... Yes No 

Other family member (Specify) 

Someone at my place of work 

If yes, does s/he speak your native language?........... Yes No 

Advocate/Social Work/Community organization staff 

If yes, does s/he speak your native language?........... Yes No 

Attorney/Lawyer 

If yes, does s/he speak your native language?........... Yes No 

Police 

If yes, does s/he speak your native language?........... Yes No

If yes, did the police provide interpretation for you?.. Yes No

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

(Continued...) 

18 5388107305 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

4. Before coming to this agency, did you know what a protection order was? (Continued...) 

Court staff 

If yes, does s/he speak your native language?........... 

If yes, did the court provide interpretation for you?.. 

If yes, did anyone else provide interpretation for you? 

Yes 

Yes 

Yes 

No 

No 

No 

If yes, who? 

Husband Child Other (specify) 

Judge 

If yes, does s/he speak your native language?........... 

If yes, did the judge provide interpretation for you?.. 

If yes, did anyone else provide interpretation for you? 

Yes 

Yes 

Yes 

No 

No 

No 

If yes, who? 

Husband Child Other (specify) 

Health care provider (e.g., doctor, nurse) 

If yes, does s/he speak your native language?........... 

Newspaper, brochure or something else in writing 

If yes, was it written in your native language?......... 

Radio 

Yes 

Yes 

No 

No 

If yes, was it in your native language?................. 

TV 

Yes No 

If yes, was it in your native language?................. 

Religious leader 

If yes, does this person speak your native language?.... 

Yes 

Yes 

No 

No 

Other (specify)

If yes, did this person speak your native language?...... Yes No 

5. What good things did you think would happen if you filed for a protection order? 

(Instruction: this question refers to what she thought before they filed). 

19 0280107301


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

6. What bad things did you think would happen if you filed for a protective order? 

(Instruction: this question refers to what she thought before they filed). 

7. Have you ever filed for a protection order against your partner? Yes No

[if yes, go to 8] 

If No, why not? (Instructions: Do not read options to the participant; mark only one.) 

I don't know about protection orders. 

I don't want to file for a protection order. 

I thought it would make things worse with my partner. 

I don't think it would do any good. 

I'm afraid of what law enforcement (police or immigration officers) would do. 

I didn't think I needed a protection order. 

Yes No 

against your partner (e.g., husband, boyfriend, or girlfriend)? [if no, go to 11] 

8. Within the past 6 months, did you file for a protection order

i.) If yes, how long ago did you first file? 

(Instruction: For the "X" fill in the number of days that temporary protective 

orders are in effect in your jurisdiction, or the number of days from the time 

of filing to the hearing for the full order. Mark only one.) 

Within the past X days (Instruction: Go to ii below) 

More than X days ago (Instruction: Go to iii below) 

ii.) If less than X days ago, do you currently have a temporary Yes No 

 protection order against your partner? 

[if no, go to 9] 

a.) If yes, did you use an interpreter that was provided by

 the program where you filed for the protective order? Yes No 

b.) If yes, did a friend, family member, or other person

 provide interpretation for you? Yes No 

c.) If yes, what changes in your partner have you noticed

 as a result of getting the temporary order?

20 1756107300


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

iii.) If more than X days ago, did you return - at least once ­ Yes No

 to court to get the full protection order?

a.) If no, Why not?

[After answering a), go to 9] 

b.) If yes, did you have an attorney who represented you? Yes No 

c.) If yes, was your partner represented by an attorney? Yes No 

d.) If yes, did you have an advocate go to court with you? Yes No 

e.) If yes, was the advocate permitted to speak in court? Yes No 

f.) If yes, did you use an interpreter that was provided by

 the program where you filed the protective order? 

Yes No 

g.) If yes, did a friend, family member, or other person

 provide interpretation for you? 

Yes No 

h.) If yes, did you tell the judge about what your partner

 did to you or what you wanted from the court? 

Yes No 

i.) If yes, did you present any of the following evidence to the judge beyond your

 talking to the judge? (Instruction: Read each option and mark all that apply.) 

Photographs 

Police Reports 

Testimony of police officer 

Testimony of children 

Testimony of any other person (e.g., witness to abuse,

property damage or injuries) 

Medical records 

Torn clothing 

Damaged property (e.g., burned, broken) 

Transcripts from 911 calls 

Evidence about the effects of violence or abuse on the children 

If yes, what kind of evidence? 

Testimony of child expert witness 

Child's medical records or testimony of child's Counselor or Doctor 

Testimony of child's teacher 

Other (Specify) 

21 1862107308


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

j.) If yes, how many times did you go back to court? # times 

What were the circumstances that led you to go back? 

k.) If yes, did you eventually get a full protective order? Yes No 

1. If yes, did your partner agree or consent to the

issuance of the full protective order? 

Yes No 

2. If yes, did the judge grant you an order after a Yes No 

hearing? 

3. If yes, what changes in your partner have you noticed as a result of getting

the order? 

4. If no, did you voluntarily drop the order? 

4a. Why? 

Yes No 

5. If no, did the judge not issue the order? 

5a. Why do you think the judge didn't issue the order? 

Yes No 

22 3036107303


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

Yes No 

[if yes, go to 3] 

l.) Do you currently have a protection order against your partner? 

1. If no, but had one before, why is the order no longer in effect? 

The order expired 

I asked the judge or court to withdraw the order 

Other (specify) 

2. If no, are you thinking about filing for a protection order? Yes No

2a. If no, Why not? 

3. If yes, how long ago did you obtain the protection order? months 

[OR WEEKS] 

4. If yes, how long was the protection order issed for? months 

5. If yes, what specific things were ordered by the judge in the protection

order 

(Instruction: Read the response categories to the participant; mark all 

that apply by noting if the remedy was contained in the temporary order 

or the full order; mark both options if both apply.) 

In the In the 

Protective Order Remedies... Temporary Order Full Order 

7. Your partner must give up use of the car or other

possessions (If other possessions, give examples).

1. Your partner cannot abuse you or your children. 

2. Your partner must stay away from you. 

3. Your partner cannot contact you in any way (in person,

via phone, email, mail, or through other people). 

4. You can use your home on your own without your partner

staying there. 

5. Your partner must immediately turn over your personal

property/documents. 

6. Your partner must give you access to, or copies of, any

 documents relating to your immigration application. 

(Continued...) 

23 7680107302 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

In the In the 

Protective Order Remedies... Temporary Order Full Order 

8. You are granted custody of your children. 

10. Your partner must have someone supervise him while

 visiting the children. 

9. Your partner is granted visitation with your children. 

11. Your partner cannot remove the children from the

 court's jurisdiction. 

12. Your partner cannot remove the children from the

 United States without a court order. 

13. Your partner must turn over the children's passports

 to you or the court. 

14. Your partner must sign a statement also signed by the

 judge, to inform the relevant embassy or consulate

 that they must not issue a visitor's visa or any other

visas to the child/children without a court order. 

15. Your partner is/was required to provide financial

 support for the children. 

16. Your partner is/was required to provide financial

 support for you. 

17. Your partner is/was required to pay your (or your

 children's) medical expenses or health care costs. 

18. Your partner is/was required to pay for repair of

 property s/he damaged (e.g., broken door, window). 

19. Your partner is/was ordered to attend batterer

 treatment or treatment for anger management. 

20. Your partner is/was ordered to attend drug or alcohol

 counseling. 

21. Your partner's guns or other weapons were removed from

 his/her possession. 

22. Your partner shall do whatever is necessary to ensure

 your application for permanent residency is approved. 

23. Your partner cannot withdraw your application for

 permanent residency, which has been filed by him/her

 (or someone else). 

24. Your partner must pay any fees associated with you

 and/or children's immigration cases. 

25. Your partner cannot contact the immigration

 authorities to report you. 

26. Your partner cannot contact the Consulate or the

 Embassy about your immigration status. 

27. Your partner must sign a form to help obtain his/her

 birth certificate. 

(Continued...) 

24 6190107307 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

In the In the 

Protective Order Remedies... Temporary Order Full Order 

28. Your partner must sign a form to request information

 from an immigration case s/he filed. 

29. Your partner must turn over to the court copies of

 documents about previous marriages and divorces,

 including where each occurred. 

30. Other things ordered? 

6. If yes, what changes have you noticed in your partner since getting the

temporary order? 

7. If yes, what changes have you noticed in your partner since getting the

full order? 

8. If yes, what things would have been helpful to you, but were not included in

your temporary order? 

9. If yes, what things would have been helpful to you, but were not included in

your full order? 

25 9504107309


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

9. Overall, how helpful was the court staff and judge when you filed for a protection

order? 

(Instruction: Utilize the Visual Card to assist the subject in selecting the 

correct response and note the answer below). 

A Little Helpful 

Pick one: Helpful 

Very

Helpful 

Not 

Helpful 

How Helpful... Not A Little Helpful Very

Helpful Helpful Helpful 

9. Overall, how helpful was the court staff and

 judge when you filed for a protection order? 

i.) What was good or helpful about the process? 

ii.) What would you have liked to make it better? 

iii.) How was the process of filing for a protection order different from

 what you had expected? 

26 7047107309


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

10. Overall, how helpful is or was the protection order? 

(Instruction: Utilize the Visual Card to assist the subject in selecting the 

correct response and note the answer below). 

Pick one: 

A Little 

Helpful 

Helpful Very

Helpful 

Not 

Helpful 

How Helpful... Not 

Helpful 

A Little 

Helpful 

Helpful Very

Helpful 

10. How helpful is or was the protection order? 

i.) What was good or helpful about the process? 

ii.) What would you have liked to make it better? 

iii.) How was the process of filing for a protection order different from

 what you had expected? 

11. Would you recommend that another woman you know get a protection Yes No

 order? 

i.) Why or why not? 

12. Did you feel that getting a protection order would put you in Yes No

 more danger for any reason? 

i.) If yes, why did you think it would put you in more danger? 

27 2462107305


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

13. During the past 6 months, has your partner done any of the following? 

(Instruction: All participants should answer this question. Read all options and mark 

Yes/No/NA (Not applicable) to indicate if the partner did what is indicated and Yes/No 

to indicate if a protection order was in effect at the time). 

Yes No 

1. Used physical abuse toward you. Yes No NA If yes, did you have a

protection order at the time? 

If yes, did you have a

protection order at the time?

Yes No 

2. Refused to stay away from you even Yes No NA

 though you asked him/her to or

 s/he was ordered to do so. 

3. Had contact with you (in person or

 via phone, email, mail, or through

 other people) even though you

 asked him/her not to or s/he was

 ordered not to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

Yes No 

5. Returned to your home even though Yes No NA

 you asked him/her not to or s/he

 was ordered not to. 

If yes, did you have a

protection order at the time? 

Yes No 

6. Kept your personal Yes No NA

 property/documents when s/he was

 supposed to give them to you. 

If yes, did you have a

protection order at the time? 

If yes, did you have a

protection order at the time?

Yes No 

7. Refused to give you access to, or Yes No NA

 copies of, any documents

 supporting your immigration

 application even though you asked

 him/her to or s/he was ordered to. 

8. Continued to use the car or other

 possessions even though you asked

 him/her not to or s/he was ordered

 not to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

If yes, did you have a

protection order at the time?

Yes No 

9. Refused to give you access to your Yes No NA

 children even though you have

 custody. 

Yes No 

If yes, did you have a

protection order at the time? 

10. Did not follow required Yes No NA

 supervision (or other conditions,

 e.g. return times, no contact with

 you during exchange of children)

 when visiting the children. 

If yes, did you have a

protection order at the time?

Yes No 

11. Removed the children from the Yes No NA

 court's jurisdiction when there

 was an order not to. 

(Continued...) 

4. Stayed at your home (even if you

 asked him/her to leave or s/he was

 ordered to leave) and you now

 share it with him/her. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

28 4661107308


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

Yes No 

12. Removed the children from the Yes No NA

 United States when there was an

 order not to. 

If yes, did you have a

protection order at the time? 

13. Did not turn over the children's

 passports to you or the court even

 though ordered to do so. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

14. Sought a visitor's visa or any

 other visas for the children from

 an embassy or consulate. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

15. Did not provide financial support

 for the children even though you

asked or s/he was ordered to do

 so. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

Yes No 

If yes, did you have a

protection order at the time? 

16. Did not provide you with financial Yes No NA

 support even though you asked or

 s/he was ordered to do so. 

If yes, did you have a

protection order at the time?

Yes No 

17. Did not pay your (or your Yes No NA

 children's) medical expenses or

 health insurance costs even though

 you asked or s/he was ordered to

 do so. 

18. Did not pay for repair of property

 s/he damaged (e.g., broken door,

 window) even though you asked or

 s/he was ordered to do so. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

19. Did not attend batterer treatment

 or treatment for anger management

 program, even though ordered to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

20. Did not attend drug or alcohol

 counseling, even though ordered

 to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

21. Did not give up his/her gun(s) or

 other weapons from his or her

 possession, even though ordered

 to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

22. Withdrew your application for

 permanent residency, which had

 been filed on your behalf. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

23. Interfered in some other way with

 your application for permanent

 residency being approved. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

24. Did not pay fees associated with

 your or children's immigration

 cases, even though ordered to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

25. Called the immigration authorities

 to report you. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

(Continued...) 

29 1840107304


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

Yes No 

26. Contacted the U.S. Consulate, or Yes No NA

 the Embassy about your immigration

 status. 

If yes, did you have a

protection order at the time? 

If yes, did you have a

protection order at the time?

Yes No 

27. Did not sign a form to help obtain Yes No NA

 his/her birth certificate even

 though ordered to. 

Yes No 

If yes, did you have a

protection order at the time? 

28. Did not sign a form to request Yes No NA

 information from an immigration

 case s/he filed, even though

 ordered to. 

29. Did not turn over copies of

 documents about previous marriages

 and divorces, including where each

 occured, even though ordered to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

30. Was there anything else s/he was

 ordered to do that s/he did not

 do? If yes, specify. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

14. If yes to any items above, did you do any of the following when your partner [did

 this/these things]? 

1. Told someone about it (i.e., the abuse/violation) Yes No 

[if no, go to 1d] 

1a. If yes, whom did you tell? 

(Instruction: Do not read options to participant; probe until there are no further 

responses. Mark all that apply and answer all applicable follow-up questons.) 

Female Friend 

If yes, was she from your home country?................. 

If yes, does she speak your native language?............ 

Male Friend 

Yes 

Yes 

No 

No 

If yes, was he from your home country?.................. 

If yes, does he speak your native language?............. 

Mother 

Yes 

Yes 

No 

No 

Sister 

Father 

Brother 

(Continued...) 

30 7422107306 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 

Cousin 

If yes, was this cousin male or female?................. Male Female 

If yes, was s/he from your home country?................ Yes No 

If yes, does s/he speak your native language?........... Yes No 

0 1

Other family member (Specify) 

Someone at my place of work 

If yes, does s/he speak your native language?........... Yes No 

Advocate/Social Work/Community organization staff 

If yes, does s/he speak your native language?........... Yes No 

Attorney/Lawyer 

If yes, does s/he speak your native language?........... Yes No 

Police 

If yes, does s/he speak your native language?........... Yes No

If yes, did the police provide interpretation for you?.. Yes No

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

If yes, did you go to the police so they would make an

arrest?................................................. Yes No 

If yes, did you go to the police so that they would make

a report, even though you didn't want them to arrest

your partner?........................................... Yes No 

Court staff 

If yes, does s/he speak your native language?........... Yes No

If yes, did the court provide interpretation for you?.. Yes No

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

Judge 

If yes, does s/he speak your native language?........... Yes No

If yes, did the judge provide interpretation for you?.. Yes No

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

(Continued...) 

31 3123107300 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 

Health care provider (e.g., doctor, nurse) 

If yes, does s/he speak your native language?................ 

Religious leader 

If yes, does this person speak your native language?......... 

Yes 

Yes 

No 

No 

Other (specify) 

If yes, did this person speak your native language?........... 

1b. If yes, how do you feel after you told someone? 

Yes No 

0 1

1c. If yes, was their response helpful to you in some way?...... Yes No 

1d. If no, tell us the reason(s) you decided not to tell anyone? 

1e. If no, is there something that would have helped you decide

 to tell someone?............................................. Yes No 

If yes, What? 

2. Kept a journal or calendar of your partner's violations of the Yes No 

protection order/abuse?..................................... [if no, go to 2e] 

2a. If yes, what are the reasons you decided to do this? 

(Continued...) 

32 3193107307 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
0 1

ID# 

2b. If yes, how did it make you feel to do this? 

2c. If yes, what good things happened when you did this? 

2d. If yes, what bad things happened when you did this? 

2e. If no, what are the reasons you decided not to do this? 

3. Kept letters, emails, or phone recordings of your partner's Yes No 

violations of the protective order/abuse?..................... [if no, go to 3e] 

3a. If yes, what are the reasons you decided to do this? 

3b. If yes, how did it make you feel to do this? 

3c. If yes, what good things happened when you did this? 

(Continued...) 

33 8325107309 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
0 1

ID#

3d. If yes, what bad things happened when you did this? 

3e. If no, what are the reasons you decided not to do this? 

4. Documented the impact on the violation of the protection Yes No 

 order/abuse on you or your children?..................... [if no, go to 4f] 

4a. If yes, how did you do this? 

Photographs 

Tell a doctor, nurse, or counselor so they would write it in your medical record 

Told a friend about the abuse 

Was the friend Male Female 

Other (Specify)

4b. If yes, what are the reasons you decided to do this?

4c. If yes, how did it make you feel to do this? 

4d. If yes, what good things happened when you did this? 

34 7156107300


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
0 1

ID#

4e. If yes, what bad things happened when you did this? 

4f. If no, what are the reasons you decided not to do this? 

5. Called police to have them make an arrest for violation of Yes No 

protection order/abuse?..................................... [if no, go to 5e] 

5a. If yes, what are the reasons you decided to do this? 

5b. If yes, how did it make you feel to do this? 

5c. If yes, what good things happened when you did this? 

5d. If yes, what bad things happened when you did this? 

5e. If no, what are the reasons you decided not to do this? 

35 1460107302


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

6. Called police to report violations of protection order/abuse Yes No 

 not to make an arrest or have the police do anything?......... [if no, go to 6e] 

6a. If yes, what are the reasons you decided to do this? 

6b. If yes, how did it make you feel to do this? 

6c. If yes, what good things happened when you did this? 

6d. If yes, what bad things happened when you did this? 

6e. If no, what are the reasons you decided not to do this? 

36 3647107301


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

VII. Posttraumatic Stress Disorder Checklist (PCL) and Center for 

Epidemiological Studies-Depression Scale (CES-D) 

Script: The next set of statements ask about your feelings during the past month. For 

each statement, point to the place on the scale between "Never" and "All The Time" 

that shows how often during the past month that you have had this feeling. There is 

no right or wrong answer, just the way you feel. 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

Never Rarely Some 

Times 

All The 

Time 

In the past month, how often have you... Never Rarely Some All The 

Times Time 

1. Had repeated, disturbing memories, thoughts, or images

 of the abuse? 

2. Had repeated disturbing dreams about the abuse? 

3. Suddenly acted or felt as if the abuse was happening

 again (as if you were reliving it)? 

4. Felt very upset when something reminded you of the

 abuse? 

5. Had physical reactions (e.g., heart pounding, trouble

 breathing, sweating) when something reminded you of the

 abuse? 

6. Avoided thinking about or talking about the abuse? 

7. Avoided activities or situations because they reminded

 you of the abuse? 

8. Had trouble remembering important parts of the abuse? 

9. Felt a loss of interest in activities that you used to

 enjoy? 

10. Experienced feeling distant or cut off from other people? 

11. Felt unable to have loving feelings for those close to

 you? 

12. Been upset by things that usually don't bother you? 

13. Did not feel like eating; your appetite was poor? 

14. Could not stop feeling bad even with help from my family

15. Felt that you were just as good as other people? 

(Continued...) 

37 4011107307 

 or friends? 

16. Had trouble keeping your mind on what you were doing? 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

In the past month, how often have you... Never Rarely Some All The 

Times Time 

17. Felt depressed? 

18. Felt that everything you did was an effort? 

20. Thought your life had been a failure? 

19. Felt hopeful about the future? 

22. Slept restlessly? 

21. Felt fearful? 

24. Talked less than usual? 

23. Felt happy? 

26. Felt that people were unfriendly? 

25. Felt lonely? 

28. Had crying spells? 

27. Enjoyed life? 

30. Felt that people disliked you? 

29. Felt sad? 

32. Had trouble finishing daily tasks? 

31. Felt like everything takes an effort? 

38 6948107308


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

VIII. Exposure to Other Traumatic Events 

Script: We're almost finished. Next, I'm going to ask you about things that may or 

may not have happened to you at any time in your life. Answer "Yes" or "No" to 

indicate if it ever happened to you. Then we will ask when and how often these things 

happened to you. 

1. At any time in your life, has anyone else [other than your

 partner] hit you on a part of your body other than the bottom Yes No with something like a belt, hairbrush, stick, or other hard

 object? 

1a. How old were you when this first happened?...................... Age:

1b. How old were you the last time this happened?................... Age:

1c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

2. At any time in your life, has anyone [other than your

 partner] thrown or knocked you down, hit you with a fist or Yes No 

 kicked you hard, beat you up, or grabbed you around the neck

 and choked you? 

2a. How old were you when this first happened?...................... Age:

2b. How old were you the last time this happened?................... Age:

2c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

3. At any time in your life, has anyone [other than your

 partner] ever made you do anything sexual (have intercourse, Yes No 

 touching, etc.) when you did not want to? 

3a. How old were you when this first happened?...................... Age:

3b. How old were you the last time this happened?................... Age:

3c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

39 0174107303


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

4. At any time in your life, have you been in a natural disaster

 such as an earthquake, flood, fire, tornado, or Yes No 

 hurricane/typhoon? 

4a. How old were you when this first happened?...................... Age: 

4b. How old were you the last time this happened?................... Age: 

4c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

5. At any time in your life, have you been in a war zone? Yes No 

5a. How old were you when this first happened?...................... Age: 

5b. How old were you the last time this happened?................... Age: 

5c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

6. At any time in your life, have you been involved in a serious Yes No

 accident? 

6a. How old were you when this first happened?...................... Age: 

6b. How old were you the last time this happened?................... Age: 

6c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

7. At any time in your life, have you been threatened with or Yes No harmed with a weapon such as a gun or knife? 

7a. How old were you when this first happened?...................... Age: 

7b. How old were you the last time this happened?................... Age: 

7c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

40 6687107308


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

8. At any time in your life, have you been held captive against Yes No

 your will? 

8a. How old were you when this first happened?...................... Age: 

8b. How old were you the last time this happened?................... Age: 

8c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

9. At any time in your life, have you been present when another Yes No

 person was raped, beaten, or killed? 

9a. How old were you when this first happened?...................... Age: 

9b. How old were you the last time this happened?................... Age: 

9c. How many times has this happened in your life?...... Number of times: 

Too many to count: 

10. At any time in your life, have you witnessed or been exposed Yes No to physical abuse between adults in the house you grew up in? 

10a. How old were you when this first happened?..................... Age: 

10b. How old were you the last time this happened?.................. Age: 

10c. How many times has this happened in your life?..... Number of times: 

Too many to count: 

41 4206107303


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

IX. Social Support Scale 

Script: Lastly, I'm going to ask about the support you have from family and friends 

(other than the partner that is abusing you). For each statement, point to the place 

on the scale between "Not True" and "True" that shows how true the statement is for 

you. Do you have any questions? 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct

response.)

Mostly

As of now... Not Not Mostly

True True True True 

Pick one: 

Not 

True 

Mostly

Not 

True 

Mostly

True 

True 

1. There is at least one person I know whose advice I can

 really trust. 

2. When I need suggestions for how I deal with a personal

 problem I know there is someone I can turn to. 

3. There is someone I can turn to for advice about handling

hassles over household responsibilities. 

5. There is someone I could turn to for advice about

 changing my job or finding a new one. 

4. If a family crisis arose not many of my friends would be

 able to give me good advice about handling it. 

6. If I had to go out of town for a few weeks, someone I

 know would look after my home (the plants, pets, yard,

 children, etc.) 

7. If I needed a quick emergency loan of $100, there is

 someone I could get it from. 

8. If I needed some help in moving to a new home, I would

 have a hard time finding someone to help me. 

 finding anyone to take me. 

9. If I were sick, there would be almost no one I could

 find to help me with my daily chores. 

10. If I needed a ride somewhere, I would have a hard time

42 8888107303


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 1

END OF QUESTIONNAIRE 

Conclusion/Debriefing Script: Thank you very much for your time. Your participation 

is very important to this study, which will help understand how to better serve 

battered immigrant women as they seek to obtain protection orders. As we noted 

before, we will want to talk with you one more time (a follow-up interview), in about 

3-4 months, sometime in [name month], to ask similar questions and find out how you 

are doing. 

If you would like to talk to someone after having completed this questionnaire, [NAME 

- person at the partner organization] is available to speak with you. I am also going 

to give you a list of local and national organizations that can assist you; these 

resources include domestic violence hotlines and social service agencies. Please 

call upon these resources and [NAME] if you need any help; they are here to help you. 

I would like to go ahead and schedule a date for the follow-up interview. This date 

can be changed later if it will not work for you. I will call 2 months before the 

scheduled follow-up interview to confirm your contact information, 1 week before hand 

to confirm the scheduled appointment, and 1 day before to remind you of the 

appointment. 

Do you have any questions about the questionnaire, the follow-up interview, or

anything else? Is there anything else you would like to tell me?

Interviewer's Impressions: (Instruction: Note your impression of the interview, 

i.e., level of participant engagement, participant demeanor, unusual or unique 

participant circumstances, special considerations for follow-up, or other issues 

that might be noteworthy.) 

43 1048107304


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
I. Demographics 

13. How important is your religi

Not very Moderately Very 

important important importan

A-44

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-45

I. Demographics 15. What is your total family inc

(i.e., income for everyone living in your 

None $0 - $9,999 $10,000 - $14,999 $15,000 - $24,999 $25,000 - $34,999 $35,000 - $49,999 $50,000 - $64,999 $65,000 and over 

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-46

I. Demographics 18. What is your present person

None$0 - $9,999$10,000 - $14,999$15,000 - $24,999$25,000 - $34,999$35,000 - $49,999$50,000 - $64,999$65,000 and over

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-47

I. Demographics 29. What is your immigration st

U.S. citizen (U.S. born) Naturalized citizen (Foreign born) Lawful permanent resident (Permanent visa, green card) Undocumented (Persons without legal permissio

the United States either because inspection or because they had eoverstayed or violated the terms 

Temporary (Conditional resident,Legal non

e.g., student,work, tourist, tempovisa. Have permission from the or study in the U.S. Status is limdependant upon a specific familirelationship, or is designed to ofpersons due to conditions in thei

Refugee/Asylee Don’t know 

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-48

I. Demographics 31. What is your partner’s immigra

U.S. citizen (U.S. born) Naturalized citizen (Foreign born) Lawful permanent resident (Permanent visa, green card) Undocumented (Persons without legal permissio

the United States either because inspection or because they had eoverstayed or violated the terms 

Temporary (Conditional resident,Legal non

e.g., student,work, tourist, tempovisa. Have permission from the or study in the U.S. Status is limdependant upon a specific familirelationship, or is designed to ofpersons due to conditions in thei

Refugee/Asylee Don’t know 

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
II. Stephenson Multigroup Accu

Scale (SMAS) 

NOT 

TRUE

MOSTLY 

NOT TRUE

MOSTLY 

TRUE

A-49

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
III. Psychological Maltreatment 

Inventory 

NEVER SOME OFTEN 

TIMES 

A-50

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-51

IV. Conflict Tactics Scale 

• Once or twice during the last year 

(seldom or rarely) 

• 3-10 times during the last year 

(sometimes) 

• More than 10 times during the last y

(often or all the time) 

• This has happened before, but not in • This has never happened. 

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
V. IPV Threat Appraisal Scale a

Scale 

Not At 

All 

Some 

Likelihood 

High 

Likelihoo

A-52

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-53

V. IPV Threat Appraisal Scale aScale 17. How worried are you about yourself safe? 

Not

Worried

A Little

Worried

Somewha

Worried 

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-54

V. IPV Threat Appraisal Scale aScale 18. How worried are you about your children safe? 

Not

Worried

A Little

Worried

Somewha

Worried 

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-55

VI. Pathway to Services and Expwith Protection Orders 9. Overall, how helpful was the cand judge when you filed for a porder? 

Not A Little Helpful 

Helpful Helpful 

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
A-56

VI. Pathway to Services and Expwith Protection Orders 10. Overall, how helpful is or waprotection order? 

Not A Little Helpful 

Helpful Helpful 

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
VII. PCL and CES-D 

NEVER RARELY SOME

TIMES

A-57

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
IX. Social Support Scale

NOT

TRUE

MOSTLY

NOT TRUE 

MOSTLY

TRUE

A-58

This document is a research report submitted to the U.S. Department of Justice. This repo

been published by the Department. Opinions or points of view expressed are those of the 

and do not necessarily reflect the official position or policies of the U.S. Department of J
APPENDIX B 

COSMOS Study Questionnaire and Visual Aids 

(Follow-Up Questionnaire) 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
1

0 2

ID# 0 2

COSMOS STUDY QUESTIONNAIRE 

Follow-Up Interview 

Introduction Script: I appreciate your willingness to complete the second interview for the study about how battered 

immigrant women use protection orders to protect themselves and their children from a partner. In this second 

interview we will be referring to the same partner that we talked about during the last interview for this study. As you 

know we are interested in understanding the barriers women face when trying to get protection orders, and whether or 

not protection orders work for the women. I am going to ask you some questions that are similar to the ones I asked 

during the last interview for this study so that we can see how things have been going since that time. What you tell me 

will be held in strict confidence, and this information will not be shared with the police, the immigration authorities, or 

any of your friends or family. Your name or other identifying information will be stored separately from the 

questionnaire under lock and key. If you do not feel comfortable answering a question, you do not have to give an 

answer; we can just skip to the next question. As a reminder, there are two possible risks to the confidentiality of the 

data collected during the study. First, if you tell us about a child who is being abused or about your intent to hurt 

someone, we are required by law to report that information to the authorities. Second, if your partner finds out about 

your participation in the study you could be at increased risk of violence or other forms of retaliation from your partner. 

The first set of questions I'm going to ask are about how your situation might have changed since we last talked to you 

for this study. 

Instruction: Remind participant that all questions about their "partner" refer to the person we talked about during the 

previous interview for this study. Ask what this partner's name is, and refer to this name when asking questions about 

the partner. This will help eliminate confusion about which person we are asking about when we refer to their "partner." 

Instruction: In most cases where questions have multiple response categories, the categories are NOT to be read to the 

participant. We have highlighted - in gray - the few cases where response categories are to be read to the participant. 

Date of Interview: 

I. Demographics 

1. What is your present work situation? (Instruction: Do not read options to participant;

 mark only one answer.) 

Working full-time (one workplace) Unemployed 

Working full-time (multiple workplaces) On maternity/parental benefit 

Working part-time (one workplace) On social assistance 

Working part-time (multiple workplaces) Don't Know 

Self-employed or business owner Other 

/ / 

1 2968316623


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

2. What is your relationship with your partner? (Instruction: This is different than living

 arrangement, which is addressed in No. 3; do not read options to participant; mark only one

 answer.)

Dating - not living together Never legally married (single) 

Child in common, but not dating or married Legally separated, but not divorced 

Legally married Separated from common-law partner 

Legally married but separated Divorced 

legally married (i.e. common-law partner) 

Consider yourself married, though not 

 3. What is the current living arrangement with your partner? (Instruction: Do not read

 options to participant; probe until there are no further responses. Mark only one answer and

 answer follow-up questions.) 

Living together full time 

If yes: 

His/Her place 

Your place 

Your and His/Her place 

Other 

Living together part time or on/off: 

If yes: 

His/Her place 

Your place 

Your and His/Her place 

Other 

Not living together 

4. What do you plan to do regarding your relationship? (Instruction: Do not read options to

 participant; mark only one answer.) 

Plans to remain in the relationship

Plans to leave the relationship

Plans to return to the relationship

Plans to remain out of the relationship

Not sure

2 4625316625


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

 5. Have you filed any of the following immigration papers?

(Instruction: Mark all that apply.) 

Naturalization

Lawful permanent residency

VAWA self-petition

VAWA cancellation

U Visa

T Visa

Other (specify):

Did not file immigration papers

 6. Who filed the immigration papers? (Instruction: Mark only one answer.) 

I did

My husband did

Did not file immigration papers; not appliable.

 7. Did you file before or after the last interview we conducted for this study? 

(Instruction: Mark only one answer.) 

Before the last interview

After the last interview

Did not file for immigration papers; not applicable

 8. Was your application approved? 

Yes

No

Not Applicable

3 6990316622


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

II. Psychological Maltreatment of Women Inventory 

Script: Now, I'm going to read you statements about things your partner may have done 

to you since we last interviewed you in [month]. By "partner" we are talking about 

[name]. For each statement, point to the place on the scale that shows how often the 

event occurred since we last interviewed you for this study. 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

Never Some 

Times 

Often Very

Often 

Since we last interviewed you for this study in Never Some Often Very

[month]... Times Often 

1. S/he called you a bad name, swore, yelled or screamed at

you. 

2. S/he treated you like less than s/he was. 

3. S/he watched over your activities or insisted you tell

 him/her where you were at all times. 

4. S/he used your money or made important financial

 decisions without talking to you about it. 

5. S/he was jealous or suspicious of your friends. 

6. S/he accused you of having an affair with another

man/woman. 

7. S/he interfered with your relationships with family or

 community members. 

8. S/he tried to keep you from doing things to help

yourself (such as learning English, getting a job,

exercising, etc.). 

9. S/he controlled your use of the telephone. 

10. S/he told you that your feelings were crazy. 

11. S/he blamed you for his/her problems. 

12. S/he told you s/he would or actually took your children

away. 

13. S/he told you s/he would or actually threw or locked you

out of the house. 

14. S/he told you s/he would or actually locked you in the

house or in a room in the house. 

15. S/he told you s/he would take away or not give you money. 

16. S/he told you s/he would or actually turned you in to

immigration officials. 

17. S/he told you s/he would or actually failed to file or

withdrew immigration papers for you or your children. 

18. S/he told you s/he would hurt you or your unborn child

when you were pregnant. 

19. S/he destroyed your property. 

4 0379316627


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

III. Conflict Tactics Scale (CTS-2) 

Script: No matter how well a couple gets along, there are times when they disagree, 

get annoyed with each other, want different things from each other, or just have 

arguments or fights. I'm going to list some things that might happen when you have 

differences with your partner. By partner we mean [name]. For each thing, tell me 

how many times your partner did these things since we last interviewed you in [month]. 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct

response.)

Number of times since last interview 

Happened 

Since we last interviewed you for this but not 

since last Never 

study in [month]... 1-2 3-10 10+ interview Happened

1. S/he grabbed me. 

3. S/he threw something at me that could hurt. 

5. S/he twisted my arm. 

7. S/he kicked me. 

9. S/he punched or hit me with something that

could hurt. 

11. S/he choked me. 

13. S/he used or told you s/he would use a

knife or gun. 

15. S/he forced me to have sex. 

17. I had sex with him/her because I was

afraid of what s/he would do if I didn't. 

him/her. 

2. S/he pushed me. 

4. S/he slapped me. 

6. S/he pulled my hair. 

8. S/he beat me up. 

10. S/he slammed me against a wall. 

12. S/he burned me on purpose. 

14. S/he used physical force against me when I

was pregnant. 

16. S/he refused to wear a condom during sex. 

18. I felt physical pain that still hurt the

 next day because of his/her abuse. 

19. I had a bruise or cut because of his/her

abuse. 

20. I passed out from being hit so hard by

(Continued...) 

5 7940316628 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

III. Conflict Tactics Scale (CTS-2) (Continued...)

Number of times since last interview 

Happened 

but not Since we last interviewed you for this since last Never 

study in [month]... 1-2 3-10 10+ interview Happened 

21. I had a broken bone from his/her abuse. 

22. I went to the doctor because of his/her

abuse. 

23. I have permanent scars because of his/her

 past abuse. 

24. I have physical health problems now because

 of his/her abuse. 

25. I have emotional problems now because of

 his/her abuse. 

6 1599316622


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

IV. IPV Threat Appraisal Scale and Fear Scale 

Script: I'm going to ask you how likely you think it is that your partner will do 

certain things in the next year. By "partner" we are talking about [name]. For each 

statement, point to the place on the scale between "Not At All" and "Definitely" that 

shows how likely you think it is that the event will happen. There is no right or 

wrong answer; just the way you feel. Do you have any questions before we begin? 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

High

Likelihood 

Some 

Likelihood 

Not At 

All Definitely 

In the next year, how likely do you Not Some High

think it is that your partner will... At All Likelihood Likelihood Definitely 

1. Threaten to harm you physically. 

2. Actually physically harm you. 

3. Force you to have sex against your will. 

4. Try to kill you. 

5. Control or dominate you. 

6. Embarrass you. 

7. Take away your money. 

8. Tell you s/he will physically harm someone you

know, such as friends, co-workers, parents,

etc. 

9. Actually physically harm someone you know,

 such as friends, co-workers, parents, etc. 

10. Call immigration authorities to get you in

trouble. 

11. Call police to get you in trouble. 

12. Throw or lock you out of the house or room. 

13. Destroy your property or important documents. 

14. Violate a protective order. 

15. Track you down or find you. 

16. Try to take away, get custody, or kidnap your

child or children. 

17. Not sponsor petition for green card or visa

for you or your children. 

7 8363316628


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

Script: For the next two questions, point to the place on the scale that indicates how

worried you are. 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

A Little 

Worried 

Somewhat 

Worried 

Very 

Worried 

Not 

Worried 

How worried are you... Not A Little Somewhat Very

Worried Worried Worried Worried 

18. How worried are you about keeping yourself safe? 

19. How worried are you about keeping your children

safe? 

8 2170316628


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

V. Pathway To Services And Experience With Protective Orders 

Script: The next set of questions I'm going to ask are about your decision whether or 

not to file for a protection order, and how happy you are with the process for 

getting a protection order. There are no right or wrong answers; just what has been 

your experience. 

1. Since we last interviewed you for this study in [month], did you Yes No

file for a protection order against your partner (e.g., husband,

boyfriend, or girlfriend)? By "partner" we are talking about [if no, go to 5

 [name]. on page 16.] 

1.1) If yes, how long ago did you first file? 

(Instruction: For the "X" fill in the number of days that temporary protective 

orders are in effect in your jurisdiction, or the number of days from the time 

of filing to the hearing for the full order. Mark only one.) 

Within the past X days (Instruction: Go to 1.2 below) 

More than X days ago (Instruction: Go to 1.3 below) 

1.2) If less than X days ago, do you currently have a temporary Yes No 

 protection order against your partner? 

[if no, go to 3

on page 15.] 

1.2a) If yes, did you use an interpreter that was provided by

 the program where you filed for the protective order? Yes No 

1.2b) If yes, did a friend, family member, or other person

 provide interpretation for you? Yes No 

1.2c) If yes, what changes in your partner have you noticed

 as a result of getting the temporary order?

1.3) If more than X days ago, did you return - at least once ­ Yes No 

 to court to get the full protection order? 

1.3a) If no, why? 

[After answering a), go to 2 on page 11.] 

[If yes, go to 1.3b on page 10]. 

(Continued...) 

9 0709316624 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

1.3b) If yes, did you have an attorney who represented you? Yes No 

1.3c) If yes, was your partner represented by an attorney? Yes No 

1.3d) If yes, did you have an advocate go to court with you? Yes No 

1.3e) If yes, was the advocate permitted to speak in court? Yes No 

1.3f) If yes, did you use an interpreter that was provided

 by the program where you filed the protective order? 

Yes No 

1.3g) If yes, did a friend, family member, or other person

 provide interpretation for you? 

Yes No 

1.3h) If yes, did you tell the judge about what your

 partner did to you or what you wanted from the court? 

Yes No 

1.3i) If yes, did you present any of the following evidence to the judge beyond

 your talking to the judge? (Instruction: Read each option and mark all that

 apply.) 

Photographs 

Police Reports 

Testimony of police officer 

Testimony of children 

Testimony of any other person (e.g., witness to abuse,

property damage or injuries) 

Medical records 

Torn clothing 

Damaged property (e.g., burned, broken) 

Transcripts from 911 calls 

Evidence about the effects of violence or abuse on the children 

If yes, what kind of evidence? 

Testimony of child expert witness 

Child's medical records or testimony of child's counselor or doctor 

Testimony of child's teacher 

Other (Specify) 

1.3j) If yes, how many times did you go back to court? # times 

What were the circumstances that led you to go back? 

10 8190316626


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

1.3k) If yes, did you eventually get a full protective order? Yes No 

1. If yes, did your partner agree or consent to the

issuance of the full protective order? 

Yes No 

2. If yes, did the judge grant you an order after a Yes No 

 hearing? 

3. If yes, what changes in your partner have you noticed as a result of getting

 the order? 

4. If no, did you voluntarily drop the order? 

4a. Why? 

Yes No 

5. If no, did the judge not issue the order? 

5a. Why do you think the judge didn't issue the order? 

Yes No 

2.) Do you currently have a protection order against your partner? Yes No 

[if yes, go to 3] 

2.1 If no, but had one before, why is the order no longer in effect? 

The order expired 

I asked the judge or court to withdraw the order 

Other (specify) 

2.2 If no, are you thinking about filing for a protection order? Yes No

2a. If no, Why not? 

2.3 If yes, how long ago did you obtain the protection order? months 

[OR WEEKS] 

2.4 If yes, how long was the protection order issed for? months 

11 9697316629


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

2.5 If yes, what specific things were ordered by the judge in the protection

order (Protection Order Remedies)? 

(Instruction: Read the response categories to the participant; mark all that apply by 

noting if the remedy was contained in the temporary order or the full order; mark both 

options if both apply.) 

In the In the 

Protective Order Remedies... Temporary Order Full Order 

2.5.3 Your partner cannot contact you in any way (in

person, via phone, email, mail, or through other

people). 

2.5.5 Your partner must immediately turn over your personal

property/documents. 

application. 

2.5.7 Your partner must give up use of the car or other

 possessions (If other possessions, give examples). 

2.5.1 Your partner cannot abuse you or your children. 

2.5.2 Your partner must stay away from you. 

2.5.4 You can use your home on your own without your

partner staying there. 

2.5.6 Your partner must give you access to, or copies of,

any documents relating to your immigration

2.5.8 You are granted custody of your children. 

2.5.9 Your partner is granted visitation with your children. 

2.5.10 Your partner must have someone supervise him/her

while visiting the children. 

2.5.11 Your partner cannot remove the children from the

court's jurisdiction. 

2.5.12 Your partner cannot remove the children from the

United States without a court order. 

2.5.13 Your partner must turn over the children's passports

to you or the court. 

2.5.14 Your partner must sign a statement also signed by the

 judge, to inform the relevant embassy or consulate

 that they must not issue a visitor's visa or any

other visas to the child/children without a court

order. 

(Continued...) 

12 1364316622 

2.5.15 Your partner is/was required to provide financial

support for the children. 

2.5.16 Your partner is/was required to provide financial

support for you. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

In the In the 

Protective Order Remedies... Temporary Order Full Order 

2.5.17 Your partner is/was required to pay your (or your

children's) medical expenses or health care costs.

2.5.18 Your partner is/was required to pay for repair of

property s/he damaged (e.g., broken door, window). 

2.5.19 Your partner is/was ordered to attend batterer

treatment or treatment for anger management. 

2.5.20 Your partner is/was ordered to attend drug or alcohol

counseling. 

2.5.21 Your partner's guns or other weapons were removed

from his/her possession. 

2.5.22 Your partner shall do whatever is necessary to ensure

your application for permanent residency is approved. 

2.5.23 Your partner cannot withdraw your application for

permanent residency, which has been filed by him/her

(or someone else). 

2.5.24 Your partner must pay any fees associated with you

and/or children's immigration cases. 

2.5.25 Your partner cannot contact the immigration

 authorities to report you. 

2.5.26 Your partner cannot contact the Consulate or the

Embassy about your immigration status. 

2.5.27 Your partner must sign a form to help obtain his/her

birth certificate. 

2.5.28 Your partner must sign a form to request

 information from an immigration case s/he filed. 

2.5.29 Your partner must turn over to the court copies of

 documents about previous marriages and divorces,

including where each occurred. 

2.5.30 Other things 

13 3157316624


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

2.6 If yes, what changes have you noticed in your partner since getting the

temporary order? 

2.7 If yes, what changes have you noticed in your partner since getting the

full order? 

2.8 If yes, what things would have been helpful to you, but were not included

 in your temporary order? 

2.9 If yes, what things would have been helpful to you, but were not included

 in your full order? 

14 2786316621


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

3. Overall, how helpful was the court staff and judge when you filed for a protection

 order? 

(Instruction: Utilize the Visual Card to assist the subject in selecting the 

correct response and note the answer below). 

A Little Helpful 

Pick one: Helpful 

Very

Helpful 

Not 

Helpful 

Not A Little Helpful Very

Overall, how helpful are or were the court staff Helpful Helpful Helpful 

and judge when you filed for a protection order? 

3.1) What was good or helpful about the process? 

3.2) What would you have liked to make it better? 

3.3) How was the process of filing for a protection order different from

 what you had expected? 

15 0782316625


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

4. Overall, how helpful is or was the protection order? 

(Instruction: Utilize the Visual Card to assist the subject in selecting the 

correct response and note the answer below). 

Pick one: 

A Little 

Helpful 

Helpful Very

Helpful 

Not 

Helpful 

Not 

Helpful 

A Little 

Helpful 

Helpful Very

Helpful 

How helpful is or was the protection order? 

4.1) What was good or helpful about the process? 

4.2) What would you have liked to make it better? 

4.3) How was the process of filing for a protection order different from

 what you had expected? 

5. Would you recommend that another woman you know get a protection Yes No order? 

5.1) Why or why not? 

6. Did you feel that getting a protection order would put you in Yes No

more danger for any reason? 

6.1) If yes, why did you think it would put you in more danger? 

16 5123316629


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

7. During the past 6 months, has your partner done any of the following? 

(Instruction: All participants should answer this question. Read all options and mark 

Yes/No/NA (Not applicable) to indicate if the partner did what is indicated and Yes/No 

to indicate if a protection order was in effect at the time). By "partner," we are 

talking about [name]. 

Yes No 

7.1 Used physical abuse toward you. Yes No NA If yes, did you have a

protection order at the time? 

If yes, did you have a

protection order at the time?

Yes No 

7.2 Refused to stay away from you Yes No NA

 even though you asked him/her to

 or s/he was ordered to do so. 

7.3 Had contact with you (in person

 or via phone, email, mail, or

through other people) even though

 you asked him/her not to or s/he

was ordered not to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

Yes No 

7.5 Returned to your home even though Yes No NA

 you asked him/her not to or s/he

was ordered not to. 

If yes, did you have a

protection order at the time? 

Yes No 

7.6 Kept your personal Yes No NA

property/documents when s/he was

supposed to give them to you. 

If yes, did you have a

protection order at the time? 

If yes, did you have a

protection order at the time?

Yes No 

7.7 Refused to give you access to, or Yes No NA

 copies of, any documents

 supporting your immigration

application even though you asked

 him/her to or s/he was ordered

 to. 

7.8 Continued to use the car or other 

possessions even though you asked

 him/her not to or s/he was

 ordered not to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

If yes, did you have a

protection order at the time?

Yes No 

7.9 Refused to give you access to Yes No NA

 your children even though you

 have custody. 

Yes No 

If yes, did you have a

protection order at the time? 

7.10 Did not follow required Yes No NA

 supervision (or other conditions,

e.g. return times, no contact

 with you during exchange of

 children) when visiting the

 children. 

If yes, did you have a

protection order at the time?

Yes No 

7.11 Removed the children from the Yes No NA

 court's jurisdiction when there

was an order not to. 

(Continued...) 

7.4 Stayed at your home (even if you

 asked him/her to leave or s/he

 was ordered to leave) and you now

 share it with him/her. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

17 1656316626


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

Yes No 

7.12 Removed the children from the Yes No NA

United States when there was an 

order not to. 

If yes, did you have a

protection order at the time? 

7.13 Did not turn over the children's

 passports to you or the court

 even though ordered to do so. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.14 Sought a visitor's visa or any

other visas for the children from 

an embassy or consulate. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.15 Did not provide financial support

for the children even though you

asked or s/he was ordered to do

so. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

Yes No 

If yes, did you have a

protection order at the time? 

7.16 Did not provide you with Yes No NA

 financial support even though you

asked or s/he was ordered to do

so. 

If yes, did you have a

protection order at the time?

Yes No 

7.17 Did not pay your (or your Yes No NA

children's) medical expenses or

health insurance costs even 

though you asked or s/he was

ordered to do so. 

7.18 Did not pay for repair of

property s/he damaged (e.g.,

broken door, window) even though

 you asked or s/he was ordered to

do so. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.19 Did not attend batterer treatment

 or treatment for anger management

program, even though ordered to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.20 Did not attend drug or alcohol

counseling, even though ordered

to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.21 Did not give up his/her gun(s) or

other weapons from his or her

possession, even though ordered

to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.22 Withdrew your application for

permanent residency, which had

been filed on your behalf. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.23 Interfered in some other way with

your application for permanent

residency being approved. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.24 Did not pay fees associated with

 your or children's immigration

cases, even though ordered to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

(Continued...) 

18 4890316629


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

Yes No 

7.26 Contacted the U.S. Consulate, or Yes No NA

the Embassy about your

 immigration status. 

If yes, did you have a

protection order at the time? 

If yes, did you have a

protection order at the time?

Yes No 

7.27 Did not sign a form to help Yes No NA

 obtain his/her birth certificate

 even though ordered to. 

Yes No 

If yes, did you have a

protection order at the time? 

7.28 Did not sign a form to request Yes No NA

information from an immigration

 case s/he filed, even though

 ordered to. 

7.29 Did not turn over copies of

 documents about previous

 marriages and divorces, including

 where each occured, even though

 ordered to. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

7.30 Was there anything else s/he was

 ordered to do that s/he did not

 do? If yes, specify. 

Yes No NA If yes, did you have a

protection order at the time?

Yes No 

Yes No 

If yes, did you have a

protection order at the time? 

7.25 Called the immigration Yes No NA

 authorities to report you. 

8. If yes to any items above, did you do any of the following when your partner [did 

this/these things]? 

8.1 Told someone about it (i.e., the abuse/violation) Yes No 

[if no, go to 1d] 

8.1a If yes, whom did you tell? 

(Instruction: Do not read options to participant; probe until there are no further 

responses. Mark all that apply and answer all applicable follow-up questons.) 

Female Friend 

If yes, was she from your home country?................. 

If yes, does she speak your native language?............ 

Male Friend 

Yes 

Yes 

No 

No 

If yes, was he from your home country?.................. 

If yes, does he speak your native language?............. 

Mother 

Yes 

Yes 

No 

No 

Sister 

Father 

Brother 

(Continued...) 

19 0078316623 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

Cousin 

If yes, was this cousin male or female?................. Male Female 

If yes, was s/he from your home country?................ Yes No 

If yes, does s/he speak your native language?........... Yes No 

Other family member (Specify) 

Someone at my place of work 

If yes, does s/he speak your native language?........... Yes No 

Advocate/Social Work/Community organization staff 

If yes, does s/he speak your native language?........... Yes No 

Attorney/Lawyer 

If yes, does s/he speak your native language?........... Yes No 

Police 

If yes, does s/he speak your native language?........... Yes No

If yes, did the police provide interpretation for you?.. Yes No

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

If yes, did you go to the police so they would make an

arrest?................................................. Yes No 

If yes, did you go to the police so that they would make

a report, even though you didn't want them to arrest

your partner?........................................... Yes No 

Court staff 

If yes, does s/he speak your native language?........... Yes No

If yes, did the court provide interpretation for you?.. Yes No

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

Judge 

If yes, does s/he speak your native language?........... Yes No

If yes, did the judge provide interpretation for you?.. Yes No

If yes, did anyone else provide interpretation for you? Yes No 

If yes, who? 

Husband Child Other (specify) 

(Continued...) 

20 0964316627 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 

Health care provider (e.g., doctor, nurse) 

If yes, does s/he speak your native language?................ 

Religious leader 

If yes, does this person speak your native language?......... 

Yes 

Yes 

No 

No 

Other (specify) 

If yes, did this person speak your native language?........... 

8.1b If yes, how do you feel after you told someone? 

Yes No 

0 2

8.1c If yes, was their response helpful to you in some way?...... Yes No 

8.1d If no, tell us the reason(s) you decided not to tell anyone? 

8.1e If no, is there something that would have helped you decide

 to tell someone?............................................ Yes No 

If yes, what? 

8.2 Kept a journal or calendar of your partner's violations of the Yes No 

protection order/abuse?..................................... [if no, go to 2e] 

8.2a If yes, what are the reasons you decided to do this? 

(Continued...) 

21 6445316627 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
0 2

ID# 

8.2b If yes, how did it make you feel to do this?

8.2c If yes, what good things happened when you did this?

8.2d If yes, what bad things happened when you did this?

8.2e If no, what are the reasons you decided not to do this?

8.3 Kept letters, emails, or phone recordings of your partner's Yes No 

violations of the protective order/abuse?..................... [if no, go to 3e] 

8.3a If yes, what are the reasons you decided to do this?

8.3b If yes, how did it make you feel to do this?

8.3c If yes, what good things happened when you did this?

(Continued...) 

22 2274316623 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

8.3d If yes, what bad things happened when you did this? 

8.3e If no, what are the reasons you decided not to do this? 

8.4 Documented the impact on the violation of the protection Yes No 

 order/abuse on you or your children?..................... [if no, go to 4f] 

8.4a If yes, how did you do this? 

Photographs 

Told a doctor, nurse, or counselor so they would write it in your medical record 

Told a friend about the abuse 

Was the friend Male Female 

Other (Specify)

8.4b If yes, what are the reasons you decided to do this?

8.4c If yes, how did it make you feel to do this? 

8.4d If yes, what good things happened when you did this? 

23 2146316621


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

8.4e If yes, what bad things happened when you did this?

8.4f If no, what are the reasons you decided not to do this?

8.5 Called police to have them make an arrest for violation of Yes No 

protection order/abuse?..................................... [if no, go to 5e] 

8.5a If yes, what are the reasons you decided to do this?

8.5b If yes, how did it make you feel to do this?

8.5c If yes, what good things happened when you did this?

8.5d If yes, what bad things happened when you did this?

8.5e If no, what are the reasons you decided not to do this?

24 0473316622


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

8.6 Called police to report violations of protection order/abuse Yes No 

not to make an arrest or have the police do anything?......... [if no, go to 6e] 

8.6a If yes, what are the reasons you decided to do this? 

8.6b If yes, how did it make you feel to do this? 

8.6c If yes, what good things happened when you did this? 

8.6d If yes, what bad things happened when you did this? 

8.6e If no, what are the reasons you decided not to do this? 

25 6928316623


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

VI. Posttraumatic Stress Disorder Checklist (PCL) and Center for 

Epidemiological Studies-Depression Scale (CES-D) 

Script: The next set of statements ask about your feelings during the past month. For 

each statement, point to the place on the scale between "Never" and "All The Time" 

that shows how often during the past month that you have had this feeling. There is 

no right or wrong answer, just the way you feel. 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Pick one: 

Never Rarely Some 

Times 

All The 

Time 

In the past month, how often have you... Never Rarely Some All The 

Times Time 

1. Had repeated, disturbing memories, thoughts, or images

 of the abuse? 

2. Had repeated disturbing dreams about the abuse? 

3. Suddenly acted or felt as if the abuse was happening

again (as if you were reliving it)? 

4. Felt very upset when something reminded you of the

abuse? 

5. Had physical reactions (e.g., heart pounding, trouble

breathing, sweating) when something reminded you of the

abuse? 

6. Avoided thinking about or talking about the abuse? 

7. Avoided activities or situations because they reminded

you of the abuse? 

8. Had trouble remembering important parts of the abuse? 

9. Felt a loss of interest in activities that you used to

enjoy? 

10. Experienced feeling distant or cut off from other people? 

11. Felt unable to have loving feelings for those close to

you? 

12. Been upset by things that usually don't bother you? 

13. Did not feel like eating; your appetite was poor? 

14. Could not stop feeling bad even with help from my family

15. Felt that you were just as good as other people? 

(Continued...) 

26 5094316626 

 or friends? 

16. Had trouble keeping your mind on what you were doing? 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

In the past month, how often have you... Never Rarely Some All The 

Times Time 

17. Felt depressed? 

18. Felt that everything you did was an effort? 

20. Thought your life had been a failure? 

19. Felt hopeful about the future? 

22. Slept restlessly? 

21. Felt fearful? 

24. Talked less than usual? 

23. Felt happy? 

26. Felt that people were unfriendly? 

25. Felt lonely? 

28. Had crying spells? 

27. Enjoyed life? 

30. Felt that people disliked you? 

29. Felt sad? 

32. Had trouble finishing daily tasks? 

31. Felt like everything takes an effort? 

27 9313316624


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

VII. Exposure to Other Traumatic Events 

Script: We're almost finished. Next, I'm going to ask you about things that may or 

may not have happened to you since we last interviewed you for this study in [month]. 

Answer "Yes" or "No" to indicate if it happened to you since we last interviewed you 

for this study in [month]. By "partner," we are talking about [name]. 

Since we last interviewed you for this study in [month]... 

1. Has anyone [other than your partner] ever made you do

anything sexual (have intercourse, touching, etc.) when you Yes No 

 did not want to? 

2. Have you been in a natural disaster such as an earthquake, Yes No flood, fire, tornado, or hurricane/typhoon? 

3. Have you been involved in a serious accident? Yes No 

4. Have you been threatened with or harmed with a weapon such as Yes No

a gun or knife? 

5. Have you been held captive against your will? Yes No 

6. Have you been present when another person was raped, beaten, Yes No or killed? 

28 0631316628


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

VIII. Social Support Scale 

Script: Lastly, I'm going to ask about the support you have from family and friends 

(other than your partner). By "partner," we are talking about [name]. For each 

statement, point to the place on the scale between "Not True" and "True" that shows 

how true the statement is for you. Do you have any questions? 

(Instruction: Utilize the Visual Card to assist the subject in selecting the correct 

response.) 

Mostly

As of now... Not Not Mostly

True True True True 

Pick one: 

Not 

True 

Mostly

Not 

True 

Mostly

True 

True 

1. There is at least one person I know whose advice I can 

really trust. 

2. When I need suggestions for how I deal with a personal 

problem I know there is someone I can turn to. 

3. There is someone I can turn to for advice about handling

hassles over household responsibilities. 

5. There is someone I could turn to for advice about 

changing my job or finding a new one. 

4. If a family crisis arose not many of my friends would be

 able to give me good advice about handling it. 

6. If I had to go out of town for a few weeks, someone I

 know would look after my home (the plants, pets, yard,

 children, etc.) 

7. If I needed a quick emergency loan of $100, there is

 someone I could get it from. 

8. If I needed some help in moving to a new home, I would 

have a hard time finding someone to help me. 

 finding anyone to take me. 

9. If I were sick, there would be almost no one I could

 find to help me with my daily chores. 

10. If I needed a ride somewhere, I would have a hard time

29 9443316628


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID# 0 2

END OF QUESTIONNAIRE

Conclusion/Debriefing Script: Thank you very much for your time. Your participation

is very important to this study, which will help understand how to better serve

battered immigrant women as they seek to obtain protection orders. As you know this

is the last interview and your participation in the study is now complete, but your

relationship with this agency will continue. 

If you would like to talk to someone after having completed this questionnaire,

[NAME - person at the partner organization] is available to speak with you. I am 

also going to give you a list of local and national organizations that can assist

you; these resources include domestic violence hotlines and social service agencies.

Please call upon these resources and [NAME] if you need any help; they are here to

help you. 

If you are interested in the results of the study, they will be available from

[partner organization] in approximately one year. 

Do you have any questions about the questionnaire or anything else? Is there 

anything else you would like to tell me? 

Interviewer's Impressions: (Instruction: Note your impression of the interview, 

i.e., level of participant engagement, participant demeanor, unusual or unique 

participant circumstances, special considerations for follow-up, or other issues 

that might be noteworthy.) 

30 9885316628


This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
II. Psychological Maltreatment of Women 

Inventory 

NEVER SOME

TIMES

OFTEN VERY 

OFTEN 

B-31

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
III. Conflict Tactics Scale

B-32

• Once or twice since the last interview 

(seldom or rarely) 

• 3-10 times since the last interview 

(sometimes) 

• More than 10 times since the last interview 

(often or all the time) 

• This has happened before, but not since the 

last interview 

• This has never happened 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
IV. IPV Threat Appraisal Scale 

and Fear Scale 

Not At 

All 

Some 

Likelihood Definitely High 

Likelihood 

B-33

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
IV. IPV Threat Appraisal Scale 

and Fear Scale 

18. How worried are you about keeping 

yourself safe? 

Not 

Worried 

A Little 

Worried 

Very 

Worried 

Somewhat 

Worried 

B-34 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
IV. IPV Threat Appraisal Scale 

and Fear Scale 

19. How worried are you about keeping 

your children safe? 

Not 

Worried 

A Little 

Worried 

Very 

Worried 

Somewhat 

Worried 

B-35 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
B-36

V. Pathway to Services and Experience 

with Protection Orders 

3. Overall, how helpful was the court staff 

and judge when you filed for a protection 

order? 

Not 

Helpful 

A Little

Helpful 

Helpful Very 

Helpful 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
B-37

V. Pathway to Services and Experience 

with Protection Orders 

4. Overall, how helpful is or was the 

protection order? 

Not 

Helpful 

A Little

Helpful 

Helpful Very 

Helpful 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
VI. PCL and CES-D 

NEVER RARELY SOME

TIMES

ALL THE

TIME 

B-38

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
VIII. Social Support Scale

NOT

TRUE

MOSTLY

NOT TRUE 

MOSTLY

TRUE

TRUE 

B-39

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
APPENDIX C 

Consent Form

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID #

IRB No.: 03-302 

GEORGETOWN UNIVERSITY 

Consent to Participate in Research 

Project Name: Use and Outcomes of Protection Orders by Battered Immigrant Women 

Principal Investigator: Mary Ann Dutton, Ph.D. Telephone: 202-687-1997 

Georgetown University 

Co-Principal Investigator: Nawal Ammar, Ph.D. Telephone: 330-672-2775 

 Kent State University 

Co-Investigator: Leslye Orloff, J.D. Telephone: 202-326-0042 

Legal Momentum 

Project Coordinator: Darci Terrell Telephone: 405-969-3078 

COSMOS Corporation 

Sponsor: The National Institute of Justice 

The Georgetown University Institutional Review Board has given approval for this research project. For 

information on your rights as a research participant, call the Institutional Review Board office: 202-687-

1506. 

Introduction: You are invited to consider participating in this research study. We will be examining the 

decision making, access, and effectiveness of civil protection orders for immigrant women who have 

experienced violence or abuse in an intimate relationship. This form will describe the purpose and nature of 

the study, its possible risks and benefits, other options available to you, and your rights as a participant in the 

study. Please take whatever time you need to discuss the study with anyone you care to talk with. The 

decision to participate or not is yours. If you decide to participate, please sign and date the last line of this 

form. 

Background and purpose of the study: Current research does not address how immigrant women utilize 

civil protection orders as a means of protecting themselves and their children from intimate partner violence, 

the barriers immigrant women encounter when applying for and obtaining protection orders, and the 

effectiveness of such orders. We are conducting this study to examine these issues, and to also determine 

what factors influence an immigrant woman’s decision to seek a protection order, and what community, 

individual, or other factors affect whether or not immigrant women actually obtain a protection order. 

Total number of people: A total of about 350 women will take part in this study. 

General plan of the study: We will conduct initial and follow-up interviews with individuals who meet the 

following selection criteria: 1) females over 18 years of age; 2) born outside of U.S., 3) whose most recent 

incident of intimate partner violence occurred within the past 12 months, and 4) who are seeking help 

through one of our partner organizations. You were selected because of your participation in [name of 

program]. All interviews will be conducted by the advocate from [name of program]. The interviews will 

Rev. 1/26/05 C-1 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID #

IRB No.: 03-302 

take approximately one hour and a half and will be held at [name of program] where you usually meet with 

your advocate. During the interviews, you will be asked questions about how you have adapted to living in 

the U.S., how happy you are with your life, the threat of danger you feel from your partner, and other related 

questions. Following the interviews, you will spend a few minutes talking with the advocate about what the 

interview was like for you. If you feel upset or would like to talk with someone further, the advocate from 

[name of program] will be available to help you. 

Length of the study for each participant: We expect that the interviews will each take about one hour and 

a half. 

Possible benefits of participating in the study: You may benefit from having an opportunity to talk about 

the issues related to your relationship. There are no other direct benefits to you for participating in this 

study. The information you share with us during the study will help to develop an understanding of how 

immigrant women use protection orders, the barriers they face when applying for protection orders, and the 

effectiveness of the protection orders. 

Possible risks of participating in the study: You may feel uncomfortable or become upset when you talk 

about your experiences. However, you may find that talking with the interviewer about your experiences 

feels supportive or is helpful to you in some way, although participation in this project is not considered 

counseling or any other type of therapeutic service. 

Who can participate in the study: To participate in the study, persons must meet all of the following 

selection criteria: 1) female over 18 years of age; 2) born outside of U.S., 3) whose most recent incident of 

intimate partner violence occurred within the past 12 months, and 4) who are seeking help through one of our 

partner organizations. 

Confidentiality of the data collected during the study: Your responses to the interview questions will 

remain confidential and anonymous. No names or personally identifying characteristics will be recorded on 

the questionnaire. We will code your questionnaire with a number. The advocate, the principal investigator, 

and the project coordinator will be the only ones who can link your name to the number on the questionnaire 

for the purpose of following up with you later. The questionnaire will be kept in a locked drawer and will be 

destroyed at the end of the study. The questionnaire will never be a part of your file at [name of program]. 

No names or identifying details will be used in any publication or other documents resulting from this study. 

You should know about two possible risks to the confidentiality of the data collected during the study. First, 

if you tell us about a child who is being abused or about your intent to hurt someone, we are required by law 

to report that information to authorities. Second, if your partner finds out about your participation in the 

study, you could be at increased risk of violence or other forms of retaliation from your partner. 

Costs to you for participating: There are no costs to you for participating in this study. 

Payments to you for participating: You will be paid a total of $40 in cash for participating in this study; 

$15 will be paid to you for completion of the initial interview, and $25 will be paid to you for completion of 

the follow-up interview. 

Rev. 1/26/05 C-2 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID #

IRB No.: 03-302 

Your rights as a participant in the study: Participation in this study is entirely voluntary. You have the 

right to leave the study at any time. You do not have to answer any question you do not want to answer or 

that you feel would put you at any risk. Leaving the study will not result in any penalty or loss of benefits to 

which you are entitled. Should you decide to leave the study, just tell the interviewer that you no longer 

wish to participate. 

Questions: Should you have any questions at any time about this study, please contact Dr. Mary Ann 

Dutton at 202-687-1997. If you have any questions about your rights as a research participant, call the 

Georgetown University Institutional Review Board office at 202-687-1506. 

Interviewer’s statement: 

(Instruction: Mark one answer only) 

O The participant read the consent form. 

O I read the consent form to the participant. 

I have discussed the procedures, the possible risks and benefits, the standard and research aspects of the 

study, and have answered all of the questions that the participant and the participant’s family members have 

asked. 

Interviewer’s signature ___________________________ Date _________________ 

Participant’s consent 

I have read the information provided in this Informed Consent Form or it was read to me by the interviewer. 

All my questions were answered to my satisfaction. I voluntarily agree to participate in this study. 

[Upon signing, you will receive a copy of this form, unless you prefer not to. The original will be kept in a 

locked drawer and will be destroyed at the end of the study.] 

Participant’s signature _______________________________________ Date _____________ 

Rev. 1/26/05 C-3 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
APPENDIX D 

Administrative Forms 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
____________________________________ 

____________________________________ 

Administrative Form for Initial Interview 

PARTICIPANT FEE ACKNOWLEDGEMENT FORM 

(INITIAL INTERVIEW) 

I, ______________________________, have participated in the initial interview 

(print name above) 

for the COSMOS research project. 

In exchange for time spent during the interview, I have received $15. 

Signature of Participant 

Date 

Rev. 1/20/05 D-1 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Initial Interview 

COSMOS Study Questionnaire - INTERVIEWER ID ASSIGNMENT 

Instruction: Site Contact Person should assign each interviewer a unique ID number, beginning 

with 01, 02, 03, etc., and note this assignment on this form. Return this form to COSMOS with 

the first submission of materials. Please keep a copy of this form for your records. If new 

interviewers are utilized at a later time, please assign them a new unique ID#, add them to this 

form, and re-submit to COSMOS. 

The Interviewer ID Number must be noted on the first page of the COSMOS Study Questionnaire, 

in the two boxes located to the right of the Participant ID Number. This will enable the study 

team to track who conducted each interview and will assist us if we have questions about any 

questionnaire. Interviewers should be informed of their assigned interviewer ID number so they 

can note it on the questionnaires. 

Interviewer 

ID # 

Interviewer First and Last Name 

01 

02 

03 

04 

05 

06 

07 

08 

09 

10 

11 

12 

13 

14 

Rev. 4/6/05 

D-2 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Initial Interview 

PROCEDURES FOR MANAGING FORMS WITH PRE-PRINTED ID NUMBERS 

The study team will provide all materials needed to administer the questionnaire. This includes the 

questionnaire and consent form with Participant ID Numbers already preprinted on the forms, and the 

Screening Checklist and Participant Contact Sheet with the Participant ID Number blank. The interviewer 

will fill in the Participant ID Number on the Screening Checklist and Participant Contact Form only if a 

client screens into the study. If a client screens out of the study, the interviewer will leave the Participant 

ID Number blank on the Screening Checklist (the Participant Contact Form will not be filled out if the 

client screens out of the study). For example, if you fill out the Screening Checklist for a client who 

screens out of the study, you will leave the Participant ID Number blank on the Screening Checklist, and 

fill out the rest of the form; the Participant Contact Sheet will not be filled out. On the other hand, if a 

client screens into the study, the interviewer will hand write the Participant ID Number onto the Screening 

Checklist and Participant Contact Sheet, utilizing the Participant ID Number on the next questionnaire that 

is to be used, i.e., if the next questionnaire to be used has the Participant ID Number 020010 (see 

explanation of the Participant ID Number below) then the interviewer will hand write 020010 onto the 

Screening Checklist and Participant Contact Sheet, and utilize the questionnaire and consent form with ID 

020010 for that participant. 

Procedures for Managing Forms with Pre-Printed ID Numbers: 

1. Screen each potential participant per the directions noted in the manual. 

2. Completely fill out the Screening Checklist for each client that is screened, regardless of 

whether they screen in or out of the study. 

3. If the client screens out, leave the Participant ID Number blank on the Screening Checklist. 

4. If the client is eligible for the study and agrees to participate, the interviewer will: 

a) Hand write the Participant ID Number that will be used for that participant onto the 

Screening Checklist and the Participant Contact Sheet. The Participant ID Number 

appears on the COSMOS Study Questionnaire and the Consent Form. It is extremely 

important for tracking purposes that the Participant ID Number match on the 

questionnaire, consent form, Screening Checklist, and Participant Contact Sheet. 

b) The interviewer should hand write their Interviewer ID Number on the COSMOS Study 

Questionnaire, page 1, on the line that follows the Participant ID Number at the top right 

side on each page of the forms. 

NOTE: The Participant ID Number only appears on the Questionnaire, Consent Form, 

Screening Checklist, and Participant Contact Sheet. 

Example: 

ID # 0 2 0 0 1 0 

Preprinted ID Number, appears on the questionnaire and consent On the first page of the questionnaire, space 

form; the boxes are blank on the Screening Checklist and for the Interviewer ID Number, to be assigned 

Participant Contact Sheet. The interviewer will add this number to by the site, and filled in by the interviewer. 

the Screening Checklist and Contact Sheet only if the client 

screens into the study. 

If you have any questions about the process for managing ID numbers and forms, please contact 

Darci Terrell at (301) 215-9100 or dterrell@cosmoscorp.com 

Rev. 2/3/05 

D-3 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
______________________________________________________________________________ 

______________________________________________________________________________ 

Administrative Form for Initial Interview 

ID # 

PARTICIPANT CONTACT SHEET 

Instruction: Do not read options to the participant; probe until there are no further responses. 

1. What is a phone number where it would be OK to call you? ( ) 

• Is the phone number listed in your name? Circle: yes no 

• Do you expect to be available at this telephone number in 3 months? Circle: yes no 

• Do you expect to move during the next 3 months? Circle: yes no 

If yes, how can we contact you? 

• Best days and times to call: _____________________________________________ 

• Is it safe to leave a message with anyone who answers this phone? Circle: yes no 

• Is it safe to leave the message “Hello, I’m calling from the COSMOS Study. Please call me back 

at (202) ???-???? and leave a message about a good time to reach you?” Circle: yes no 

2. If we cannot reach you by phone, is it safe to contact you by mail? Circle: yes no 

Please list a mailing address or PO Box if it is safe to send mail to you there: 

3. Please indicate if it is safe to call you at work. Circle: yes no no work phone 

If yes, Please list a work number where we can try to contact you: ___________________ 

• Best days and times to call at work:______________________________ 

• Is it safe to leave a message with any person who answers the phone? Circle: yes no 

• Is it safe to leave a message on your voicemail ? Circle: yes no 

4. Please indicate if it is safe to call your cell phone. Circle: yes no no cell phone 

If yes, Please list a cell number where we can try to contact you:_____________________ 

• Best days and times to call your cell phone: __________________________ 

• Is it safe to leave a message with any person who answers the phone? Circle: yes no 

• Is it safe to leave a message on your voicemail ? Circle: yes no 

5. Please indicate if it is safe to call your pager. Circle: yes no no pager 

If yes, Please list a pager number where we can try to contact you: ____________________ 

6. Please indicate if it is safe to call your fax number. Circle: yes no no fax 

If yes, Please list a fax number where we can contact you: ____________________________ 

7. Please indicate if it is safe to email you. Circle: yes no no email 

If yes, Please list an e-mail address where we can try to contact you: __________________ 

1 

Rev. 1/20/05 D-4 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Initial Interview ID # 

-CONFIDENTIAL— 

(Please list the names of other people you feel comfortable with, and who would know 

where to find you? Think about relatives, friends, neighbors, co-workers, and list as many 

people as you can. You can change or remove any of these phone numbers by calling the 

advocate who interviewed you or anyone else at [agency phone number]. We will not tell 

these contact people any information except that we are from the COSMOS Study and we 

are trying to reach you to participate in the study. We will not tell them what the study is 

about or any other details about the study or about you. 

Person’s 

Name 

Person’s 

Phone Number 

Person’s 

relationship to you 

Person’s 

Address 

1. 

2. 

3. 

4. 

5. 

6. 

7. 

8. 

( You may want to let these people know that you have given permission 

for us to call and find out where you are. 

2 

Rev. 1/20/05 D-5 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Initial Interview 

QUESTIONNAIRE CHECKLIST 

This checklist does not need to be submitted to COSMOS; it is intended to assist the 

interviewers in tracking the tasks involved in administering the Questionnaire to 

participants. Details about each task can be found in Section 5 of the Training Manual. 

Preparation for Questionnaire Administration 

 Confirm receipt of the Initial Questionnaire Package to the Project Coordinator, and inform 

the Project Coordinator if any items are missing from the Package 

 Screen potential participants and complete Screening Checklist 

 Introduce the research project 

 Conduct consent discussion and obtain written consent 

Administration of the Questionnaire 

 Administer the Questionnaire 

 Check each page of the Questionnaire to make sure all questions are answered, filled in 

correctly, and that all notes are legible 

 Provide Participant Fee and have Participant sign Acknowledgement Form 

 Conduct Participant debriefing, including scheduling the appointment for the follow-up 

interview 

Submission of Questionnaires and Consent Forms to COSMOS (weekly) 

 Complete the Questionnaire Log for each submission to COSMOS 

 Make copies of each questionnaire, screening checklist, fee acknowledgement form, and 

consent form (these serve as a back-up) 

 Fill out the UPS label and package the original materials for submission to COSMOS. The 

package should include: 

o 	Questionnaire Log 

o 	Original versions of the Questionnaire 

o 	Original versions of the Screening Checklist 

o 	Original versions of the consent form for each Questionnaire 

o 	Original versions of the Participant Fee Acknowledgement Form for each 

Questionnaire 

 Call UPS to request a pick-up of the package. 

 Once the project coordinator confirms receipt of the package, send the backup copies to 

COSMOS following the same procedures. 

Rev. 1/20/05 D-6 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Initial Interview 

QUESTIONNAIRE LOG 

Date of Submission: 

Site Name: 

Name of Person Submitting Package: 

Phone: Email: 

Instruction: Fill out and submit the Questionnaire Log each time you submit completed questionnaires to 

COSMOS. For each questionnaire submitted, note the ID number in the far left-hand column, and note with a 

check mark that you are submitting the questionnaire, consent form, screening checklist, and fee 

acknowledgement form in the submission. COSMOS will use this form to check the contents of the package 

when it is received. Also note the date of the scheduled follow-up interview, and use the far right-hand column 

“Comments” to note if there are any unusual circumstances. We suggest you keep a copy of each Questionnaire 

Log as a record of your submissions to COSMOS. 

ID Number Screening 

Checklist 

(check mark if 

included) 

Questionnaire 

(check mark if 

included) 

Consent 

Form 

(check 

mark if 

included) 

Fee 

Form 

(check 

mark if 

included) 

Date of 

follow-up 

interview 

(mm/dd/yy) 

Comments 

Rev. 1/20/05 

D-7 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
____________________________________ 

____________________________________ 

Administrative Form for Follow-up Interview 

PARTICIPANT FEE ACKNOWLEDGEMENT FORM 

(FOLLOW-UP INTERVIEW) 

I, ______________________________, have participated in the follow-up interview 

(print name above) 

for the COSMOS research project. 

In exchange for time spent during the interview, I have received $25. 

Signature of Participant 

Date 

Rev. 1/20/05 D-8 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Follow-up Interview 

COSMOS Study Questionnaire - INTERVIEWER ID ASSIGNMENT 

Instruction: Site Contact Person should assign each NEW interviewer a unique ID number and 

note this assignment on this form. Interviewers who already have an assigned ID number (from 

the initial interview phase) should continue to use their assigned ID number. Return this form to 

COSMOS with the first submission of materials. Please keep a copy of this form for your 

records. If new interviewers are utilized at a later time, please assign them a new unique ID#, 

add them to this form, and re-submit to COSMOS. Do NOT recycle ID numbers. 

The Interviewer ID Number must be noted on the first page of the COSMOS Study Questionnaire, 

in the two boxes located to the right of the Participant ID Number. This will enable the study 

team to track who conducted each interview and will assist us if we have questions about any 

questionnaire. Interviewers should be informed of their assigned interviewer ID number so they 

can note it on the questionnaires. 

Interviewer 

ID # 

Interviewer First and Last Name 

01 

02 

03 

04 

05 

06 

07 

08 

09 

10 

11 

12 

13 

14 

Rev. 9/05 

D-9 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Follow-up Interview 

PROCEDURES FOR ASSIGNING PARTICIPANT ID NUMBERS TO FORMS 

The study team will provide all materials needed to administer the follow-up questionnaire. 

This includes the follow-up questionnaire and the fee acknowledgment form, all with the 

Participant ID Number blank. The interviewer must fill in the Participant ID Number on 

these two forms, using the same Participant ID Number from the initial questionnaire. To 

clarify, the Participant ID Number for the follow-up questionnaire will be the same 

Participant ID Number used on the initial questionnaire. The Participant ID Number can be 

found on the Participant Contact Sheet which was filled out by the site for each subject or 

from the sites’ other records. 

Procedures for Assigning Participant ID Numbers to Forms: 

1. Prior to conducting the follow-up interview, the interviewer will: 

a) Handwrite the Participant ID Number used for that participant on the initial 

questionnaire onto the Follow-up Questionnaire and Fee Acknowledgement Form. 

The Participant ID Number may be found on the Participant Contact Sheet. It is 

extremely important for tracking purposes that the Participant ID Number on the 

Follow-up Questionnaire match the Participant ID Number on the initial 

questionnaire. 

b) The interviewer should handwrite his or her Interviewer ID Number on the 

COSMOS Follow-up Study Questionnaire, page 1, on the line that follows the 

Participant ID Number at the top right side on each page of the forms. 

NOTE: The Participant ID Number only appears on the Questionnaire and Fee 

Acknowledgment Form. 

Example: 

ID # 

ID Numbers should be handwritten on the questionnaire and fee On the first page of the questionnaire, space 

acknowledgment form; take the ID number for that participant from for the Interviewer ID Number, to be assigned 

the initial questionnaire Participant Contact Sheet. by the site, and filled in by the interviewer. 

If you have any questions about the process for managing ID numbers and forms, please 

contact Darci Terrell at (301) 215-9100 or dterrell@cosmoscorp.com 

Rev. 11/15/05 

D-10

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Follow-up Interview 

QUESTIONNAIRE CHECKLIST 

FOLLOW-UP INTERVIEW 

This checklist does not need to be submitted to COSMOS; it is intended to assist the interviewers in tracking the tasks involved in 

administering the Follow-up Questionnaire to participants. Details about each task can be found in Section 8 of the Training 

Manual. 

Preparation for Follow-up Questionnaire Administration 

 Confirm receipt of the Follow-up Questionnaire Package to the Project Coordinator, and inform the 

Project Coordinator if any items are missing from the Package. 

 Schedule the follow-up interview with the participant. 

Administration of the Follow-up Questionnaire 

 Prior to beginning the follow-up interview, ensure that the participant is coherent and psychologically 

capable of participating in the interview. If the participant appears ill, intoxicated, etc., re-schedule the 

follow-up interview for another day. 

 You will receive the Questionnaire with the ID number pre-printed on the form in the upper right-hand 

corner. Write the Participant ID Number and the Interviewer ID Number in the upper-right hand 

corner of the questionnaire. Please refer to the document “Procedures for Assigning Participant ID 

Numbers to Forms” for detailed instructions. 

 Write your 2-digit Interviewer ID Number on page 1 of the COSMOS Study Questionnaire—Followup Interview in the upper right hand corner, in the 2 blank boxes that follow the Participant ID 

Number. 

 Use the script at the beginning of the follow-up questionnaire to re-introduce the project and explain 

the reasons for the conducting the follow-up interview. 

 Administer the Follow-up Questionnaire. 

 Check each page of the Questionnaire to make sure all questions are answered, filled in correctly, and 

that all notes are legible. 

 Provide Participant Fee and have participant sign the Fee Acknowledgement Form. 

 Conduct participant debriefing using the script on the last page of the Follow-up Questionnaire. 

Submission of Questionnaires and Consent Forms to COSMOS (weekly) 

 Complete the Questionnaire Log for each submission to COSMOS. 

 Make copies of each questionnaire and fee acknowledgement form (these serve as a back-up). 

 Fill out the UPS label and package the original materials for submission to COSMOS. The package 

should include: 

Rev. 10/05 D-11 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Follow-up Interview 

o Questionnaire Log 

o Original versions of the Follow-up Questionnaire 

o Original versions of the Participant Fee Acknowledgement Form for each Questionnaire 

 Call UPS to request a pick-up of the package. 

 Once you receive confirmation that COSMOS has received the package, send the backup copies in the 

next shipment of questionnaires to COSMOS. 

Rev. 10/05 D-12 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Administrative Form for Follow-up Interview 

QUESTIONNAIRE LOG 

FOLLOW-UP QUESTIONNAIRES 

Date of Submission: 

Site Name: 

Name of Person Submitting Package: 

Phone: Email: 

Instruction: Fill out and submit the Questionnaire Log each time you submit completed questionnaires to 

COSMOS. For each questionnaire submitted, note the ID number in the far left-hand column, and note with a 

check mark that you are submitting the questionnaire, consent form, screening checklist, and fee 

acknowledgement form in the submission under the appropriate column. COSMOS will use this form to check 

the contents of the package when it is received. Use the far right-hand column “Comments” to note if there are 

any unusual circumstances. We suggest you keep a copy of each Questionnaire Log as a record of your 

submissions to COSMOS. 

ID Number Questionnaire 

(check mark if 

included) 

Fee Form 

(check mark 

if included) 

Comments 

Rev. 10/05 

D-13 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner Name: Ayuda 

Contact: 

Soraya Fata 

1707 Kalorama Road, NW 

Washington, DC 20009 

202-387-4848 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

ID # 

Date Submitted 

to Site 

Screening Checklist 

completed for this 

ID 

(Yes or No) 

Date completed 

questionnaire 

submitted to 

COSMOS 

Client eligible to 

participate? 

(Yes or No) 

Client agree to 

hear consent 

presentation? 

(Yes or No) 

Client sign 

consent form? 

(Yes or No) 

Questionnaire 

completed for 

this ID 

Site Paid for this 

Interview 

(Date, Amount) 

010011-- 02/03/05 Questionnaire Not Completed 

010021-- 02/03/05 05/30/06 Yes Yes Yes Yes 08/01/05 *See Note 

010031--

010041--

010051--

02/03/05 

02/03/05 

02/03/05 

05/30/06 Yes 

05/30/06 Yes 

Questionnaire Not Completed 

Yes 

Yes 

Yes 

Yes 

Yes 

Yes 

11/29/05 

11/26/05 

*See Note 

*See Note 

010061--

010071--

02/03/05 

02/03/05 

06/05/06 no checklist 

06/05/06 no checklist 

Yes (per Soraya) 

Yes (per Soraya) 

Yes (per Soraya) 

Yes (per Soraya) 

Yes 

Yes 

04/13/06 

04/14/06 

*See Note 

*See Note 

010081-- 02/03/05 05/30/06 no checklist Yes (per Soraya) Yes (per Soraya) Yes 04/18/06 *See Note 

010091-- 02/03/05 06/05/06 no checklist Yes (per Soraya) Yes (per Soraya) Yes 04/13/06 *See Note 

010101-- 02/03/05 

010111-- 02/03/05 

010121-- 02/03/05 

010131-- 02/03/05 

010141-- 02/03/05 

010151-- 02/03/05 

010161-- 02/03/05 

010171--

010181--

02/03/05 

02/03/05 05/30/06 Yes Yes Yes Yes 12/01/05 *See Note 

010191-- 02/03/05 

010201-- 02/03/05 

010211-- 02/03/05 

010221-- 02/03/05 

010231-- 02/03/05 

010241-- 02/03/05 

010251-- 02/03/05 

010261-- 02/03/05 

010271-- 02/03/05 

010281-- 02/03/05 

010291-- 02/03/05 

010301-- 02/03/05 

010311--

010321--

02/03/05 

02/03/05 

010331- 02/03/05 

010341-- 02/03/05 

010351-- 02/03/05 

010361-- 02/03/05 

010371-- 02/03/05 

010381-- 02/03/05 

010391-- 02/03/05 

010401-- 02/03/05 

010411-- 02/03/05 

010421-- 02/03/05 

010431-- 02/03/05 

010441-- 02/03/05 

010451-- 02/03/05 

010461-- 02/03/05 

010471-- 02/03/05 05/30/06 no checklist Yes (per Soraya) Yes (per Soraya) Yes 03/02/05 **See Note 

010481--

010491--

010501--

02/03/05 

02/03/05 

02/03/05 

Questionnaires Not Completed 

Questionnaires Not Completed 

*Note: The funds for payment for these initial interviews were subtracted 

from an amount owed by Ayuda to COSMOS for unused subject incentive 

fees (which were advanced to the site at the beginning of the project). 

Questionnaires Not Completed 

**Note: The funds for payment for this initial interview were subtracted from 

an amount owed by Ayuda to COSMOS for unused subject incentive fees 

(which were advanced to the site at the beginning of the project). 

*NO FOLLOW-UP INTERVIEWS WERE CONDUCTED BY THIS SITE 

COSMOS Draft, 7/27/2006 D-14 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner Name: API Domestic Violence Resource Project (DVRP) 

Contact: 

Srijana Chettri 

P.O. Box 14268

Washington, DC 14268

202-464-4477

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) 

020011-- 02/03/05 05/06/05 Yes Yes Yes Yes 06/08/05 8/19/05 $30 

020021-- 02/03/05 05/06/05 Yes Yes Yes Yes 06/09/05 8/19/05 $30 

020031-- 02/03/05 05/06/05 Yes Yes Yes Yes 06/25/05 8/24/05 $30 

020041-- 02/03/05 05/06/05 Yes Yes Yes Yes 08/05/05 8/24/05 $30 

020051-- 02/03/05 06/15/06 Yes Yes Yes Yes 04/27/06 *See Note 

020061-- 02/03/05 

020071-- 02/03/05 

020081-- 02/03/05 *Note: The funds for payment for this initial interview were 

020091-- 02/03/05 subtracted from an amount owed by DVRP to COSMOS for 

020101-- 02/03/05 unused subject incentive fees (which were advanced to the site 

020111-- 02/03/05 at the beginning of the project). 

020121-- 02/03/05 

020131-- Questionnaires Not Completed 

020141--

02/03/05 

02/03/05 

020151-- 02/03/05 

020161-- 02/03/05 

020171-- 02/03/05 

020181-- 02/03/05 

020191-- 02/03/05 

020201-- 02/03/05 

*NO FOLLOW-UP INTERVIEWS WERE CONDUCTED BY THIS SITE 

COSMOS Draft, 7/27/2006 D-15 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner Name: Manavi 

Contact: 

Soma Dixit 

P.O. Box 3103

New Brunswick, NJ 08903

732-435-1414

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for this this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) ID (Date, Amount) 

030011-- 05/06/05 

030021-- 05/06/05 

030031-- 05/06/05 

030041-- 05/06/05 

030051-- Questionnaires Not Completed 

030061--

05/06/05 

05/06/05 

030071-- 05/06/05 

030081-- 05/06/05 

030091-- 05/06/05 

030101-- 05/06/05 

Questionnaires Not Completed 

*Note: The funds for payment for these initial interviews were 

subtracted from an amount owed by Manavi to COSMOS for 

unused subject incentive fees (which were advanced to the site at 

the beginning of the project). 

05/10/06 Yes Yes Yes Yes 07/13/05 *See Note 

030111-- 05/06/05 

030121-- 05/06/05 

030131-- 05/06/05 

030141-- 05/06/05 

030151-- 05/06/05 

030161-- 05/06/05 

030171-- 05/06/05 

030181-- 05/06/05 

030191-- 05/06/05 

030201-- 05/06/05 

030211-- 05/06/05 

030221-- 05/06/05 

030231-- 05/06/05 

030241-- 05/06/05 05/10/06 Yes Yes Yes Yes 06/23/05 *See Note 

030251-- 05/06/05 Questionnaire Not Completed 

*NO FOLLOW-UP INTERVIEWS WERE CONDUCTED BY THIS SITE 

COSMOS Draft, 7/27/2006 D-16 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: Texas Rio Grande Legal Aid 

Contact: 

Laura Martinez

4920 N. IH-35 2nd Floor

Austin, TX 78751

512-374-2700 2731

INITIAL QUESTIONNAIRE 

From Screening Checklist: 

Date completed Screening Checklist Client agree to 

Date questionnaire completed for this Client eligible hear consent Client sign Questionnaire Site Paid for this 

Submitted submitted to ID to participate? presentation? consent form? completed for Interview* 

ID # (Yes or No) (Yes or No) (Yes or No) (Yes or No) to Site COSMOS (Date, Amount) this ID 

040011-- 05/16/05 02/10/06 Yes Yes Yes Yes 06/14/05 4/20/06 $30 

040021-- 05/16/05 Questionnaire Not Completed Yes (per Lori) Yes (per Lori) Yes 

040031-- 05/16/05 02/10/06 Yes Yes Yes Yes 06/21/05 4/20/06 $30 

040041-- 05/16/05 02/10/06 Yes Yes Yes 06/28/05 4/20/06 $30 

040051-- 05/16/05 Questionnaire Not Completed 

040061-- 05/16/05 02/10/06 Yes Yes Yes Yes 07/12/05 4/20/06 $30 

040071-- 05/16/05 05/03/06 Yes Yes Yes Yes 04/07/06 5/19/06 $50 

040081-- 05/16/05 Questionnaire Not Completed 

040091-- 05/16/05 04/12/06 no checklist Yes (per Lori) Yes (per Lori) Yes 03/29/06 4/20/06 $50 

040101-- 05/16/05 05/03/06 Yes Yes Yes Yes 04/19/06 5/19/06 $50 

040111-- 05/16/05 05/03/06 Yes Yes Yes Yes 04/28/06 5/19/06 $50 

040121-- 05/16/05 02/10/06 Yes Yes Yes Yes 06/13/05 4/20/06 $30 

040131-- 05/16/05 04/12/06 no checklist Yes (per Lori) Yes (per Lori) Yes 03/30/06 4/20/06 $50 

040141-- 05/16/05 05/03/06 Yes Yes Yes Yes 04/07/06 5/19/06 $50 

040151-- 05/16/05 04/12/06 no checklist Yes (per Lori) Yes (per Lori) Yes 04/03/06 4/20/06 $50 

040161-- 05/16/05 04/12/06 no checklist Yes (per Lori) Yes (per Lori) Yes 04/03/06 4/20/06 $50 

040171-- 05/16/05 05/03/06 Yes Yes Yes Yes 04/06/06 5/19/06 $50 

040181-- 05/16/05 04/12/06 no checklist Yes (per Lori) Yes (per Lori) Yes 03/30/06 4/20/06 $50 

040191-- 05/16/05 04/12/06 no checklist Yes (per Lori) Yes (per Lori) Yes 03/30/06 4/20/06 $50 

040201-- 05/16/05 04/12/06 no checklist Yes (per Lori) Yes (per Lori) Yes 04/03/06 4/20/06 $50 

040211-- 03/28/06 

040221-- 03/28/06 

040231-- 03/28/06 

040241-- 03/28/06 

040251-- 03/28/06 

040261-- 03/28/06 

040271-- 03/28/06 

040281-- 03/28/06 

040291-- 03/28/06 

040301-- 03/28/06 

040311-- 03/28/06 

040321-- 03/28/06 

040331-- 03/28/06 

040341-- 03/28/06 

040351-- 03/28/06 Questionnaires Not Completed 

040361-- 03/28/06 

040371-- 03/28/06 

040381-- 03/28/06 

040391-- 03/28/06 

040401-- 03/28/06 

040411-- 03/28/06 

040421-- 03/28/06 

040431-- 03/28/06 

040441-- 03/28/06 

040451-- 03/28/06 

040461-- 03/28/06 

040471-- 03/28/06 

040481-- 03/28/06 

040491-- 03/28/06 

040501-- 03/28/06 05/03/06 Yes Yes Yes Yes 04/13/06 5/19/06 $50 

Continued 

COSMOS Draft, 7/27/2006 D-17 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: Texas Rio Grande Legal Aid 

Contact: 

Laura Martinez

4920 N. IH-35 2nd Floor

Austin, TX 78751

512-374-2700 2731

FOLLOW-UP QUESTIONNAIRE 

From Screening Checklist: 

Date ID # Date completed Client agree to 

Submitted to Site follow-up question- hear consent Client sign Questionnaire Site Paid for this 

for Follow-up naire received by presentation? consent form? completed for Interview 

ID # (Date, Amount) COSMOS (Yes or No) (Yes or No) this ID (Date, Amount) 

040011--

040021--

040031--

040041--

040051--

040061--

040071--

040081--

040091--

040101--

040111--

040121-- 05/03/06 Yes Yes Yes 02/13/06 7/31/06 $20** 

040131--

040141--

040151--

040161--

040171--

040181--

040191--

040201--

040211--

040221--

040231--

040241--

040251--

040261--

040271--

040281--

040291--

040301--

040311--

040321--

040331--

040341--

040351--

040361--

040371-- * During the second wave of recruitment for new partner organizations, Texas Rio Grande Legal Aid 

040381-- recruited two additional staff to assist in boosting subject recruitment. As part of the incentive for the 

040391-- recruitment of these new staff, the study agreed to pay $50 per interview to the organization for each 

040401-- interview completed by these new staff (which is the same amount paid to all other second wave partner 

040411-- organizations). All earlier payments to the site were for the originally negotiated amount of $30 per 

040421-- completed initial questionnaire. 

040431--

040441-- **Funds for payment for this follow-up interview were subtracted from an amount owed by Texas Rio 

040451-- Grande Legal Aid to COSMOS for unused subject incentive fees (which were advanced to the site at the 

040461-- beginning of the project), and as a result of the reconciliation, $20 was owed by COSMOS to the site. 

040471--

040481--

040491--

040501--

COSMOS Draft, 7/27/2006 D-18 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: Iowa Coalition Against Domestic Violence 

Contact: 

Sonia Parras 

515 28th Street, Suite 104 

Des Moines, IA 50312 

515-244-2117 

INITIAL QUESTIONNAIRE 

From Screening Checklist: 

Date completed Client agree to hear 

questionnaire Screening Checklist Client eligible to consent Client sign Questionnaire Site Paid for this 

Date Submitted submitted to completed for this ID participate? presentation? consent form? completed for this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) ID (Date, Amount) 

060011-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/06/05 8/19/05 $30 

060021-- 06/20/05 02/15/06 Yes Yes Yes Yes 07/26/05 4/4/06 $30 

060031-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/11/05 8/19/05 $30 

060041-- 06/20/05 02/15/06 Yes Yes Yes Yes 11/03/05 4/4/06 $30 

060051-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/18/05 8/19/05 $30 

060061-- 06/20/05 04/13/06 Yes Yes Yes Yes 03/29/06 6/21/06 $30 

060071-- 06/20/05 Questionnaires Not Completed 060081-- 06/20/05 

060091-- 06/20/05 05/02/06 Yes Yes Yes Yes 04/18/06 6/21/06 $30 

060101-- 06/20/05 06/05/06 Yes Yes Yes Yes 04/10/06 6/21/06 $30 

060111-- 06/20/05 04/13/06 Yes Yes Yes Yes 12/15/05 6/21/06 $30 

060121-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/12/05 8/19/05 $30 

060131-- 06/20/05 02/15/06 Yes Yes Yes Yes 07/20/05 4/4/06 $30 

060141-- 06/20/05 02/15/06 Yes Yes Yes Yes 12/19/05 4/4/06 $30 

060151-- 06/20/05 05/22/06 Yes Yes Yes Yes 02/01/06 6/21/06 $30 

060161-- 06/20/05 02/15/06 Yes Yes Yes Yes 07/13/05 4/4/06 $30 

060171-- 06/20/05 02/15/06 Yes Yes Yes Yes 07/13/05 4/4/06 $30 

060181-- 06/20/05 05/02/06 Yes Yes Yes Yes 04/25/06 6/21/06 $30 

060191-- 06/20/05 05/02/06 Yes Yes Yes Yes 04/27/06 6/21/06 $30 

060201-- 06/20/05 06/05/06 Yes Yes Yes Yes 02/03/06 6/21/06 $30 

060211-- 06/20/05 07/21/05 Yes Yes Yes Yes 06/29/05 8/19/05 $30 

060221-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/05/05 8/19/05 $30 

060231-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/08/05 8/19/05 $30 

060241-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/18/05 8/19/05 $30 

060251-- 06/20/05 04/13/06 Yes Yes Yes Yes 04/01/06 6/21/06 $30 

060261-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/11/05 8/19/05 $30 

060271-- 06/20/05 02/15/06 Yes Yes Yes Yes 09/12/05 4/4/06 $30 

060281-- 06/20/05 05/22/06 Yes Yes Yes Yes 04/18/06 6/21/06 $30 

060291-- 06/20/05 02/15/06 Yes Yes Yes Yes 11/21/05 4/4/06 $30 

060301-- 06/20/05 05/02/06 Yes Yes Yes Yes 03/23/06 6/21/06 $30 

060311-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/29/05 8/19/05 $30 

060321-- 06/20/05 07/21/05 Yes Yes Yes Yes 06/29/05 8/19/05 $30 

060331-- 06/20/05 02/15/06 Yes Yes Yes Yes 09/21/05 4/4/06 $30 

060341-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/07/05 8/19/05 $30 

060351-- 06/20/05 07/21/05 Yes Yes Yes Yes 07/07/05 8/19/05 ($30 ) 

060361-- 06/20/05 05/02/06 Yes Yes Yes Yes 02/01/06 6/21/06 $30 

060371-- 06/20/05 02/15/06 Yes Yes Yes Yes 08/01/05 4/4/06 $30 

060381-- 06/20/05 02/15/06 Yes Yes Yes Yes 08/01/05 4/4/06 $30 

060391-- 06/20/05 02/15/06 Yes Yes Yes Yes 08/01/05 4/4/06 $30 

060401-- 06/20/05 04/13/06 Yes Yes Yes Yes 03/03/06 6/21/06 $30 

060411-- 06/20/05 02/15/06 Yes Yes Yes Yes 08/15/05 4/4/06 $30 

060421-- 06/20/05 02/15/06 Yes Yes Yes Yes 08/03/05 4/4/06 $30 

060431-- 06/20/05 Questionnaires Not Completed 060441-- 06/20/05 

060451-- 06/20/05 03/30/06 Yes Yes Yes Yes 03/24/06 4/4/06 $30 

060461-- 06/20/05 05/02/06 Yes Yes Yes Yes 03/28/06 6/21/06 $30 

060471-- 06/20/05 05/02/06 Yes Yes Yes Yes 04/12/06 6/21/06 $30 

060481-- 06/20/05 04/13/06 Yes Yes Yes Yes 03/30/06 6/21/06 $30 

060491-- 06/20/05 05/02/06 Yes Yes Yes Yes 04/18/06 6/21/06 $30 

060501-- 06/20/05 03/30/06 Yes Yes Yes Yes 03/23/06 4/4/06 $30 

Continued 

COSMOS Draft, 7/27/2006 D-19 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: Iowa Coalition Against Domestic Violence 

Contact: 

Sonia Parras 

515 28th Street, Suite 104 

Des Moines, IA 50312 

515-244-2117 

FOLLOW-UP QUESTIONNAIRE 

From Screening Checklist: 

Date completed Client agree to hear 

Date ID # follow-up consent Client sign Questionnaire Site Paid for this 

Submitted to Site question- naire presentation? consent form? completed for this Interview 

ID # for Follow-up received by (Yes or No) (Yes or No) ID (Date, Amount) 

060011-- 12/12/05 05/02/06 Yes Yes 04/13/06 6/21/06 $55 

060021--

060031-- 12/13/05 04/13/06 Yes Yes 04/05/06 6/21/06 $55 

060041-- 12/13/06 06/05/06 Yes Yes 05/17/06 6/21/06 $55 

060051--

060061-- 12/13/05 05/02/06 Yes Yes 04/11/06 6/21/06 $55 

060071--

060081--

060091-- 12/13/05 05/02/06 Yes Yes 04/25/06 6/21/06 $55 

060101--

060111-- 12/13/05 04/13/06 Yes Yes 03/31/06 6/21/06 $55 

060121--

060131--

060141-- 12/13/05 03/30/06 Yes Yes 02/08/06 4/4/06 $55 

060151-- 12/13/05 05/22/06 Yes Yes 05/12/06 6/21/06 $55 

060161-- 12/13/05 05/22/06 Yes Yes 05/15/06 6/21/06 $55 

060171-- 12/13/05 05/02/06 Yes Yes 04/20/06 6/21/06 $55 

060181-- 12/13/05 05/22/06 Yes Yes 05/13/06 6/21/06 $55 

060191-- 12/13/05 05/22/06 Yes Yes 05/08/06 6/21/06 $55 

060201-- 12/13/06 06/05/06 Yes Yes 05/17/06 6/21/06 $55 

060211-- 12/13/05 04/13/06 Yes Yes 04/04/06 6/21/06 $55 

060221-- 12/13/05 03/30/06 Yes Yes 03/24/06 4/4/06 $55 

060231-- 12/13/05 03/30/06 Yes Yes 03/10/06 4/4/06 $55 

060241-- 12/13/05 03/30/06 Yes Yes 03/17/06 4/4/06 $55 

060251-- 12/13/05 05/02/06 Yes Yes 6/21/06 $55 

060261-- 12/13/06 06/05/06 Yes Yes 04/10/06 6/21/06 $55 

060271--

060281-- 12/13/06 06/05/06 Yes Yes 05/30/06 6/21/06 $55 

060291--

060301-- 12/13/05 05/02/06 Yes Yes 04/21/06 6/21/06 $55 

060311-- 12/13/05 03/30/06 Yes Yes 01/26/06 4/4/06 $55 

060321-- 12/13/05 03/30/06 Yes Yes 01/02/06 4/4/06 $55 

060331--

060341-- 12/13/05 03/30/06 Yes Yes 01/25/06 4/4/06 $55 

060351-- 12/13/05 05/22/06 Yes Yes 05/15/06 6/21/06 $55 

060361-- 12/13/05 05/02/06 Yes Yes 04/04/06 6/21/06 $55 

060371--

060381--

060391--

060401--

060411--

060421--

060431--

060441--

060451--

060461--

060471--

060481--

060491--

060501-- 12/13/05 04/13/06 Yes Yes 03/31/06 6/21/06 $55 

COSMOS Draft, 7/27/2006 D-20 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: Task Force on Family Violence 

Contact: 

Nou Vang 

1400 N. 6th Street 

Milwaukee, WI 53212 

414-276-1911 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for this Subject Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for Interview this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) (Date, Amount) 

070011-- 04/05/06 04/21/06 Yes Yes Yes Yes 04/14/06 4/27/06 $50 4/27/06 $15 

070021-- 04/05/06 04/21/06 Yes Yes Yes Yes 04/11/06 4/27/06 $50 4/27/06 $15 

070031-- 04/05/06 04/21/06 Yes Yes Yes Yes 04/10/06 4/27/06 $50 4/27/06 $15 

070041-- 04/05/06 04/21/06 Yes Yes Yes Yes 04/12/06 4/27/06 $50 4/27/06 $15 

070051-- 04/05/06 05/02/06 Yes Yes Yes Yes 04/18/06 6/12/06 $50 6/12/06 $15 

070061-- 04/05/06 04/21/06 Yes Yes Yes Yes 04/13/06 4/27/06 $50 4/27/06 $15 

070071-- 04/05/06 05/02/06 Yes Yes Yes Yes 04/19/06 6/12/06 $50 6/12/06 $15 

070081-- 04/05/06 05/02/06 Yes No Yes Yes 04/19/06 6/12/06 $50 6/12/06 $15 

070091-- 04/05/06 05/02/06 Yes Yes Yes Yes 04/16/06 6/12/06 $50 6/12/06 $15 

070101-- 04/05/06 05/02/06 Yes Yes Yes Yes 04/20/06 6/12/06 $50 6/12/06 $15 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

Partner name: Legal Aid Society of Minneapolis 

Contact: 

Kirsten Olson 

430 First Avenue North, Suite 300 

Minneapolis, MN 55401 

612-746-3716 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for this Subject Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for Interview this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) (Date, Amount) 

080011-- 04/05/06 Questionnaires Not Completed 080021-- 04/05/06 

080031-- 04/05/06 06/05/06 yes yes yes yes 05/17/06 6/21/06 $50 6/21/06 $15 

080041-- 04/05/06 06/05/06 yes yes yes yes 05/03/06 6/21/06 $50 6/21/06 $15 

080051-- 04/05/06 Questionnaires Not Completed 080061-- 04/05/06 

080071-- 04/05/06 06/05/06 yes yes yes yes 05/12/06 6/21/06 $50 6/21/06 $15 

080081-- 04/05/06 06/05/06 yes yes yes yes 05/23/06 6/21/06 $50 6/21/06 $15 

080091-- 04/05/06 Questionnaires Not Completed 080101-- 04/05/06 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

COSMOS Draft, 7/27/2006 D-21 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: Legal Assistance Corporation of Central Massachusetts 

Contact: 

Arose Nielsen 

405 Main Street 

Worcester, MA 01608 

508-752-3722 x3017 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for Subject Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for this Interview this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) (Date, Amount) 

090011-- 04/07/06 06/02/06 yes yes yes yes 05/03/06 6/12/06 $50 6/12/06 $15 

090021-- 04/07/06 06/02/06 yes yes yes yes 05/16/06 6/12/06 $50 6/12/06 $15 

090031-- 04/07/06 06/02/06 yes yes yes yes 05/22/06 6/12/06 $50 6/12/06 $15 

090041-- 04/07/06 

090051-- 04/07/06 

090061-- 04/07/06 

090071-- 04/07/06 Questionnaires Not Completed 

090081-- 04/07/06 

090091-- 04/07/06 

090101-- 04/07/06 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

Partner name: Florida Immigrant Advocacy Center 

Contact: 

Maria Jose Fletcher 

3000 Biscayne Blvd., Suite 400 

Miami, FL 33137 

305-573-1106 

INITIAL QUESTIONNAIRE* From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

questionnaire completed for Client eligible to hear consent Client sign Questionnaire Site Paid for Subject Paid for 

Date Submitted submitted to this ID participate? presentation? consent form? completed for this Interview this Interview 

ID # (Yes or No) to Site COSMOS (Yes or No) (Yes or No) (Yes or No) this ID (Date, (Date, Amount) 

110011--

110021--

04/13/06 

04/13/06 Questionnaires Not Completed 

110031-- 04/13/06 6/6/2006 yes yes yes yes 05/26/06 6/21/06 $50 6/21/06 $15 

110041-- 04/13/06 

110051-- 04/13/06 

110061-- 04/13/06 

110071-- 04/13/06 

110081-- 04/13/06 

110091-- 04/13/06 

110101-- 04/13/06 Questionnaires Not Completed 

110111-- 04/13/06 

110121-- 04/13/06 

110131-- 04/13/06 

110141-- 04/13/06 

110151-- 04/13/06 

110161-- 04/13/06 

110171-- 04/13/06 6/6/2006 yes yes yes yes 04/19/06 6/21/06 $50 6/21/06 $15 

110181-- 04/13/06 

110191-- 04/13/06 

110201-- 04/13/06 

110211--

110221--

04/13/06 

04/13/06 Questionnaires Not Completed 

110231-- 04/13/06 

110241-- 04/13/06 

110251-- 04/13/06 

110261-- 04/13/06 6/6/2006 yes yes yes yes 05/22/06 06/21/06 $50 6/21/06 $15 

110271-- 04/13/06 

110281--

110291--

04/13/06 

04/13/06 Questionnaires Not Completed 

110301-- 04/13/06 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

COSMOS Draft, 7/27/2006 D-22 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: The Bridge 

Contact: 

Karen Amaya 

213 W. Southmore, Suite 302 

Pasadena, TX 77502 

713-472-0753 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for this Subject Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for Interview this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) (Date, Amount) 

120011-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/12/06 6/12/06 $50 6/12/06 $15 

120021-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/08/06 6/12/06 $50 6/12/06 $15 

120031-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/15/06 6/12/06 $50 6/12/06 $15 

120041-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/05/06 6/12/06 $50 6/12/06 $15 

120051-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/04/06 6/12/06 $50 6/12/06 $15 

120061-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/16/06 6/12/06 $50 6/12/06 $15 

120071-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/22/06 6/12/06 $50 6/12/06 $15 

120081-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/23/06 6/12/06 $50 6/12/06 $15 

120091-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/16/06 6/12/06 $50 6/12/06 $15 

120101-- 04/26/06 05/30/06 Yes Yes Yes Yes 05/21/06 6/12/06 $50 6/12/06 $15 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

Partner name: A Woman's Place of Merced County 

Contact: 

Diana Almanza 

815 W. 18th Street 

Merced, CA 95340 

209-725-7900 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for Subject Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for this Interview this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) (Date, Amount) 

140011-- 04/17/06 05/24/06 Yes Yes Yes Yes 05/02/06 6/12/06 $50 6/12/06 $15 

140021-- 04/17/06 05/24/06 Yes Yes Yes Yes 04/26/06 6/12/06 $50 6/12/06 $15 

140031-- 04/17/06 05/24/06 Yes Yes Yes Yes 04/27/06 6/12/06 $50 6/12/06 $15 

140041-- 04/17/06 05/30/06 Yes Yes Yes Yes 05/23/06 6/12/06 $50 6/12/06 $15 

140051-- 04/17/06 05/24/06 Yes Yes Yes Yes 05/02/06 6/12/06 $50 6/12/06 $15 

140061-- 04/17/06 05/24/06 Yes Yes Yes Yes 05/09/06 6/12/06 $50 6/12/06 $15 

140071-- 04/17/06 05/30/06 Yes Yes Yes Yes 05/12/06 6/12/06 $50 6/12/06 $15 

140081-- 04/17/06 05/24/06 Yes Yes Yes Yes 05/09/06 6/12/06 $50 6/12/06 $15 

140091-- 04/17/06 05/30/06 Yes Yes Yes Yes 05/02/06 6/12/06 $50 6/12/06 $15 

140101-- 04/17/06 05/24/06 Yes Yes Yes Yes 04/25/06 6/12/06 $50 6/12/06 $15 

140111-- 04/17/06 05/24/06 Yes Yes Yes Yes 05/03/06 6/12/06 $50 6/12/06 $15 

140121-- 04/17/06 05/24/06 Yes Yes Yes Yes 05/01/06 6/12/06 $50 6/12/06 $15 

140131-- 04/17/06 05/24/06 Yes Yes Yes Yes 04/28/06 6/12/06 $50 6/12/06 $15 

140141-- 04/17/06 05/30/06 Yes Yes Yes Yes 05/26/06 6/12/06 $50 6/12/06 $15 

140151-- 04/17/06 05/30/06 Yes Yes Yes Yes 05/16/06 6/12/06 $50 6/12/06 $15 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

COSMOS Draft, 7/27/2006 D-23 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: Alliance for Battered and Abused International Women 

Contact: 

Amelia Berry 

YWCA of Greater Cincinnati 

898 Walnut Street 

Cincinnati, OH 45202 

513-361-2146 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible to hear consent Client sign Questionnaire Site Paid for this Subject Paid for 

Submitted submitted to this ID participate? presentation? consent form? completed for Interview this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) (Date, Amount) 

150011-- 04/28/06 06/02/06 yes yes yes yes 05/14/06 6/12/06 $50 6/12/06 $15 

150021-- 04/28/06 06/02/06 yes yes yes yes 05/11/06 6/12/06 $50 6/12/06 $15 

150031-- 04/28/06 06/02/06 yes yes yes yes 05/22/06 6/12/06 $50 6/12/06 $15 

150041-- 04/28/06 06/02/06 yes yes yes yes 05/19/06 6/12/06 $50 6/12/06 $15 

150051-- 04/28/06 06/02/06 yes yes yes yes 05/25/06 6/12/06 $50 6/12/06 $15 

150061-- 04/28/06 06/02/06 yes yes yes yes 05/19/06 6/12/06 $50 6/12/06 $15 

150071-- 04/28/06 06/02/06 yes yes yes yes 05/19/06 6/12/06 $50 6/12/06 $15 

150081-- 04/28/06 06/02/06 yes yes yes yes 05/23/06 6/12/06 $50 6/12/06 $15 

150091-- 04/28/06 06/02/06 yes yes yes yes 05/24/06 6/12/06 $50 6/12/06 $15 

150101-- 04/28/06 06/02/06 yes yes yes yes 05/24/06 6/12/06 $50 6/12/06 $15 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

Partner name: Family Tree Housing and Family Services 

Contact: 

Linda Barringer 

3805 Marshall Street, Suite 201 

Wheat Ridge, CO 80033 

303-467-2604 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for this Subject Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for Interview this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) (Date, Amount) 

160011-- 05/01/06 06/02/06 yes yes yes yes 05/03/06 6/12/06 $50 6/12/06 $15 

160021-- 05/01/06 06/02/06 yes yes yes yes 05/05/06 6/12/06 $50 6/12/06 $15 

160031-- 05/01/06 06/02/06 yes yes yes yes 05/05/06 6/12/06 $50 6/12/06 $15 

160041-- 05/01/06 06/02/06 yes yes yes yes 05/09/06 6/12/06 $50 6/12/06 $15 

160051-- 05/01/06 06/02/06 yes yes yes yes 05/09/06 6/12/06 $50 6/12/06 $15 

160061-- 05/01/06 06/02/06 yes yes yes yes 05/25/06 6/12/06 $50 6/12/06 $15 

160071-- 05/01/06 06/02/06 yes yes yes yes 05/09/06 6/12/06 $50 6/12/06 $15 

160081-- 05/01/06 Questionnaire Not Completed 

160091-- 05/01/06 06/02/06 yes yes yes yes 05/30/06 6/12/06 $50 6/12/06 $15 

160101-- 05/01/06 06/02/06 yes yes yes yes 05/26/06 6/12/06 $50 6/12/06 $15 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

COSMOS Draft, 7/27/2006 D-24 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
MASTER TRACKING LOG FOR USE AND OUTCOMES OF 

PROTECTION ORDERS FOR BATTERED IMMIGRANT WOMEN 

Partner name: Shelter for Abused Women & Children 

Contact: 

Susana Colaluci 

2635 Weeks Avenue 

Naples, FL 34112 

239-775-3862 

INITIAL QUESTIONNAIRE* 

From Screening Checklist: 

Screening 

Date completed Checklist Client agree to 

Date questionnaire completed for Client eligible hear consent Client sign Questionnaire Site Paid for this Subject Paid for 

Submitted submitted to this ID to participate? presentation? consent form? completed for Interview this Interview 

ID # to Site COSMOS (Yes or No) (Yes or No) (Yes or No) (Yes or No) this ID (Date, Amount) (Date, Amount) 

170011-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/05/06 6/12/06 $50 6/12/06 $15 

170021-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/22/06 6/12/06 $50 6/12/06 $15 

170031-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/27/06 6/12/06 $50 6/12/06 $15 

170041-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/27/06 6/12/06 $50 6/12/06 $15 

170051-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/18/06 6/12/06 $50 6/12/06 $15 

170061-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/24/06 6/12/06 $50 6/12/06 $15 

170071-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/21/06 6/12/06 $50 6/12/06 $15 

170081-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/20/06 6/12/06 $50 6/12/06 $15 

170091-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/19/06 6/12/06 $50 6/12/06 $15 

170101-- 04/28/06 06/01/06 Yes Yes Yes Yes 05/20/06 6/12/06 $50 6/12/06 $15 

*NO FOLLOW-UP INTERVIEWS WILL BE CONDUCTED BY THIS SITE 

COSMOS Draft, 7/27/2006 D-25 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
APPENDIX E

E-Mail Letter to Recruit Second Wave Partner Organizations

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
-----Original Message-----

From: Leslye Orloff [mailto:lorloff@legalmomentum.org] 

Sent: Wed 3/22/2006 10:27 AM 

To: Barasch, Amy; Ramona Natera; Yer Vang, IPW; Jennifer Rose (JennR); familylawlistserve@yahoogroups.com; advisorycommittee-listserve@yahoogroups.com; publicbenefitslistserve@yahoogroups.com; CLINICkathleen@aol.com; Jack Holmgren; ecastaneda@nls-la.org; Emily Chen; 

dajphnson@atlantalegalaid.org; jenniferdouglass@idaholegalaid.org; kbettcher@pslegal.org; 

amycfox_lifespan@yahoo.com; thomasp@klsinc.org; vapplegarth@gbls.org; Hema Sarangapani; 

hsarangapani@gbls.org; kconklin@mcadsv.org; rachel.sibley@smrls.org; stark-virginia@centro-legal.org; 

bellucci@njcbw.org; Laura Contreras; harroyo@baylegal.org; Maria Jose Fletcher 

Cc: nammar@kent.edu; Mary Ann Dutton, Ph.D.; Terrell, Darci; Ericka Echavarria; Leslye 

Orloff 

Subject: Urgent Help Needed By May 31, 2006 on Important CPO Research 

To: Allies, Attorneys, and Advocates 

From: Leslye Orloff, Immigrant Women Program, Legal Momentum 

Date: March 22, 2006 

Please Distribute Widely To Any Others Who May Be Interested 

YOUR HELP URGENTLY NEEDED TO 

CONDUCT INTERVIEWS FOR IMPORTANT RESEARCH ON 

BARRIERS TO AND EFFECTIVENESS OF 

PROTECTION ORDERS FOR IMMIGRANT WOMEN

 Interviewer Payment: $50 per survey 

Deadline for Completion of Survey Interviews: May 31, 2006 

The grant “Use and Outcomes of Protection Orders by Battered Immigrant Women” was 

awarded to COSMOS Corporation in November 2003, by the National Institute of Justice, U.S. 

Department of Justice. COSMOS is collaborating with nationally-renowned experts Leslye 

Orloff of Legal Momentum, Mary Ann Dutton of Georgetown University, and Nawal Ammar 

of Kent University to conduct a research study on this issue. 

The purpose of the study is to determine the effectiveness of protection orders when used by 

immigrant women. Specific aims of the study are to: 

1. Examine the factors that affect the decision-making about whether or not to obtain 

protection orders, as well as the systemic, community, and individual factors that affect 

whether woman who petitions actually obtains a full protection order; and, 

2. Compare the outcome for women who obtain a full protection order, who file for, but do 

not obtain protection order, and who do not file for a protection order. 

Some of the important policy and practice implications of this study will include training judges, 

justice system, and Department of Homeland Security personnel, improving cultural competency 

of domestic violence services and removing barriers the immigrant victims experience in 

obtaining help to counter domestic violence including protection orders. 

E-1

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Data will be collected by interviewing foreign-born, adult, battered immigrant women from a 

broad spectrum of ethnic backgrounds, including Asian, Latino, African, Middle-Eastern, and 

European communities who have sought services for and/or related to domestic violence. We 

need your help to interview immigrant survivors of domestic violence with whom you work who 

are seeking or have sought help from your agency. The interview takes about 1-2 hours and the 

survey instrument is in English. We are looking for interviewers who can conduct survey by 

orally translating the questions into the survivor’s native language, unless she is comfortable 

communicating in English. We would like to identify about 250 immigrant women survivors 

from a range of countries of origin. 

We are turning to advocates and attorneys across the country who have experience 

working with immigrant survivors to conduct interviews of your clients. We are looking 

for interviewers who can conduct a minimum of 10 surveys by May 31, 2006. Interviewers 

will be compensated $50 per completed survey and survivor-participants will be paid $15 for 

participating in the interview. 

If you are interested in participating in this study, please complete the attached Statement 

of Work and return to Darci Terrell, the Project Coordinator of this study: at (405) 969-

3067, or dterrell@cosmoscorp.com. We will decide on a case-by-case basis about requests 

to help us conduct less than 10 surveys, with a particular emphasis on populations hardest 

to reach. If you have any questions, please direct them to Darci Terrell at (405)-969-3078. 

Thank you for all of your help on this, 

Leslye E. Orloff 

Immigrant Women Program 

Legal Momentum. 

E-2

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
STATEMENT OF WORK 

[Organization/Interviewer] will assist COSMOS Corporation in recruiting and interviewing 

subjects for its grant entitled “Use and Outcomes of Protection Orders for Battered Women.” 

[Organization/Interviewer] agrees to first provide the following information to COSMOS prior to 

beginning any recruitment of participants: 

! Technical point of contact (please print): 

Name: 

Title: 

Organization: _____________________________________________ 

Address: _________________________________________________ 

_________________________________________________ 

Telephone number: 

E-mail address: 

! Number of participants [Organization/Interviewer] expects to recruit for this 

study:

 __________________ 

! General description of the ethnic composition of target population: [INSERT 

DESCRIPTION OF ETHNIC COMPOSITION]

 ____________________________________________________ 

____________________________________________________ 

[Organization/Interviewer] Payments 

[Organization/Interviewer] will be reimbursed at the rate of $50.00 per recruited subject upon 

receipt by the research team of completed original survey instruments. This amount will cover 

all costs related to: 

! Training on administration procedures and survey content. Survey interviewers 

will be provided and asked to review written materials describing the survey 

administration procedures, and the study instrument (survey). Darci Terrell, of 

COSMOS Corporation will be available to answer any questions that arise from 

organizations and interviewers at 405-969-3078, or dterell@cosmoscorp.com. 

E-3

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
! Recruiting and obtaining consent from the participant; 

! Conducting the interview, which will last approximately between 1 and 2 hours, 

and thoroughly completing the study instrument per instructions; 

! Providing the completed original study instruments to the project team for data 

entry when and where instructed – either weekly or biweekly – utilizing prepaid 

UPS envelopes; and 

! Providing biweekly email updates to the project team on the progress of 

recruitment and survey administration. 

Participant Payments 

[Organization/Interviewer] will be reimbursed for payment of the $15 survey fee to participants 

they interview. 

! Study participants will receive $15 for completion of the interview. 

! [Organization/Interviewer] will be forwarded subject payments together with the 

organization’s payment after the completed surveys are received. 

! [Organization/Interviewer] is responsible for the disbursement of payment to the 

participants at the completion of the interview. The organization/interviewer is 

encouraged to provide these funds to the participant at the time of the interview. 

All participant surveys must be completed by May 31, 2006 and received by COSMOS 

Corporation by June 9, 2006. Payment to the organization/interviewer will be made by 

COSMOS Corporation upon receipt of completed original survey instruments. 

 [ORGANIZATION/INTERVIEWER]

 By: _______________________________ Dated: _________________ 

 COSMOS Corporation: 

By: _______________________________ Dated: ______________ 

E-4

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
APPENDIX F 

Training Manual for Questionnaire Administration 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Use and Outcomes of Protection Orders 

by Battered Immigrant Women

Training Manual 

for Questionnaire Administration

April 2005

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
CONTENTS 

Page 

Section 

1. Project Team Members and Partners...............................................................................1 

2. Introduction to the Project...............................................................................................4 

2.1 Introduction..............................................................................................................4

2.2 Role of the Partners Organizations ..........................................................................5 

2.3 Overview of the COSMOS Study Questionnaire (Initial Interview) .......................5 

2.4 Overview of the COSMOS Study Questionnaire (Follow-up Interview) ................6 

2.5 Scan Format of Questionnaires ...............................................................................6 

2.6 Definitions ...............................................................................................................7

3. Screening Potential Participants......................................................................................8 

3.1 Identifying Potential Participants.............................................................................8 

3.2 Participant Screening: Protection Order Status ......................................................8 

3.3 Participant Screening: Selection Criteria................................................................9 

3.4 Participant Screening: Participants That Do Not Qualify for the Study ................9 

3.5 Participant Recruitment ..........................................................................................9 

4. Informed Consent and Confidentiality..........................................................................11 

4.1 Risks to Respondents .............................................................................................11 

4.2 Risk Management ..................................................................................................11 

4.3 Procedures for Acquiring Informed Consent.........................................................12 

4.4 Debriefing with the Participant..............................................................................14 

4.5 Confidentiality and Data Monitoring Procedures..................................................16 

5. Logistics for Initial Questionnaire Administration .......................................................17 

5.1 Preparation for Initial Questionnaire Administration ............................................17 

5.2 Administration of the Initial Questionnaire ...........................................................19 

5.3 Activities to be Conducted Following 

Administration of the Initial Questionnaire ...........................................................22 

5.4 Activities to be Conducted at COSMOS Following Submission 

of the Completed Questionnaires...........................................................................23 

6. Logistics for Follow-up Questionnaire Administration ................................................24 

6.1 Safety Procedures for Re-Contacting the Participant ............................................24 

6.2 Re-Contact Schedule..............................................................................................24 

6.3 Preparation for Follow-up Questionnaire Administration.....................................24 

6.4 Administration of the Follow-up Questionnaire....................................................24 

COSMOS Corporation, rev. 4.6.05 i 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
6.5 Activities to be Conducted Following Administration of the 

 Follow-up Questionnaire .......................................................................................24 

7. Team Collaboration and Information Sharing...............................................................25 

7.1 Introduction to the BIW Project Partners Listserv.................................................25 

7.2 Biweekly Conference Calls ...................................................................................25 

Exhibits 

Page 

3-1 Screening Checklist.....................................................................................................E-1

4-1 Project Consent Form .................................................................................................E-2 

4-2 Participant Contact Sheet ...........................................................................................E-5 

4-3 Participant Fee Acknowledgement Form....................................................................E-7 

5-1 Questionnaire Log .......................................................................................................E-8

5-2 Questionnaire Checklist ..............................................................................................E-9 

5-3 Interviewer ID Assignment .......................................................................................E-10 

5-4 Example of Teleform Format ....................................................................................E-11 

5-5 Example of How to Fill Out UPS Form ....................................................................E-12 

Appendices 

A. COSMOS Study Questionnaire (Initial Interview)........................................................ A-1 

B. Visual Cards ...................................................................................................................B-1 

COSMOS Corporation, rev. 4.6.05 ii 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
1. PROJECT TEAM MEMBERS AND PARTNERS 

Project Team Members 

Mary Ann Dutton, Ph.D., Principal Investigator 

Georgetown University, Department of Psychiatry 

Georgetown University Medical Center 

620 Kober Cogan Hall 

Washington, DC 20007 

ph: 202-687-1997 

cell: 301-526-0658 

mad27@georgetown.edu 

Nawal Ammar, Ph.D., Co-Principal Investigator 

Kent State University 

P.O. Box 5190 

Kent, OH 44242 

ph: 330-672-0314 

nammar@kent.edu 

Leslye Orloff, J.D., Co-Investigator 

Legal Momentum (formerly NOW Legal Defense and Education Fund) 

1522 K Street, NW, Suite 550 

Washington, DC 20005 

ph: 202-326-9942 

cell: 202-210-8886 

lorloff@legalmomentum.org 

Joyce Noche, J.D., Senior Analyst 

Legal Momentum (formerly NOW Legal Defense and Education Fund) 

1522 K Street, NW, Suite 550 

Washington, DC 20005 

ph: 202-326-0043 

jnoche@legalmomentum.org 

Darci Terrell, Project Coordinator 

COSMOS Corporation 

3 Bethesda Metro Center, Suite 950 

Bethesda, MD 20814 

ph: 301-215-9100 (COSMOS headquarters) 

405-969-3078 (direct) 

cell: 405-620-3511 

dterrell@cosmoscorp.com 

COSMOS Corporation, rev. 4.6.05 1 

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been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Project Partners 

Texas Rio Grande Legal Aid 

Laura Martinez-McIntosh 

2201 Post Road, Suite 104 

Austin, TX 78704-4300 

512-447-7707, x334 

lauramartinez@trla.org 

Iowa Coalition Against Domestic Violence 

Sona Paras Konrad 

515 28th Street, Suite 104 

Des Moines, IA 50312 

515-244-8028 

Soniaicadv@aol.com 

Legal Aid Foundation of Los Angeles (LAFLA) 

Dahlia Setareh 

1102 S. Crenshaw Blvd. 

Los Angeles, CA 90019 

213-640-3933 

DSetareh@lafla.org 

Ayuda 

Soraya Fata 

1736 Columbia Road NW 

Washington, DC 20009 

202-387-0434, x19 

sfata@ayudainc.org 

Domestic Violence Resource Project (API DVRP) 

Srijana Chettri 

P.O. Box 14268 

Washington, DC 20044 

202-464-4477, x221 

srijana@dvrp.org 

COSMOS Corporation, rev. 4.6.05 2 

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been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Manavi 

Soma Dixit 

P.O. Box 3103 

New Brunswick, NJ 08903-3103 

732-435-1414 

manavi@att.net 

Access 

Joanna Ladki 

6450 Maple Street 

Dearborn, MI 48126 

313-216-2226 

jladki@accesscommunity.org 

COSMOS Corporation, rev. 4.6.05 3 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
2. INTRODUCTION TO THE PROJECT 

2.1 Introduction 

In November 2003, the team of COSMOS Corporation, Georgetown University, Kent State 

University, and Legal Momentum (formerly NOW Legal Defense and Education Fund) was 

awarded the grant entitled “Use and Outcomes of Protection Orders by Battered Immigrant 

Women” from the National Institute of Justice (NIJ), U.S. Department of Justice, to examine the 

decision-making factors, accessibility, and effectiveness of civil protection orders for battered 

immigrant women. Specific aims of the study are to: 

1. Examine the factors that affect the decision to file a petition for a civil 

protection order among battered immigrant women seeking help for IPV; 

2. Examine the systemic, community, and individual factors that affect whether 

a woman who petitions actually obtains a full protection order; and 

3. Compare the outcomes for women who obtain a full protection order; who file 

for, but do not obtain a full protection order; and who do not file for a 

protection order at 3-4-month follow-up. 

The policy and practice implications of this research will include judicial and justice system 

education, training of immigration judges and Bureau of Citizenship and Immigration Services 

staff, fostering improved cultural competency of domestic violence services, and improving 

access to and the justice system’s response to immigrant victims. 

Data will be collected through face-to-face interviews with participants. Participants will 

be approximately 350 battered immigrant women from the Asian, Latino, African, Middle 

Eastern, and European communities who are seeking help for intimate partner violence (IPV) 

from one of seven partner organizations which offer legal and advocacy services to these 

populations. Advocates or caseworkers from these agencies will administer initial and follow-up 

questionnaires (i.e., two interviews) to study participants and maintain contact with participants 

in between the initial and follow-up interviews. 

The Georgetown University Institutional Review Board is the IRB of record for the project 

“Use and Outcomes of Protection Orders by Battered Immigrant Women” (IRB #03-302). The 

IRB approved the research protocol and consent form on January 19, 2004. 

Participants will be paid $40 in cash for completion of both the initial and follow-up 

interviews on a prorated basis as follows: $15 after completion of the initial interview, and $25 

after completion of the follow-up interview. 

COSMOS Corporation, rev. 4.6.05 4 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Each partner organization will receive $85 total per participant for administration of both 

the initial and follow-up interviews and maintaining contact with the participant between 

interviews. The per participant fee will be paid to the site on a prorated basis as follows: $30 

after the completion of the initial interview and submission of the completed study instrument to 

COSMOS; $55 after completion of the follow-up interview and submission of the completed 

study instrument to COSMOS. 

As the lead organization, COSMOS will disburse all site and participant fees. Participant 

fees will be disbursed to each organization in advance of administering the questionnaire to 

participants (so the partner organizations are not required to “front” these funds). Each partner 

organization will be required to sign a letter of agreement outlining the scope of work for the 

project, and this letter will be signed by authorized representatives from the partner organization 

and COSMOS. Any questions regarding the agreements between the partner organization and 

COSMOS may be directed to the project coordinator, Darci Terrell, who serves as the COSMOS 

representative on this project. 

2.2 Role of the Partner Organizations 

Seven partner organizations have been recruited to administer the questionnaire to their 

clients who meet the participant selection criteria (the list of partner organizations appears in 

Section 1 of the Manual). The partner organizations are the link to the population of battered 

immigrant women who are the focus of the research project. The partner organizations were 

selected based on the types of immigrant women they serve, with the overall goal of targeting 

women who come from a wide range of countries of origin. The interviewers within each 

partner organization will receive training from the research team on the specifics of 

questionnaire administration. The interviewers will be responsible for recruiting eligible 

participants, conducting the consent discussion with the participant, administering the initial 

interview, maintaining contact with the participant during the 3-4 month interim, and scheduling 

and administering the follow-up interview. 

2.3 Overview of the COSMOS Study Questionnaire (Initial Interview) 

The COSMOS Study Questionnaire (Initial Interview) (see Appendix A) is divided into the 

following sections: 

I. Demographics: to assess age, number of children, immigration status, country of 

origin, ethnicity, marital status, and other related items. 

II. Stephenson Multigroup Acculturation Scale: to assess acculturation on two 

subscales: dominant society immersion and ethnic society immersion. 

COSMOS Corporation, rev. 4.6.05 5 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
III. Psychological Maltreatment of Women Inventory: to measure 

dominance/isolation and verbal/emotional types of psychological abuse. 

IV. Conflict Tactics Scale: to measure the frequency of physical violence, injury, and 

sexual coercion by a current or former partner. 

V. IPV Threat Appraisal Scale: to assess participants’ expectation that IPV will occur 

within the next 12 months. 

VI. Experience with Protection Orders: to inquire about participants’ experience in 

obtaining a protection order and the process of deciding whether or not to file for a 

protection order. 

VII. Posttraumatic Stress Disorder Checklist (PCL) and Center for Epidemiological 

Studies – Depression Scale (CES-D): to assess interpersonal symptoms of 

posttraumatic stress and depression, respectively. 

VIII. Exposure to Traumatic Events: to assess the participants’ level of exposure to 

traumatic events during their lifetime 

IX. Social Support Scale: to assess the level of social support that participants’ 

perceive that they receive from family and friends. 

The questionnaire is a mixture of open-ended questions requiring the interviewer to write 

the participant’s responses, and close-ended questions that are either multiple choice or 

true/false. Details about how to fill out the questionnaire can be found in Section 5.2 of the 

Manual under the heading, “Administration of the Initial Questionnaire.” 

2.4 Overview of the COSMOS Study Questionnaire (Follow-up Interview) 

The follow-up interview will contain questions from the initial interview as well as new 

questions. The follow-up interview will omit any items for which the answers will not change. 

2.5 Scan Format of the Questionnaires 

The initial and follow-up questionnaires will be printed on a form that can be scanned 

directly into a database. COSMOS will provide the printed questionnaires to each partner 

organization in advance. Detailed instructions on how to fill out the questionnaire can be found 

in Section 5 of this manual. 

COSMOS Corporation, rev. 4.6.05 6 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
2.6 Definitions 

Intimate partner violence (IPV): Actual or threatened physical or sexual violence or 

psychological and emotional abuse directed toward a 

spouse, ex-spouse, current or former boyfriend or 

girlfriend, or current or former dating partner. Intimate 

partners (or relationships) may be heterosexual or of the 

same sex. Some of the common terms used to describe 

intimate partner violence are domestic abuse, spouse abuse, 

domestic violence, courtship violence, battering, marital 

rape, and date rape. 

Civil protection order (CPO): A court order restricting one party from contacting or 

harming another party. Generally, state statutes condition 

issuance of a protection order on the existence of an 

underlying act of abuse which constitutes a criminal act, 

including: assault, battery, burglary, kidnapping, criminal 

trespassing, interference with child custody, sexual assault, 

rape, threats and attempts to do violence or bodily harm, 

interference with personal liberty, unlawful or forcible 

entry into a residence, child abuse, false imprisonment, 

stalking, harm to pets, and destruction of property. 

Participants: The persons taking the questionnaire will be referred to in 

this Training Manual, and thereafter, as participants. 

Interviewer: The person or persons designed by each site to administer 

the questionnaire to participants. 

COSMOS Corporation, rev. 4.6.05 7 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
3. SCREENING POTENTIAL PARTICIPANTS 

3.1 Identifying Potential Participants 

The partner organizations are urged to begin the process of identifying potential 

participants as soon as possible. A potential participant should first be approached with a 

request to determine their interest in hearing more about the study. The following script is 

recommended: 

REQUEST TO CONDUCT SCREENING: 

[Name of Organization] working on a study to find out if immigrant women 

use protection orders, and if so, if the protection orders were helpful. We will 

be interviewing a lot of women, like yourself, to find out about their decisions 

and experiences with protection orders. I would like to ask you a few questions 

to see if you would qualify to participate in the project. Everything you tell me 

will be kept private. It is okay if I ask you a few questions? 

If the client agrees to answer the screening questions, the interviewer should next determine if 

the client meets the selection and disqualification criteria listed below. The interviewer should 

complete the Screening Checklist (see Exhibit 3-1) for each client that is screened, regardless of 

whether the client passes the screening. Ideally, the Screening Checklist is completed on the 

same day that the interview is conducted. If the client wishes to conduct the interview at a later 

time, the interviewer should reconfirm (on the day that the interview is conducted) the client’s 

protection order status, and the disqualification criteria. All Screening Checklists will be 

submitted to COSMOS. 

3.2 Participant Screening: Protection Order Status 

Participants may be new clients or any client who first came to the partner organization in 

the last six months. Participants will fall into one of the following two categories: 

1. Have not filed a protection order against an intimate partner within the last 6 months; 

OR 

2. Within the last 6 months have filed for a protection order (whether the temporary or full 

order was granted or not). 

The interviewer will note which category the participant belongs to on the Screening 

Checklist. We are interested in achieving a balance of participants in the above-noted two 

categories. The research team will be responsible for monitoring recruitment levels in each 

category (based on the information you provide in the Screening Checklist) and will notify the 

partner organizations if a shift in recruitment is required (i.e., if more participants are needed in 

any one of the noted categories). 

COSMOS Corporation, rev. 4.6.05 8 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
3.3 Participant Screening: Selection Criteria 

Clients who have been identified as potential participants and have agreed to proceed with 

the screening must be queried to determine if they meet ALL of the selection criteria listed 

below: 

1) Female status; 

2) Age 18 years or older; 

3) Born outside of the U.S.; 

4) Seeking help due to IPV from one of the partner agencies within the last 6 months; 

AND 

5) The most recent IPV incident having occurred within the past 12 months. 

3.4 Participant Screening: Participants That Do Not Qualify for the Study 

Clients must also be queried to determine if they meet the ANY of the following criteria, 

which would result in their not qualifying to participate in the study: 

1) We are seeking clients who would qualify for a protection order in the U.S., thus if 

a client was not physically or sexually abused in the U.S., they would not qualify 

for the study; OR 

2) Clients who –by law– do not meet the qualifications to receive a protection order 

(e.g., women who were emotionally abused only) would not qualify for the study. 

In addition, to the two criteria noted above, any of the following would result in the client 

not qualifying for the study: 

3) Current serious mental illness, including women who are acutely suicidal; 

4) Serious mental retardation; 

5) Serious hearing impairment that would prevent verbal administration of the 

questionnaire; 

6) Acute intent to harm others; OR 

7) Alcohol or other substance intoxication. 

3.5 Participant Recruitment 

If the client meets the selection criteria for the study, AND is not disqualified from 

participation, then the interviewer should proceed to determine if the client is interested in 

participating in the study. The following script is recommended: 

COSMOS Corporation, rev. 4.6.05 9 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
REQUEST TO PARTICIPATE IN THE STUDY: 

You are eligible to participate in the study. If you choose to participate, we 

will interview you two times, now and again in about 3-4 months. Each 

interview will take about 1 1⁄2 hours to complete. We will pay you $40 total to 

complete both interviews; you will receive $15 in cash to complete the first 

interview, and we will pay you $25 in cash when you complete the last interview 

in 3-4 months. In the interviews, we will ask questions about you and your 

family, how you have adapted to living in the U.S., how happy you are with your 

life, the threat of danger you feel from your partner, your experience with 

protection orders, and other related questions. You do not have to participate 

in the study if you don’t want to and this will not affect your eligibility to 

receive services from [agency]. If you would like to participate, we would ask 

you to sign a consent form that explains what the study is about, what you will 

be asked to do, the risks and benefits of being in the study, and the steps we will 

take to protect (or keep private) all the information that you give us. Are you 

interested in reading the consent form? 

If the client is interested in reading the consent form, the interviewer should proceed with 

the consent discussion, which is detailed in the next section of the Manual. 

COSMOS Corporation, rev. 4.6.05 10 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
4. INFORMED CONSENT AND CONFIDENTIALITY

Due to the sensitive and personal nature of the COSMOS Study Questionnaire, participants 

will be required to read and sign an informed consent document before completing both the 

initial and follow-up interviews. Also, procedures have been developed to protect the identity of 

participants and the information they provide. No personal identifying information such as 

Social Security Number, address, etc., will be collected from participants. Safety concerns will 

be paramount in all contacts with participants. 

4.1 Risks to Respondents 

The questionnaire asks participants to provide personal and sensitive information about 

their lives and relationships. As part of the consent procedure, participants are informed about 

potential risks, including the possibility that if their abusive partner learns of their involvement 

in the study, they could be at increased risk of violence or other forms of retaliation from their 

partner. Also, participants are informed that if they tell the interviewer about a child who is 

being abused or about their intent to hurt someone, that the interviewer may be required by law 

to report that information to the authorities. Lastly, it is possible that participants may feel 

uncomfortable or become upset when they talk about their personal experiences. However, 

participants may find that talking with the interviewer about their experiences feels supportive or 

is helpful in some way. 

4.2 Risk Management 

A Detailed Safety Protocol has been developed to codify the procedures for minimizing the 

risks to participants and others, as follows: 

• If at any point, the interviewer or the participant herself believes that the 

participant might be in increased danger due to her participation in the study, their 

involvement will be terminated immediately, until such time as the increased 

danger is no longer present. 

• If the participant tells the interviewer of their intent to harm someone else or 

themselves, the interviewer should probe to determine if the intent is legitimate, 

and if so, should terminate the interview immediately. The interviewer should 

then contact their organizational supervisor and follow their organization’s 

guidelines for mandatory reporting. The interviewer should then contact the 

principal investigator (Dr. Mary Ann Dutton, 301-526-0658) to discuss the 

incident. If the principal investigator is not available, the interview should contact 

the project coordinator (Darci Terrell, 301-215-9100). Additional contact 

information for the principal investigator and project coordinator can be found in 

Section 1 of this Manual. 

COSMOS Corporation, rev. 4.6.05 11 

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been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
• If the participant begins to tell of a child that is being abused, the interviewer 

should remind the participant of the mandatory reporting requirements. If the 

participant tells of a child that is being abused, the interviewer should terminate 

the interview immediately. The interviewer should then contact their 

organizational supervisor and follow their organization’s guidelines for mandatory 

reporting. The interviewer should then contact the principal investigator (Dr. 

Mary Ann Dutton, 301-526-0658) to discuss the incident. If the principal 

investigator is not available, the interview should contact the project coordinator 

(Darci Terrell, 301-215-9100). Additional contact information for the principal 

investigator and project coordinator can be found in Section 1 of this Manual. 

• All interviews will be conducted in private. 

• A careful debriefing will be conducted following each interview to ensure that 

participants have not been upset by the nature of the interview, and to provide 

appropriate referrals if appropriate. 

• All participants will be given referrals to community agencies that can provide 

emergency service or other assistance. 

The investigators believe that any foreseeable risks involved can be managed so that 

participants will not be placed at increased risk of serious physical or psychological jeopardy. 

The investigators have conducted similar studies with the same population and have not received 

any reports that the study resulted in adverse outcomes for any participant. In fact, many 

participants have expressed appreciation for the opportunity to talk about their situation. 

4.3 Procedures for Acquiring Informed Consent 

An informed consent document (see Exhibit 4-1) was developed to ensure that participants 

understand the purpose of the study, the nature of participation in the study, procedures, potential 

risks and benefits to them, and persons who they may contact to inquire further about their 

participation. Once a client has agreed to participate in the study, the next step is to introduce 

the consent process and form to the participant. 

Introduce Consent Process and Forms to Participants 

The interviewer must present a brief overview of the consent process to the participant to 

explain why they are reading the consent form and why they must sign it if they wish to 

participate in the study. The interviewer must not assume that the participant will be familiar 

with consent forms, the issue of confidentiality, or their rights as research participants. The 

following script is provided to assist interviewers who are conducting the consent discussions in 

introducing the consent process to participants. 

COSMOS Corporation, rev. 4.6.05 12 

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been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
CONSENT PRESENTATION: 

“In order for you to participate in the study, you must read a consent form that explains: 

• What this study is about; 

• What you will be asked to do; 

• The risks and benefits of participating in the study; and 

• The steps the researchers will take to protect (or keep private) the information that 

you give us. 

I will be happy to explain any part of the form or answer any questions you may have. Once 

you read the consent form, you will be asked to sign the form. By signing the form, you are 

saying that you read the form, that anything you didn’t understand was explained to you, and 

that you agree to participate in the study. 

I would like to remind you that your participation in the study is voluntary, which means you 

do not have to participate if you don’t want to. 

If you would like, I can read the form to you. Would you like to read the form yourself or 

would you like me to read the form to you? If you choose, you may take the unsigned consent 

form home to read more carefully and return at a later time to complete the consent process. 

Upon signing the form, you will receive a copy of the form, unless you prefer not to. The 

original form will be kept in a locked drawer and will be destroyed at the end of the study. 

Both the participant and the interviewer must sign the consent form in order to finalize the 

consent process. Ideally, the participant will complete the questionnaire immediately following 

the consent discussion; however, it is acceptable to conduct the interview at a later prescheduled 

date (i.e., if the participant cannot do the interview immediately following the consent 

discussion, the interview should schedule a date and time for the interview before the participant 

departs). 

Participant Questions about the Consent Form 

The interviewer must make every effort to answer all of the participants’ questions about 

the consent form, process, etc. Below are some examples of questions that participants might 

ask and information to help answer the questions. Every question that might be raised is not 

listed here; the interviewer should answer the question if the answer is known. However, if the 

interviewer does not know the answer, the interviewer should politely excuse herself (tell the 

participant, “I don’t know the answer to that question, but let me find out”) and call the lead 

contact for the organization, the principal investigator (Mary Ann Dutton-phone number listed 

on the consent form), or project coordinator (Darci Terrell-phone number listed on the consent 

form) to find the answer. 

COSMOS Corporation, rev. 4.6.05 13 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Questions that may be raised by participants: 

1. Do I have to sign this now? 

Answer: You must sign the form in order to participate in the study; however, you 

are free to take the form home and read it more carefully and return at a later time to 

speak with me about the form and sign it. 

2. The form says (or you indicated when you read the form to me) that I might 

become upset when I talk about my feelings. What are you going to ask that 

might make me upset? 

Answer: I will ask questions about your experience with abuse or violence in an 

intimate relationship and about your experience adapting to life in the U.S. It is 

possible that thinking about these things could be upsetting because it brings back 

bad memories. Remember, you do not have to answer any question that you don’t 

want to. 

3. Who will know about all the things I tell you? 

Answer: The research team will combine all the information that participants tell us; 

we will not report information for individual participants, but for all participants as a 

whole. We will not write your name on the questionnaire, only an ID number. The 

only people that can connect names to ID numbers are the principal investigator and 

the project coordinator. 

4. Will this information be published in any form, or made publicly available? 

(Will other people be able to read about what I have told you?) 

Answer: Results of this study may be reported in meetings or publications; however, 

the identity of specific study participants will not be disclosed. In other words, the 

results of the study will be reported overall, not about specific people. 

4.4 Debriefing with the Participant (after the questionnaire is administered) 

A debriefing must be provided at the conclusion of the questionnaire administration for the 

following reasons: 

1. Provide closure after the discussion of difficult issues; 

2. Assessment of the participant’s well-being, and to secure assistance for the participant if 

they require or need it; and 

3. Remind the participant of the follow-up interview, and secure contact information. 

The following script is recommended: 

COSMOS Corporation, rev. 4.6.05 14 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
DEBRIEFING PRESENTATION: 

“Thank you very much for your time. Your participation is very important to this study, 

which will help understand how to better serve battered immigrant women as they seek to 

obtain protection orders. As we noted before, we will want to talk with you one more time 

(a follow-up interview), in about 3-4 months, sometime in [name month], to ask similar 

questions and find out how you are doing. 

[NAME – person at the partner organization] is available to speak with you if you would 

like to talk to someone. I am going to give you a list of local and national organizations 

that can assist you; these resources include domestic violence hotlines and social service 

agencies. Please call upon these resources and [NAME] if you need any help; they are 

here to help you. 

Do you have any questions about the questionnaire, the follow-up interview, or anything 

else? 

I would like to go ahead and schedule a date for the follow-up interview. This date can be 

changed later if it will not work for you. I will call you two months before the appointment 

to confirm your contact information, 1 week before the appointment to confirm the date and 

time of the appointment, and 1 day before to remind you of our appointment.” 

The interviewer should complete the Participant Contact Sheet (Exhibit 4-2) following this 

discussion to secure contact information for the participant. 

Providing Compensation to the Participant 

At the conclusion of the debriefing, the interviewer will provide the prorated compensation 

to the participant, and request that the participant sign a form (see Exhibit 4-3) acknowledging 

the compensation payment and that the interviewer will be contacting them in approximately 3-4 

months to complete the follow-up interview. 

Procedures for Safely Storing Completed Consent Forms 

Consent forms should be submitted to COSMOS along with the completed study 

questionnaire. However, in the interim prior to submission of these forms/instruments to 

COSMOS, the interviewer is responsible for filing all consent forms in a secure centralized 

location that would prevent their review by unauthorized personnel (e.g., locked rooms or locked 

file cabinets). Consent forms should be filed separately from any documents that would link 

participants to the study (e.g., their completed questionnaire) or their contact information, in 

order to protect their privacy. 

COSMOS Corporation, rev. 4.6.05 15 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
4.5 Confidentiality and Data Monitoring Procedures 

The consent form will contain a participant identification (ID) number that will also appear 

on the questionnaire. The ID number is the only identifying information that will appear on the 

questionnaire. Information obtained about an individual participant will not be shared as 

individual data. All information will be summarized as group data. Data will not be stored in 

identifiable form. 

At COSMOS, the consent forms will be stored separately from the questionnaire in a 

locked and secure location. Only the Principal Investigator and Project Coordinator will have 

access to these confidential documents. 

COSMOS Corporation, rev. 4.6.05 16 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
5. LOGISTICS FOR INITIAL QUESTIONNAIRE ADMINISTRATION 

5.1 Preparation for Initial Questionnaire Administration 

Project Coordinator’s Duties 

• Disburse Participant Fees. The Project Coordinator will provide sufficient 

participant fees to each partner organization in advance of the administration of the 

initial interview. As noted previously, each participant will receive a prorated 

amount of $15 for completion and submission of the initial interview. As an 

example, if a partner organization has committed to recruiting 50 participants, 

COSMOS will disburse $750 to the partner to cover this cost up front. If the 

partner organization recruits fewer participants than anticipated, the leftover funds 

will be used towards participant fees for the follow-up interview. If the partner 

organization recruits more participants than anticipated, the organization should 

contact the Project Coordinator as soon as possible once this is known, and 

additional funds will be disbursed immediately. 

• Provide Materials for Questionnaire Administration. The Project Coordinator 

will compile all of the materials required to administer the questionnaire (Initial 

Questionnaire Package – see below) and submit these materials to the partner 

organizations. The package will be submitted by the Project Coordinator to the 

lead contact at each partner organization following the completion of the training. 

Contents of Initial Questionnaire Package 

1. Blank questionnaires (printed - not copied) each with the ID number (site code and 

participant code) pre-printed. The number of questionnaires provided will be 

equal to the number of participants the site has committed to recruiting. If a site 

recruits more participants than anticipated, the organization should contact the 

Project Coordinator as soon as possible once this is known, and additional 

questionnaires will be provided immediately (a copy of the Questionnaire is 

provided in Appendix A of the manual). 

2. Blank consent forms – two for each participant; one is for the participant’s 

signature and the project’s files, and the other copy is the participant copy (if they 

choose to keep a copy) (see Exhibit 4-1). 

3. Blank Participant Fee Acknowledgement forms – the participant will sign this 

form to acknowledge receipt of the participant fee (see Exhibit 4-3). 

COSMOS Corporation, rev. 4.6.05 17 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
4. Questionnaire Logs – for each submission of completed questionnaires and their 

accompanying consent forms to COSMOS, the Administrator will note submission 

of each questionnaire, consent form, and Participant Fee Acknowledgement Form 

by ID number on the Log, and the date of the scheduled follow-up interview, and 

include the Log in the submission to COSMOS (see Exhibit 5-1). 

5. Blank Screening Checklists – the interviewer will fill this form out for each client 

that goes through the screening process, whether the client is eligible to participate 

in the study or not (See Exhibit 3-1). 

6. Blank Questionnaire Checklists – this form outlines all of the tasks involved in 

preparing for the interview, conducting the interview, and all follow-up activities 

(see Exhibit 5-2). 

7. Blank Participant Contact Sheets – the interviewer will complete this form at the 

conclusion of the interview to acquire the information needed to re-contact the 

participant for the follow-up interview (see Exhibit 4-2). 

8. Interviewer ID Assignment form – each site will assign each interviewer a unique 

ID number and note the ID number assignment on this form (see Exhibit 5-3). 

9. Visual Cards – the visual cards will be used during the interview to assist the 

participant in answering certain questions (see Appendix B). 

10.Return envelopes and labels (for submitting completed questionnaires, consent 

forms, Screening Checklists, and Participant Fee Acknowledgement Forms, and 

Interviewer ID Assignment form to COSMOS). 

Site Contact Person’s Duties 

• Confirm receipt of the Initial Questionnaire Package to the Project Coordinator, 

and inform the Project Coordinator if any items (contents noted above) are 

missing from the Package. 

• Assign an Interviewer ID Number for each person that will administer the 

questionnaire, and inform each interviewer of their ID number assignment. The 

form that will be used to record Interviewer ID Numbers is provided in Exhibit 5-

3. The Interviewer ID Numbers are 2-digit numbers. The first Interviewer ID 

Number will be “01,” then “02,” and so on. The interviewers must note their 

Interviewer ID Number on the first page of the COSMOS Study Questionnaire, in 

the last two boxes located to the right of the participant ID number. The site 

contact person will submit the Interviewer ID Assignment form back to COSMOS 

when submitting completed questionnaires and other associated forms. The site 

contact person should keep a copy of the Interviewer ID Assignment form for 

COSMOS Corporation, rev. 4.6.05 18 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
their records. If new interviewers are utilized at a later time, the site contact 

person should assign them a new unique Interviewer ID Number, add them to the 

Interviewer ID Number Assignment, and resubmit the form to COSMOS. 

• Distribute the materials from the Initial Questionnaire Package to the 

interviewers. Contact the Project Coordinator if additional forms are needed. 

Interviewer’s Duties 

Prior to commencing any tasks related to administration of the questionnaire, each 

interviewer must be assigned an Interviewer ID Number. The contact person at each site will be 

responsible for assigning an ID number to each interviewer prior to the distribution of materials 

to the interviewers. If an interviewer has not received an ID number, they should ask the contact 

person to make the assignment. The interviewer must note their Interviewer ID Number on the 

first page of the COSMOS Study Questionnaire, in the last two boxes located to the right of the 

participant ID number (see Section 5.3 below for a graphic representation of how to note the 

Interviewer ID Number on the COSMOS Study Questionnaire). 

A checklist of all tasks that need to be completed by the interviewer is provided in Exhibit 

5-2. Details about each task are outlined below. 

• Screen and consent eligible participants. The interviewer should schedule 1.5 hour 

blocks of time for administration of the questionnaire with eligible participants. 

This time should be sufficient to conduct the consent discussion, administer the 

questionnaire, and conduct the debriefing. 

5.2 Administration of the Initial Questionnaire

 Interviewer’s Duties 

A checklist of all tasks that need to be completed is provided in Exhibit 5-2. Details about 

each task are outlined below. 

• Conduct Screening (see Section 3 of the Manual for more details on eligibility and 

disqualification criteria). Completely fill out the Screening Checklist (Exhibit 3-1) 

for each client that is screened, regardless of whether they screen in or out of the 

study. 

If the Client Screens Out: Leave the Participant ID Number blank on the 

Screening Checklist. 

COSMOS Corporation, rev. 4.6.05 19 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Preprinted ID Number, appears on the questionnaire and consent 

form; the boxes are blank on the Screening Checklist and 

Participant Contact Sheet. This number to be added to the 

Screening Checklist and Contact Sheet only if the client screens

into the study. 

On the first page of the questionnaire only,

space for the Interviewer ID Number, to be 

assigned by the site, and filled in by the 

If the Client Screens In: 1) Hand write the Participant ID Number that will 

be used for that participant onto the Screening 

Checklist and the Participant Contact Sheet (the 

Participant ID Number is pre-printed on the 

COSMOS Study Questionnaire and the Consent 

Form). 

2) Hand write the Interviewer ID Number on the 

COSMOS Study Questionnaire, page 1, on the line 

that follows the Participant ID Number (top right 

side of the page) 

Example: 

ID # 0 2 0 0 1 0 1 0 

Preprinted ID Number, appears on the questionnaire and consent On the first page of the questionnaire only, 

form; the boxes are blank on the Screening Checklist and space for the Interviewer ID Number, to be 

Participant Contact Sheet. This number to be added to the assigned by the site, and filled in by the 

Screening Checklist and Contact Sheet only if the client screens 

into the study. 

• Introduce the Research Project (see Section 3 of the Manual) 

• Obtain Informed Consent (see Section 4 of the Manual) 

• Administer the Questionnaire. The questionnaire is formatted specifically so that 

the data can be automatically scanned into a database (i.e., no manual data entry). 

An example of what the form will look like is provided in Exhibit 5-4. For form to 

scan correctly, interviewers must fill out the questionnaire according the following 

guidelines: 

1. Use black or blue pen when filling out the questionnaire. 

COSMOS Corporation, rev. 4.6.05 20 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
2. For close-ended questions: For multiple choice and true/false questions, the 

selected response should be denoted by completely filling in the corresponding circle 

next to the question. In order for information to be scanned correctly, the circles need 

to be filled out as directed. Stray marks may result in error. 

Correct way to fill in circles: ●

Incorrect way to fill in circles: O or O 

If you make a mistake and fill in the wrong box, fill in the corrected (right) answer, 

and circle it. The person responsible for scanning the form will know the answer 

circled is the correct one. Do not try to erase the incorrectly filled box. 

Example: Yes: ● No: ●

3. For open-ended questions: For open-ended questions, the Administrator should 

write only in the space or box provided and use block lettering, not cursive writing. 

Example: WRITE ANSWER IN THE BOX USING BLOCK LETTERING; DO NOT USE 

CURSIVE WRITING. 

4. The interviewer can make notes in the margins of the page, but cannot write over 

the bubbles, boxes, or scan code, or beyond the anchors (see Exhibit 5-4). 

5. Complete vs. Incomplete Questionnaires. Participants are told that they don’t have 

to answer any question that they don’t want to answer. If a participant chooses not to 

answer a question, the interviewer should note “REFUSED” next to the question. A 

questionnaire can be considered complete if most of the questions are answered. 

However, a questionnaire should be considered incomplete (and thus the participant 

fee should not be provided) if the participant stops and does not finish the interview, 

or if the participant skips a section of the questionnaire. 

6. Edit the Questionnaire. At the conclusion of the questionnaire, before issuing the 

participant fee and starting the participant debriefing, quickly scan through all pages of 

the questionnaire to ensure that all questions have been answered, that all handwritten 

notes are legible and will make sense. 

COSMOS Corporation, rev. 4.6.05 21 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
• Distribute Participant Fee and Request Participant Sign Acknowledgement. 

Once the questionnaire is complete, provide the participant fee and have the 

participant sign the Participant Fee Acknowledgement Form. As a reminder, the 

participant will receive a total of $40 for completing both interviews to include 

$15 for completion of the initial interview, and the remaining $25 will be 

provided after completion of the follow-up interview (in 3-4 months). The 

participant fee should not be provided if the questionnaire is incomplete (e.g., if 

the participant stops and does not finish the interview, or if the participant skips a 

section of the questionnaire). 

• Conduct Participant Debriefing (see Section 4 of the Manual) 

• Schedule Appointment for Follow-up Interview and Complete the Participant 

Contact Sheet 

5.3 Activities to be Conducted Following Administration of the Initial Questionnaire 

Completed questionnaires, accompanying consent forms, the Screening Checklist, and 

Participant Fee Acknowledgement Forms should be submitted weekly to COSMOS. A checklist 

of all tasks that need to be completed is provided in Exhibit 5-2. Details about each task are 

outlined below. 

• Complete the Questionnaire Log. You will use the Log to note the contents of 

each submission to COSMOS (see Exhibit 5-1). You will note each 

questionnaire, consent form, Screening Checklist, and Participant Fee 

Acknowledgement Form by ID number on the Log, as well as the date of the 

scheduled follow-up interview. As a reminder, Screening Checklists for 

participants who screened out of the study should also be submitted. The 

Participant ID Number on these Screening Checklists will be blank, but the rest of 

the form should be completedly filled out. Each of these “screened out” 

Screening Checklists should be noted on the Questionnaire log; under “ID 

Number” put “SO.” 

• Make Copies of the Submission Materials. Make one copy of each 

questionnaire, consent form, Screening Checklist, and Participant Fee 

Acknowledgement Form in the submission. These copies will serve as a backup 

in the event that the submission is lost or destroyed in the mail. COSMOS will 

confirm the receipt of your submission, and at that point, you will send the 

backup copies to COSMOS. 

COSMOS Corporation, rev. 4.6.05 22 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
• Fill out the UPS Label. Complete the UPS return label provided in the Initial 

Questionnaire Package. By using this label, the UPS charges will be billed 

directly to COSMOS’s UPS account. Exhibit 5-5 is an example of how the UPS 

return label should look. The submission address is as follows: 

Nyala Watkins 

COSMOS Corporation 

3 Bethesda Metro Center, Suite 950 

Bethesda, MD 20814 

Ph: 301-215-9100

• Package Original Materials and Request UPS Pick-up. Once the label is 

complete and copies are made, package the ORIGINAL questionnaires, consent 

forms, Screening Checklists, Participant Fee Acknowledgement Forms and the 

LOG, and call UPS for package pick-up. The number to call is on the UPS label. 

• Send Backup Copies to COSMOS. Once COSMOS confirms receipt of the 

original package, the interviewer will be requested to send the backup copies to 

COSMOS as well, utilizing the procedures noted above for submitting to 

COSMOS via UPS. 

5.4 Activities to be Conducted at COSMOS Following Submission of the Completed 

Questionnaires 

• Check enclosed Questionnaire Log (see Exhibit 5-1) against package contents; 

contact site if there are any inconsistencies. File Questionnaire Log. 

• Track ID numbers of incoming questionnaires against master ID list. 

• Scan questionnaires. 

• File questionnaires, consent forms, Screening Checklists, and Participant Fee 

Acknowledgement Forms in locked cabinet in Room X (to be determined). 

Questionnaires and consent forms are to be filed separately. 

• Process payment to site for completion of the number of initial interviews as 

noted on the Questionnaire Submission Log. Note payment to each site on 

Payment Log (to be developed). 

COSMOS Corporation, rev. 4.6.05 23 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
6. LOGISTICS FOR FOLLOW-UP QUESTIONNAIRE ADMINISTRATION 

6.1 Safety Procedures for Re-Contacting the Participant 

Ideally, an appointment (date and time) for the follow-up interview will be scheduled at the 

conclusion of the initial interview. Whether the purpose of the re-contact is to confirm or 

schedule the appointment, the following procedures should be followed to ensure the 

participant’s privacy and safety. 

• Follow the contact instructions provided by the participant on the Participant Contact 

Sheet; 

• Always refer to the project as the “COSMOS Study”; 

• When calling one of the participant’s contact persons, say “(Participant) listed you as 

someone who could help me get in touch with her. What is the best way to get in 

contact with (participant).” Do not give the contact person any of the contact 

information that the participant provided. 

• Participants should be told that if it becomes unsafe to continue the phone 

conversation at any time, they should say, “I have to go now” or “wrong number” and 

hang up. The interviewer will then call back at a later time or the next day to followup with the participant. 

6.2 Re-Contact Schedule 

• The interviewer should conduct one interim contact at approximately 2 months 

following the initial interview in order to update the Participant Contact Sheet; 

• The interviewer should contact the participant 1 week prior to the scheduled followup interview to confirm the date and time; and 

• The interview should contact the participant the day before the scheduled follow-up 

interview to confirm the date and time. 

6.3 Preparation for Follow-up Questionnaire Administration – TO COME 

6.4 Administration of the Follow-up Questionnaire – TO COME 

6.5 Activities to be Conducted Following Administration of the Follow-up Questionnaire – 

TO COME 

COSMOS Corporation, rev. 4.6.05 24 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
7. TEAM COLLABORATION AND INFORMATION SHARING 

7.1 Introduction to the BIW Project Partners Listserv 

The research team has developed a project listserv to enable communication among 

all project team members. A listserv is like an e-mail conference call. A listserv (or 

mailing list) is software that allows groups of individuals to “converse” with each other in 

writing by sending messages to only one email address. When a listserv member writes to 

the listserv address, every other member gets that message via e-mail sent to his or her 

personal mailbox. In turn, any listserv member who wishes to reply may do so by sending 

that reply to the listserv address. In this way, a large group may “converse” efficiently online without having to type multiple email addresses. 

The team has set up the listserv through Yahoo!, which provides the service for free. 

The project coordinator will send all project partners an invitation email, which will 

contain instructions for subscribing to the listserv. 

The listserv also has a website where the partners will have access to files and an 

archive of all the messages posted to the listserv. Members can elect to review all listserv 

message on the website instead of receiving email from the listserv, if they prefer. The 

web address for the listserv website is: 

http://groups.yahoo.com/group/BIWPartners/ 

Once you subscribe to the listserv, you may post messages to the listserv using the 

following email address: 

BIWPartners@yahoogroups.com 

The research team requests that ALL communication regarding the study be forwarded through 

the listserv so that all members have access to questions, answers, and information. The project 

coordinator will be responsible for monitoring and updating the listserv, and providing technical 

assistance to members. Please direct any questions about the listserv to the project coordinator. 

7.2 Biweekly Conference Calls 

Initially, the research team will conduct a biweekly conference call which all project 

partners are encouraged to attend. During these conference calls, the team members will discuss 

progress to date, obstacles encountered, problem-solving, etc. This will be a forum for asking 

questions 

COSMOS Corporation, rev. 4.6.05 25 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
about the interviews and logistics for questionnaire administration. The project coordinator will 

post the notes for these conference calls on the listserv for the benefit of those project partners 

who cannot attend. Project partners are encouraged to use the listserv to ask questions if time is 

of the essence. 

COSMOS Corporation, rev. 4.6.05 26 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
EXHIBITS 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 3-1 

ID # 

SCREENING CHECKLIST 

Interviewers should track the screening process with each participant by completing this checklist. 

The checklist will be submitted to COSMOS. Details about the screening criteria and procedures 

can be found in Section 3 of the Training Manual. 

Protection Order Status (Instruction: Check only one) 

 Client has not filed for a protection order against an intimate partner within the last 6 months. 

 Within the last 6 months, the client has filed for a protection order (whether the temporary or full order was 

granted or not). 

Selection Criteria (Instruction: Check all that apply; client must meet ALL criteria in order to be eligible for the 

study) 

 Female status 

 Age 18 years or older 

 Born outside of the U.S.; list country of birth 

 Seeking help due to IPV from {AGENCY} within the last 6 months 

Date client first came to {AGENCY}: / / (mm/dd/yy) 

 The most recent IPV incident occurred within the last 12 months 

Disqualification Criteria (Instruction: Check all that apply. Client does not qualify for the study if they meet any 

one of the following criteria) 

 Client was not physically or sexually abused in the U.S.

 Client does not–by law–meet the qualifications to receive a protection order (e.g., women who were 

emotionally abused only). 

 Client has current serious mental illness, includes women who are acutely suicidal. 

 Client has serious mental retardation. 

 Client has serious hearing impairment that would prevent verbal administration of the questionnaire. 

 Client has acute intent to harm others. 

 Client has alcohol or other substance intoxication. 

Is client eligible to participate in the study?........................................ O Yes O No 

Did client agree to hear the consent presentation? ............................... O Yes O No 

Did client sign the consent form (i.e., agree to participate in the study)? O Yes O No 

Rev. 1/20/05 E-1 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 4-1

PROJECT CONSENT FORM

ID # 

IRB No.: 03-302 

GEORGETOWN UNIVERSITY 

Consent to Participate in Research 

Project Name: Use and Outcomes of Protection Orders by Battered Immigrant Women 

Principal Investigator: Mary Ann Dutton, Ph.D. Telephone: 202-687-1997 

Georgetown University 

Co-Principal Investigator: Nawal Ammar, Ph.D. Telephone: 330-672-2775 

Kent State University 

Co-Investigator: Leslye Orloff, J.D. Telephone: 202-326-0042 

Legal Momentum 

Project Coordinator: Darci Terrell Telephone: 405-969-3078 

COSMOS Corporation 

Sponsor: The National Institute of Justice 

The Georgetown University Institutional Review Board has given approval for this research project. For 

information on your rights as a research participant, call the Institutional Review Board office: 202-687-1506. 

Introduction: You are invited to consider participating in this research study. We will be examining the 

decision making, access, and effectiveness of civil protection orders for immigrant women who have 

experienced violence or abuse in an intimate relationship. This form will describe the purpose and nature of 

the study, its possible risks and benefits, other options available to you, and your rights as a participant in the 

study. Please take whatever time you need to discuss the study with anyone you care to talk with. The 

decision to participate or not is yours. If you decide to participate, please sign and date the last line of this 

form. 

Background and purpose of the study: Current research does not address how immigrant women utilize 

civil protection orders as a means of protecting themselves and their children from intimate partner violence, 

the barriers immigrant women encounter when applying for and obtaining protection orders, and the 

effectiveness of such orders. We are conducting this study to examine these issues, and to also determine 

what factors influence an immigrant woman’s decision to seek a protection order, and what community, 

individual, or other factors affect whether or not immigrant women actually obtain a protection order. 

Total number of people: A total of about 350 women will take part in this study. 

General plan of the study: We will conduct initial and follow-up interviews with individuals who meet the 

following selection criteria: 1) females over 18 years of age; 2) born outside of U.S., 3) whose most recent 

incident of intimate partner violence occurred within the past 12 months, and 4) who are seeking help through 

one of our partner organizations. You were selected because of your participation in [name of program]. All 

interviews will be conducted by the advocate from [name of program]. The interviews will take 

approximately one hour and a half and will be held at [name of program] where you usually meet with your 

advocate. During the interviews, you will be asked questions about how you have adapted to living in the 

U.S., how happy you are with your life, the threat of danger you feel from your partner, and other related 

questions. Following the interviews, you will spend a few minutes talking with the advocate about what the 

interview was like for you. If you feel upset or would like to talk with someone further, the advocate from 

[name of program] will be available to help you. 

Rev. 2/11/05 

E-2

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 4-1 (Continued) 

ID # 

Length of the study for each participant: We expect that the interviews will each take about one hour and a 

half. 

Possible benefits of participating in the study: You may benefit from having an opportunity to talk about 

the issues related to your relationship. There are no other direct benefits to you for participating in this study. 

The information you share with us during the study will help to develop an understanding of how immigrant 

women use protection orders, the barriers they face when applying for protection orders, and the effectiveness 

of the protection orders. 

Possible risks of participating in the study: You may feel uncomfortable or become upset when you talk 

about your experiences. However, you may find that talking with the interviewer about your experiences feels 

supportive or is helpful to you in some way, although participation in this project is not considered counseling 

or any other type of therapeutic service. 

Who can participate in the study: To participate in the study, persons must meet all of the following 

selection criteria: 1) female over 18 years of age; 2) born outside of U.S., 3) whose most recent incident of 

intimate partner violence occurred within the past 12 months, and 4) who are seeking help through one of our 

partner organizations. 

Confidentiality of the data collected during the study: Your responses to the interview questions will 

remain confidential and anonymous. No names or personally identifying characteristics will be recorded on 

the questionnaire. We will code your questionnaire with a number. The advocate, the principal investigator, 

and the project coordinator will be the only ones who can link your name to the number on the questionnaire 

for the purpose of following up with you later. The questionnaire will be kept in a locked drawer and will be 

destroyed at the end of the study. The questionnaire will never be a part of your file at [name of program]. 

No names or identifying details will be used in any publication or other documents resulting from this study. 

You should know about two possible risks to the confidentiality of the data collected during the study. First, 

if you tell us about a child who is being abused or about your intent to hurt someone, we are required by law 

to report that information to authorities. Second, if your partner finds out about your participation in the 

study, you could be at increased risk of violence or other forms of retaliation from your partner. 

Costs to you for participating: There are no costs to you for participating in this study. 

Payments to you for participating: You will be paid a total of $40 in cash for participating in this study; 

$15 will be paid to you for completion of the initial interview, and $25 will be paid to you for completion of 

the follow-up interview. 

Your rights as a participant in the study: Participation in this study is entirely voluntary. You have the 

right to leave the study at any time. You do not have to answer any question you do not want to answer or 

that you feel would put you at any risk. Leaving the study will not result in any penalty or loss of benefits to 

which you are entitled. Should you decide to leave the study, just tell the interviewer that you no longer wish 

to participate. 

Questions: Should you have any questions at any time about this study, please contact Dr. Mary Ann Dutton 

at 202-687-1997. If you have any questions about your rights as a research participant, call the Georgetown 

University Institutional Review Board office at 202-687-1506. 

Rev. 2/11/05 

E-3

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 4-1 (Continued) 

ID # 

Interviewer’s statement: 

(Instruction: Mark one answer only) 

O The participant read the consent form. 

O I read the consent form to the participant. 

I have fully explained this study to the participant. I have discussed the procedures, the possible risks and 

benefits, the standard and research aspects of the study, and have answered all of the questions that the 

participant and the participant’s family members have asked. 

Interviewer’s signature ___________________________ Date _________________ 

Participant’s consent 

I have read the information provided in this Informed Consent Form or it was read to me by the interviewer. 

All my questions were answered to my satisfaction. I voluntarily agree to participate in this study. 

[Upon signing, you will receive a copy of this form, unless you prefer not to. The original will be kept in a 

locked drawer and will be destroyed at the end of the study.] 

Participant’s signature _______________________________________ Date _____________ 

Rev. 2/11/05 

E-4

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
______________________________________________________________________________ 

Exhibit 4-2 

PARTICIPANT CONTACT SHEET 

ID # 

Instruction: Do not read options to the participant; probe until there are no further responses. 

1. What is a phone number where it would be OK to call you? ( ) 

• Is the phone number listed in your name? Circle: yes no 

• Do you expect to be available at this telephone number in 3 months? Circle: yes no 

• Do you expect to move during the next 3 months? Circle: yes no 

If yes, how can we contact you? 

• Best days and times to call: _____________________________________________ 

• Is it safe to leave a message with anyone who answers this phone? Circle: yes no 

• Is it safe to leave the message “Hello, I’m calling from the COSMOS Study. Please call me back 

at (202) ???-???? and leave a message about a good time to reach you?” Circle: yes no 

2. If we cannot reach you by phone, is it safe to contact you by mail? Circle: yes no 

Please list a mailing address or PO Box if it is safe to send mail to you there: 

3. Please indicate if it is safe to call you at work. Circle: yes no no work phone 

If yes, Please list a work number where we can try to contact you: ___________________ 

• Best days and times to call at work:______________________________ 

• Is it safe to leave a message with any person who answers the phone? Circle: yes no 

• Is it safe to leave a message on your voicemail ? Circle: yes no 

4. Please indicate if it is safe to call your cell phone. Circle: yes no no cell phone 

If yes, Please list a cell number where we can try to contact you:_____________________ 

• Best days and times to call your cell phone: __________________________ 

• Is it safe to leave a message with any person who answers the phone? Circle: yes no 

• Is it safe to leave a message on your voicemail ? Circle: yes no 

5. Please indicate if it is safe to call your pager. Circle: yes no no pager 

If yes, Please list a pager number where we can try to contact you: ____________________ 

6. Please indicate if it is safe to call your fax number. Circle: yes no no fax 

If yes, Please list a fax number where we can contact you: ____________________________ 

7. Please indicate if it is safe to email you. Circle: yes no no email 

If yes, Please list an e-mail address where we can try to contact you: __________________ 

E-5 

Rev. 2/11/05 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
-CONFIDENTIAL— 

( Please list the names of other people you feel comfortable with, and who would know 

where to find you? Think about relatives, friends, neighbors, co-workers, and list as many 

people as you can. You can change or remove any of these phone numbers by calling the 

advocate who interviewed you or anyone else at [agency phone number]. We will not tell 

these contact people any information except that we are from the COSMOS Study and we 

are trying to reach you to participate in the study. We will not tell them what the study is 

about or any other details about the study or about you. 

Person’s 

Name 

Person’s 

Phone Number 

Person’s 

relationship to you 

Person’s 

Address 

1. 

2. 

3. 

4. 

5. 

6. 

7. 

8. 

(	 You may want to let these people know that you have given permission 

for us to call and find out where you are. 

E-6 

Rev. 2/11/05 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
____________________________________ 

____________________________________ 

Exhibit 4-3 

Participant Fee Acknowledgement Form 

(Initial Interview) 

I, ______________________________, have participated in the initial interview 

(print name above) 

for the COSMOS research project. 

In exchange for time spent during the interview, I have received $15. 

Signature of Participant 

Date 

E-7 

Rev. 2/11/05 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 5-1 

QUESTIONNAIRE LOG 

Date of Submission: 

Site Name: 

Name of Person Submitting Package: Phone: Email: 

Interviewer: Fill out and submit the Questionnaire Log each time you submit completed questionnaires to COSMOS. 

For each questionnaire submitted, note the ID number in the far left-hand column, and note with a check mark that you 

are submitting the questionnaire, consent form, screening checklist, and fee acknowledgement form in the submission. 

COSMOS will use this form to check the contents of the package when it is received. Also note the date of the 

scheduled follow-up interview, and use the far right-hand column “Comments” to note if there are any unusual 

circumstances. We suggest you keep a copy of each Questionnaire Log as a record of your submissions to COSMOS. 

ID Number Screening 

Checklist 

(check mark if 

included) 

Questionnaire 

(check mark if 

included) 

Consent 

Form 

(check 

mark if 

included) 

Fee 

Form 

(check 

mark if 

included) 

Date of 

follow-up 

interview 

(mm/dd/yy) 

Comments 

Rev. 2/11/05 

E-8 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 5-2 

QUESTIONNAIRE CHECKLIST 

This checklist does not need to be submitted to COSMOS; it is intended to assist the 

interviewers in tracking the tasks involved in administering the Questionnaire to 

participants. Details about each task can be found in Section 5 of the Training Manual. 

Preparation for Questionnaire Administration 

 Confirm receipt of the Initial Questionnaire Package to the Project Coordinator, and inform the Project 

Coordinator if any items are missing from the Package 

 Screen potential participants and complete Screening Checklist 

 Introduce the research project 

 Conduct consent discussion and obtain written consent 

Administration of the Questionnaire 

 Administer the Questionnaire 

 Check each page of the Questionnaire to make sure all questions are answered, filled in correctly, and 

that all notes are legible 

 Provide Participant Fee and have Participant sign Acknowledgement Form 

 Conduct Participant debriefing, including scheduling the appointment for the follow-up interview 

Submission of Questionnaires and Consent Forms to COSMOS (weekly) 

 Complete the Questionnaire Log for each submission to COSMOS 

 Make copies of each questionnaire, screening checklist, fee acknowledgement form, and consent form 

(these serve as a back-up) 

 Fill out the UPS label and package the original materials for submission to COSMOS. The package 

should include: 

o Questionnaire Log 

o Original versions of the Questionnaire 

o Original versions of the Screening Checklist 

o Original versions of the consent form for each Questionnaire 

o Original versions of the Participant Fee Acknowledgement Form for each Questionnaire 

 Call UPS to request a pick-up of the package. 

 Once the project coordinator confirms receipt of the package, send the backup copies to COSMOS 

following the same procedures. 

Rev. 1/20/05 E-9 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 5-3 

INTERVIEWER ID ASSIGNMENT 

Instruction: Site Contact Person should assign each interviewer a unique ID number, beginning 

with 01, 02, 03, etc., and note this assignment on this form. Return this form to COSMOS with 

the first submission of materials. Please keep a copy of this form for your records. If new 

interviewers are utilized at a later time, please assign them a new unique ID#, add them to this 

form, and re-submit to COSMOS. 

The Interviewer ID Number must be noted on the first page of the COSMOS Study Questionnaire, 

in the two boxes located to the right of the Participant ID Number. This will enable the study 

team to track who conducted each interview and will assist us if we have questions about any 

questionnaire. Interviewers should be informed of their assigned interviewer ID number so they 

can note it on the questionnaires. 

Interviewer 

ID # 

Interviewer First and Last Name 

01 

02 

03 

04 

05 

06 

07 

08 

09 

10 

11 

12 

13 

14 

Rev. 4/6/05 

E-10 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 5-4 

EXAMPLE OF TELEFORM FORMAT

E-11 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Exhibit 5-5 

EXAMPLE OF HOW TO FILL OUT UPS FORM

E-12 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
APPENDIX G

Screening Checklist 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
ID #

SCREENING CHECKLIST 

Interviewers should track the screening process with each participant by completing this 

checklist. The checklist will be submitted to COSMOS. Details about the screening criteria and 

procedures can be found in Section 3 of the Training Manual. 

Protection Order Status (Instruction: Check only one) 

 Client has not filed for a protection order against an intimate partner within the last 6 months. 

 Within the last 6 months, the client has filed for a protection order (whether the temporary or full order 

was granted or not). 

Selection Criteria (Instruction: Check all that apply; client must meet ALL criteria in order to be eligible for the 

study) 

 Female status 

 Age 18 years or older 

 Born outside of the U.S.; list country of birth 

 Seeking help due to IPV from {AGENCY} within the last 6 months 

Date client first came to {AGENCY}: / / (mm/dd/yy) 

 The most recent IPV incident occurred within the last 12 months 

Disqualification Criteria (Instruction: Check all that apply. Client does not qualify for the study if they meet 

any one of the following criteria) 

 Client was not physically or sexually abused in the U.S.

 Client does not–by law–meet the qualifications to receive a protection order (e.g., women who were 

emotionally abused only). 

 Client has current serious mental illness, includes women who are acutely suicidal. 

 Client has serious mental retardation. 

 Client has serious hearing impairment that would prevent verbal administration of the questionnaire. 

 Client has acute intent to harm others. 

 Client has alcohol or other substance intoxication. 

Is client eligible to participate in the study?........................................ O Yes O No 

Did client agree to hear the consent presentation? ............................... O Yes O No 

Did client sign the consent form (i.e., agree to participate in the study)? O Yes O No 

Rev. 2/3/05 G-1 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.