Social Network Index
Instructions: This questionnaire is concerned with how
many people you see or talk to on a regular basis including family,
friends, workmates, neighbors, etc. Please read and answer
each question carefully. Answer follow-up questions where
appropriate.
1. Which of the following best describes your marital
status?
____ (1) currently married & living together, or living
with someone in marital-like relationship
____ (2) never married & never lived with someone in
a marital-like relationship
____ (3) separated
____ (4) divorced or formerly lived with someone in a marital-like
relationship
____ (5) widowed
2. How many children do you have? (If you don't
have any children, check '0' and skip to question 3.)
____0 ____1
____2 ____3
____4 ____5
____6 ____7 or more
2a.
How many of your children do you see or talk to on the phone
at least
once every 2 weeks?
____0 ____1
____2 ____3
____4 ____5
____6 ____7 or more
3. Are either of your parents living? (If neither
is living, check '0' and skip to question 4.)
____ (0) neither
____ (1) mother only
____ (2) father only
____ (3) both
3a.
Do you see or talk on the phone to either of your parents at least
once every 2 weeks?
____ (0) neither
____ (1) mother only
____ (2) father only
____ (3) both
4. Are either of your in-laws (or partner's parents)
living? (If you have none, check the appropriate space and
skip to question 5.)
____ (0) neither ____ (1) mother ____
(2) father ____ (3) both ____
(4) not
only only
applicable
4a. Do you see or talk on the phone to either of your partner's
parents
at
least once every 2 weeks?
_____ (0) neither _____ (1)
mother _____ (2) father
____ (3) both
only
only
5. How many other relatives (other than your spouse, parents
& children) do you feel close to? (If '0', check that
space and skip to question 6.)
____0 ____1
____2 ____3
____4 ____5
____6 ____7 or more
5a.
How many of these relatives do you see or talk to on the phone
at least
once every 2 weeks?
____0
____1 ____2
____3 ____4
____5 ____6
____7 or more
6. How many close friends do you have? (meaning people
that you feel at ease with, can talk to about private matters,
and can call on for help)
____0 ____1
____2 ____3
____4 ____5
____6 ____7 or more
6a.
How many of these friends do you see or talk to at least once
every 2 weeks?
____0
____1 ____2
____3 ____4
____5 ____6
____7 or more
7. Do you belong to a church, temple, or other religious
group? (If not, check 'no' and skip to question 8.)
_____ no
_____ yes
7a.
How many members of your church or religious group do you talk
to
at least
once every 2 weeks? (This includes at group meetings and services.)
____0
____1 ____2
____3 ____4
____5 ____6
____7 or more
8. Do you attend any classes (school, university, technical
training, or adult education) on a regular basis? (If not,
check 'no' and skip to question 9.)
_____ no
_____ yes
8a.
How many fellow students or teachers do you talk to at least
once every
2 weeks? (This includes at class meetings.)
____0
____1 ____2
____3 ____4
____5 ____6
____7 or more
9. Are you currently employed either full or part-time?
(If not, check 'no' and skip to question 10.)
____ (0) no
_____ (1) yes, self-employed
_____ (2) yes, employed by others
9a. How many people do you supervise?
____0
____1 ____2
____3 ____4
____5 ____6
____7 or more
9b. How many people at work (other than those you supervise)
do
you talk to at least once every 2 weeks?
____0
____1 ____2
____3 ____4
____5 ____6
____7 or more
10. How many of your neighbors do you visit or talk to
at least once every 2 weeks?
_____0 ____1
____2 ____3
____4 ____5
____6 ____7 or more
11. Are you currently involved in regular volunteer work?
(If not, check 'no' and skip to question 12.)
_____ no
_____ yes
11a. How many people involved in this volunteer work do you talk
to about
volunteering-related
issues at least once every 2 weeks?
____0
____1 ____2
____3 ____4
____5 ____6
____7 or more
12. Do you belong to any groups in which you talk to one or more
members of the group about group-related issues at least once
every 2 weeks? Examples include social clubs, recreational
groups, trade unions, commercial groups, professional organizations,
groups concerned with children like the PTA or Boy Scouts,
groups concerned with community service, etc. (If you don't
belong to any such groups, check 'no' and skip the section below.)
_____ no
_____ yes
Consider those groups in which you talk to a fellow group member at least once every 2 weeks. Please provide the following information for each such group: the name or type of group and the total number of members in that group that you talk to at least once every 2 weeks.
Total number of group members
Group that you talk to at least once every 2 weeks
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1.
2.
3.
4.
5.
6.
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This scale was used for the following journal article:
Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M. Jr. (1997). Social ties and susceptibility to the common cold. Journal of the American Medical Association, 277, 1940-1944. Link to full-text (pdf)