14 Monthly Survey
14.1 Formatting Notes
General Formatting
• Brackets are used to describe skip and branching logic
• Response options in circles are forced choice, response options in check boxes are select all that apply
• < page break > is used to denote page breaks in STAR surveys
• Bolding is used to for emphasis or to highlight discrepancies (e.g., items with timeframes that conflict with the instruction text)
Instruction Text
• For surveys with items that are questions, instructions start with “The next set of questions ask about…”
• For surveys with items that are statements, instructions start with “Listed below are….” In addition, instructions describe how to select responses (e.g., “Select how much you agree with each statement”)
• By default, instruction text is on its own page
Survey Headers
• Survey headers are texts that are displayed on the top of every page in a survey and that specify times or qualifiers that apply to all questions (e.g., “In the past month…”)
• Ellipses end all survey headers
Item text
• Parentheses are used to list examples
• First person is only used in statements (i.e., not questions)
Response Option Defaults
Response options are in ascending order (e.g., No -> Yes, 0 -> 10, None -> Extreme)
Likert scales have 5 response options and use the following options for each type of response:
Frequency response options are: Never> Rarely> Sometimes> Most of the time> Always
Quantity response options are: Not at all> Slightly> Moderately> Considerably> Extremely
Agreement scale: Strongly Disagree > Mildly Disagree > Equally Agree and Disagree > Mildly Agree > Strongly Agree ### Daily Update (Content) Instructions
14.2 Content
14.2.0.1 Global Instructions
This is the monthly update. It consists of different surveys that ask about aspects of your life and your recovery including the people you talk to and the places you go, your household, personal support network, opioid use, other drug use, drug treatment services, life events, and emotions.
Completing this will take about 20 minutes and you will receive a $10 payment for completing it.
Please read through all questions carefully and answer them honestly. All of your responses will be kept completely private.
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The term “opioid” in these surveys refers to prescription opioids (like Oxycontin or Vicodin), synthetic opioids (fentanyl), and heroin. Below is a list of commonly used terms for these substances:
Oxycodone (Oxycontin, Percocet, oxy, percs, O.C., rims, tires, greenies)
Hydrocodone (Vicodin, Lortab, Norco, vike, bananas, fluff, hydros)
Morphine (Kadian, Duramorph, MS Contin, miss Emma, monkey, white stuff, M)
Codeine (lean, captain Cody, little C, schoolboy)
Buprenorphine (Suboxone, Subutex, buse, sobos, strips, oranges) Hydromorphone (Dilaudid, Exalgo, smack, dillies, footballs, juice)
Methadone (Methadose, Dolophine, tootsie roll, red rock, mud, dolls)
Oxymorphone (Opana, biscuits, mrs. O, O bomb, octagon)
Tramadol (Ultram, chill pills, trammies, ultras)
Fentanyl (Sublimaze, Actiq, apache, goodfella, TNT)
Heroin (black tar, black pearl, black, china white, dope, white lady, smack, snow, speedball)
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When we ask about your use of opioids or other drugs, we often use the term “non-medical reasons.” When you see this term please think about your use of drugs to feel intoxicated or high. This includes taking more of a drug than you were prescribed, taking it more frequently than prescribed, or using a drug for reasons other than it was prescribed for.
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14.2.0.2 Demographics
[Instructions:] The next set of questions asks for some general information about your current life.
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Which of the following have changed in your life in the past month? Select all that apply.
– School enrollment (enrolled, dropped out, or graduated) – Employment status (changed jobs or hours, retired, or lost job) – Living arrangement (changed where you live or who you live with) – None of the above [if selected, jump to question 4]
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- Are you currently enrolled in school? [Display if “school enrollment” selected in Q1] o No
o Yes
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Which of the following categories best describes your employment status? [Display if “employment status” selected in Q1]
o Employed, working 1-39 hours per week
o Employed, working 40 or more hours per week
o Not employed, looking for work
o Not employed, NOT looking for work
o Retired
o Disabled, not able to work
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Are you currently in a committed romantic relationship?
o No [Skip RAS go to WHOASSIST]
o Yes
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What is your current living arrangement? [Display if “living arrangement” selected in Q1]
o Living alone [Skip to end of demographic survey]
o Living with family/others
o Homeless shelter
o Homeless unsheltered
o Sober living/halfway house
o Other
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Who do you live with? Select all that apply. [Display if “living arrangement” selected in Q1 and “living alone” not selected in Q6]
– Spouse/significant other
– Child/grandchild
– Parent
– Other relative
– Non-relative
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Do you live with anyone who…
[Display Q7-Q10 if “living arrangement” selected in Q1 and “living alone” not selected in Q6]
Uses opioids for medical reasons (uses opioids as prescribed by their doctor)?
o No
o YesUses opioids for non-medical reasons (uses opioids to feel intoxicated or high)?
o No
o YesUses drugs other than opioids for non-medical reasons (do not include tobacco or alcohol)?
o No
o YesUses alcohol excessively (very frequently or in large amounts)?
o No
o Yes
14.3 < page break >
14.3.0.1 Relationship Assessment Scale
[This scale will be skipped by participants who indicate they are not in a relationship across Q4 of the monthly demographics survey]
[Instructions:] The next set of questions asks you to think about your relationship with your partner in the past month.
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In the past month…
How satisfied have you been with your relationship?
Not at all Mildly Moderately Considerably Extremely
How often have there been problems in your relationship?
Never Rarely Sometimes Often Always
How often have you wished you hadn’t gotten into this relationship?
Never Rarely Sometimes Often Always
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14.3.0.2 Drug Use – Monthly
[Instructions:] The next set of questions asks about your experience using drugs for non-medical reasons in the past month.
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In the past month…
Which of the following drugs have you used for non-medical reasons? Select all that apply.
– Alcohol
– Combustible tobacco products (cigarettes, cigars, cigarillos, little cigars, pipe, hookah, bidis)
– Electronic cigarettes (e-cigarette, e-vaporizer, vape pen, e-hookah, hookah pen)
– Opioids (heroin, fentanyl, oxy, etc.)
– Cannabis (marijuana, pot, grass, hash, K2, spice, etc.)
– Stimulants (cocaine, meth, speed, ecstasy, molly, Adderall, etc.)
– Inhalants (nitrous, glue, petrol, paint thinner, etc.)
– Sedatives or sleeping pills (Valium, Serepax, Rohypnol, etc.)
– Hallucinogens (LSD, acid, mushrooms, PCP, special K, etc.)
– None of the above [If selected, skip to Q5]
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In the past month…
2_1. How often have you used alcohol? [display if alcohol is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_1. How often have you had a strong desire or urge to use Alcohol? [display if alcohol is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_1. Have you failed to do what was normally expected of you because of your use of Alcohol? [display if alcohol is selected in Q1]
o No
o Yes
In the past month…
2_2. How often have you used Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_2. How often have you had a strong desire or urge to use Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_2. Have you failed to do what was normally expected of you because of your use of Combustible tobacco products? [display if Combustible tobacco products is selected in Q1]
o No
o Yes
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In the past month…
2_3. How often have you used Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_3. How often have you had a strong desire or urge to use Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_3. Have you failed to do what was normally expected of you because of your use of Electronic cigarettes? [display if Electronic cigarettes is selected in Q1]
o No
o Yes
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In the past month…
2_4. How often have you used Opioids? [display if Opioids is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_4. How often have you had a strong desire or urge to use Opioids? [display if Opioids is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_4. Have you failed to do what was normally expected of you because of your use of Opioids? [display if Opioids is selected in Q1]
o No
o Yes
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In the past month…
2_5. How often have you used Cannabis? [display if Cannabis is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_5. How often have you had a strong desire or urge to use Cannabis? [display if Cannabis is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_5. Have you failed to do what was normally expected of you because of your use of Cannabis? [display if Cannabis is selected in Q1]
o No
o Yes
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In the past month…
2_6. How often have you used Stimulants? [display if Stimulants is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_6. How often have you had a strong desire or urge to use Stimulants? [display if Stimulants is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_6. Have you failed to do what was normally expected of you because of your use of Stimulants? [display if Stimulants is selected in Q1]
o No
o Yes
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In the past month…
2_7. How often have you used Inhalants? [display if Inhalants is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_7. How often have you had a strong desire or urge to use Inhalants? [display if Inhalants is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_7. Have you failed to do what was normally expected of you because of your use of Inhalants? [display if Inhalants is selected in Q1]
o No
o Yes
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In the past month…
2_8. How often have you used Sedatives or sleeping pills? [display if Sedatives or sleeping pills is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_8. How often have you had a strong desire or urge to use Sedatives or sleeping pills? [display if Sedatives or sleeping pills is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_8. Have you failed to do what was normally expected of you because of your use of Alcohol? [display if alcohol is selected in Q1]
o No
o Yes
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In the past month…
2_9. How often have you used Hallucinogens? [display if Hallucinogens is selected in Q1]
Never Once or twice Weekly Almost daily or daily
3_9. How often have you had a strong desire or urge to use Hallucinogens? [display if Hallucinogens is selected in Q1]
Never Once or twice Weekly Almost daily or daily
4_9. Have you failed to do what was normally expected of you because of your use of Hallucinogens? [display if alcohol is selected in Q1]
o No
o Yes
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In the past month…
Which of the following types of opioids have you used? Select all that apply. [display if opioids selected in 1]
– Fentanyl (Sublimaze, Actiq, apache, goodfella, TNT)
– Heroin (black tar, black pearl, black, china white, dope, white lady, smack, snow, speedball)
– Medication for opioid treatment (e.g., Suboxone, Methadone, etc.)
– Prescription opioid not for opioid treatment (OxyContin, Vicodin, Percocet, Opana)
How did you take opioids for non-medical reasons? Select all that apply. [display if opioids selected in 1]
– Oral (swallow, chew) – Smoke (chase) – Sniff or snort – Injection (IV, muscle, under skin) – Other _______
Have you overdosed while taking opioids (passed out and/or given naloxone, treated by EMT, or went to a hospital)? [display if opioids selected in Q1] o No o 1 time o 2 – 3 times o 4 – 5 times o More than 5 times
14.4 < page break >
14.4.0.1 Medication & Treatment Adherence
[Instructions:] The next set of questions asks about medications, counseling, or other forms of treatment that you have used to help your recovery from opioids in the past month.
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What type of medication for opioid use are you currently taking?
o Medication taken daily (e.g., Suboxone, Methadone)
o Medication taken monthly (e.g., Vivitrol)
o I am not taking any medications for opioid use [If selected, skip to Q11 (withdrawal, self-help)]
o Medication taken daily (e.g., Suboxone, Methadone) and medication taken monthly (e.g., Vivitrol)
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What type of medication will you continue to take after this month as your primary medication? [Show if “daily and monthly” selected in Q1]
o Medications that are to be used daily (e.g., Suboxone, Methadone)
o Medications that are to be used monthly (e.g., Vivitrol)
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3.Which daily medication are you taking? [display if “Daily” selected in Q1 or Q2]
o Buprenorphine (Bunavail, Suboxone, Zubsolv, Subutex)
o Methadone (Methadone Intensol, Methadose, Diskets)
o Naltrexone (Revia)
o Other: _____
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Which monthly medication are you taking? [Show if “Monthly” selected in Q1 or Q2]
o Buprenorphine injection (Sublocade)
o Naltrexone injection (Vivitrol)
o Other: ______
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5_1. Did you take Buprenorphine injection (Sublocade) in the past month? [Display if “Buprenorphine injection” selected in Q4]
o No
o Yes
5_2. Did you take Naltrexone injection (Vivitrol) in the past month? [Display if “Naltrexone injection” selected in Q4]
o No
o Yes
5_3. Did you take your monthly medication in the past month? [Display if “Other” selected in Q4]
o No
o Yes
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6_1. How often did you take Buprenorphine (Bunavail, Suboxone, Zubsolv, Subutex) in the past month? [Display if “Buprenorphine” selected in Q3]
Never Rarely Sometimes Most days Every day
6_1. How often did you take Methadone (Methadone Intensol, Methadose, Diskets) in the past month? [Display if “Methadone” selected in Q3]
Never Rarely Sometimes Most days Every day
6_3. How often did you take Naltrexone (Revia) in the past month? [Display if “Naltrexone” selected in Q3]
Never Rarely Sometimes Most days Every day
6_4. How often did you take your daily medication in the past month? [Display if “Other” selected in Q3]
Never Rarely Sometimes Most days Every day
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It can be hard to take medication for opioid use. What has made it hard for you? Select all that apply.
– I forget to take it
– I lose my medication
– It’s too expensive/it’s not covered under my insurance
– Trouble getting it due to a lack of reliable transportation
– I do not like how the medication makes me feel
– The side-effects are unpleasant
– I do not think I need it anymore
– I want to be able to get high
– I do not like my doctor/clinic/treatment provider
– Other______
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In the past month…
How much have you experienced side-effects while taking your medication for opioid use?
Not at all Mildly Moderately Considerably Extremely
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How effective do you think your medication for opioid use is? [Skip if monthly or daily is not selected in Q1]
Not at all Mildly Moderately Considerably Extremely
How likely are you to continue taking your medication for opioid use? [Skip if monthly or daily is not selected in Q1]
Not at all Mildly Moderately Considerably Extremely
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In the past month…
How much have you experienced opioid withdrawal symptoms?
Not at all Mildly Moderately Considerably Extremely
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In the past month…
How often have you attended self-help meetings like AA or NA?
Never Less than weekly Weekly/near weekly Daily/near daily
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How effective do you think your self-help meetings (NA/AA) are? [Skip if Never is selected for Q15]
Not at all Mildly Moderately Considerably Extremely
How likely are you to continue attending your self-help meetings (NA/AA)? [Skip if Never is selected for Q15]
Not at all Mildly Moderately Considerably Extremely
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In the past month…
How often have you attended other individual or group counseling sessions (not including AA or NA meetings)?
Never Less than weekly Weekly/near weekly Daily/near daily
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How effective do you think your counseling is? [Skip if Never is selected for Q18]
Not at all Mildly Moderately Considerably Extremely
How likely are you to continue attending your counseling sessions? [Skip if Never is selected for Q18]
Not at all Mildly Moderately Considerably Extremely
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In the past month…
Have you taken psychiatric medication for depression, anxiety, or other mental health symptoms?
o No
o Yes
Have you attended a detox program or other inpatient residential treatment for opioid use(e.g., short or long-term residential treatment, hospitalization, rehab)? o No
o Yes
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14.4.0.2 Mid-Survey Message
You are about half-way done with the monthly update! Complete it to receive a $10 payment.
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14.4.0.3 Abstinence Confidence/Efficacy Questions
[Instructions:] The next set of questions asks about your recovery goals over the past month and in the next month.
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Thinking about the past month…
How satisfied are you with your progress toward achieving your opioid recovery goals?
Not at all Mildly Moderately Considerably Extremely
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Thinking forward to the next month…
How motivated are you to completely avoid using opioids for non-medical reasons?
Not at all Mildly Moderately Considerably Extremely
How confident are you in your ability to avoid using opioids for non-medical reasons?
Not at all Mildly Moderately Considerably Extremely
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In the next month…
Do you intend to completely avoid using any other drugs (besides opioids)?
o No
o Yes
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In the next month…
Select the drugs below that you are trying to completely avoid using. Select all that apply. [Skip if Never is selected for Q4]
– Alcohol
– Combustible tobacco products (cigarettes, cigars, cigarillos, little cigars, pipe, hookah, bidis) [If selected; skip to end of survey]
– Electronic cigarettes (e-cigarette, e-vaporizer, vape pen, e-hookah, hookah pen) [If selected; skip to end of survey]
– Cannabis (marijuana, pot, grass, hash, etc.)
– Stimulants (cocaine, meth, speed, ecstasy, molly, Adderall, etc.)
– Inhalants (nitrous, glue, petrol, paint thinner, etc.)
– Sedatives or sleeping pills (Valium, Serepax, Rohypnol, etc.)
– Hallucinogens (LSD, acid, mushrooms, PCP, special K, etc.)
– Other __________
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14.4.0.4 Brief Pain Inventory (Short Form, Modified)
[Instructions:] The next set of questions asks about any pain you have experienced in the past month.
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In the past month…
How bad has your pain been on average?
Not at all Mildly Moderately Considerably Extremely
How much has pain interfered with your enjoyment of life?
Not at all Mildly Moderately Considerably Extremely
How much has pain interfered with your general activity?
Not at all Mildly Moderately Considerably Extremely
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In the next month…
What treatments or medications will you receive for your pain? Select all that apply. (Do not include medication you are receiving to help your opioid recovery efforts)
– Opioid pain medications
– Non-opioid pain medications
– Surgical outpatient procedure (lidocaine injection, steroid injection, trigger point injection, medication pump, etc.)
– Surgeries (spinal fusion, discectomy, arthroscopic, etc.)
– Physical/occupational therapy
– Alternative treatments (e.g., massage, yoga, acupuncture, meditation, herbal supplements, etc.)
– No treatments or medications
– Other
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14.4.0.5 Behavior and Symptom Identification Scale (BASIS-32)
[Instructions:] Listed on the next page are problems that some people may experience. Select the response that best describes how much difficulty you have been having in each problem area. Think about your experiences in the past month.
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In the past month, how much difficulty have you had with…
Depression, feeling hopeless
None at all Mild Moderate Considerable Extreme
Fear, anxiety, or panic
None at all Mild Moderate Considerable ExtremeConfusion, loss of memory
None at all Mild Moderate Considerable Extreme
Disturbing thoughts or beliefs
None at all Mild Moderate Considerable ExtremeHearing voices, seeing things
None at all Mild Moderate Considerable Extreme
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In the past month, how much difficulty have you had with…
Manic, bizarre behavior
None at all Mild Moderate Considerable Extreme
Mood swings, unstable moods
None at all Mild Moderate Considerable Extreme
Uncontrollable, repetitive behavior (e.g., eating disorder, hand washing, hurting yourself)
None at all Mild Moderate Considerable Extreme
Sexual activity or preoccupation
None at all Mild Moderate Considerable Extreme
Controlling temper, outburst of anger, violence
None at all Mild Moderate Considerable Extreme
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14.4.0.6 Perceived Stress Scale
[Instructions:] The next set of questions ask about your feelings and thoughts in the past month.
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In the past month…
How often have you felt that you were unable to control the important things in your life?
Never Rarely Sometimes Often Always
How often have you felt confident about your ability to handle your personal problems?
Never Rarely Sometimes Often Always
How often have you felt that things were going your way?
Never Rarely Sometimes Often Always
How often have you felt difficulties were piling up so high that you could not overcome them?
Never Rarely Sometimes Often Always
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14.4.0.7 World Health Organization Quality of Life (WHOQOL-BREF 2)
[Instructions:] The next set of questions asks about your quality of life in the past month.
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In the past month, how satisfied are you with…
Your overall quality of life
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your physical health
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your mental health
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your sleep
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
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In the past month, how satisfied are you with…
Your daily living activities
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your capacity for work
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Yourself
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your personal relationships
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
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In the past month, how satisfied are you with…
Your sex life
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your opportunities for leisure activities
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
The support you get from your friends
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
The conditions of your living place (e.g., your house, apartment)
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
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In the past month, how satisfied are you with…
The conditions of your neighborhood
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your access to health services
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your access to transportation
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your ability to concentrate
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
Your energy for everyday life
Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
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14.4.0.9 End of Survey Message
You have now completed the monthly update! You will receive an additional $10 in your next study payment. Thank you!
14.4.2 Burden Survey
[Instructions:] Listed on the next page are statements that describe how people may feel about their experience with the STAR app and other study technology over the past month. For each statement, select how much you agree or disagree that the statement describes you.
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Thinking about the daily update…
Completing the daily update interfered with my daily activities.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
I disliked completing the daily update.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
Please share any positive or negative comments you have about the daily update.
[Text]
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Thinking about the daily video check-in…
Completing the daily video check-in interfered with my daily activities.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
I disliked completing the daily video check-in.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
Please share any positive or negative comments you have about the daily video check-in.
[Text]
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Thinking about the monthly update…
Completing the monthly update interfered with my daily activities.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
I disliked completing the monthly update.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
Please share any positive or negative comments you have about the monthly update.
[Text]
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Thinking about sharing your GPS location data…
I disliked sharing my GPS location data.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
Please share any positive or negative comments you have about sharing your GPS location data.
[Text]
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Thinking about sharing your phone call logs…
I disliked sharing my phone call logs.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
Please share any positive or negative comments you have about sharing your phone call logs.
[Text]
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Thinking about sharing your SMS logs and message text…
I disliked sharing my SMS logs and message text.
Strongly disagree Mildly disagree Agree and disagree equally Mildly agree Strongly agree
Please share any positive or negative comments you have about sharing your SMS logs and message text.
[Text]
14.4.0.8 Social Connectedness
[Instructions:] The next set of questions asks about social support. Think about support you have given and received in person or online (e.g., over email, Facebook, Twitter, etc.) in the past month.
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In the past month, how often was there someone …
1. …who you could count on to listen to you when you needed to talk?
…who gave you information to help you understand a situation?
Never Rarely Sometimes Often Always
How often did you get support from someone in person (not over email, Facebook, Twitter, etc.)?
Never Rarely Sometimes Often Always
< page break > In the past month, how often did others …
. …count on you to listen when they needed to talk?
Never Rarely Sometimes Often Always
. …get information from you to help them understand a situation?
Never Rarely Sometimes Often Always
How often did you give support to someone in person (not over email, Facebook, Twitter, etc.)?
Never Rarely Sometimes Often Always
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