Form Approved OMB No: 0920-0445 Expiration Date: 10/31/2002 Health Education State Questionnaire Health Education State Questionnaire Questions Standards and Guidelines 1 - 4 Elementary School Instruction 5 - 10 Middle/Junior High School Instruction 11 - 16 Senior High School Instruction 17 - 22 Student Assessment 23 - 31 Staffing and Staff Development 32 - 40 Health Education Collaboration 41 - 42 Health Education Evaluation 43 Health Education Coordinator 44 - 53 Public reporting burden for this collection of information is estimated to average 40 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, Mailstop D-24, Atlanta, GA 30333; Attention PRA (0920-0445). Special Instructions 1. This questionnaire focuses on your state practices and policies. 2. When we use the word “policy,” we mean any mandate issued by the state school board, state legislature, or other state agency that affects health education in districts or schools throughout your state. Please consider any policies officially adopted at the state level. These include policies developed by your state, or those based on model policies developed elsewhere. 3. We recognize that there may be some exceptions to the policies, but please answer the questions based on what is customary in your state. Please do not consider district or school practices or policies when answering the questions. (We will ask about district and school practices and policies when we collect information from districts and schools across the country.) 4. If you would like more information about this study or would like clarification of any questions in this survey, please call Tim Smith at 1-800-647-9664, extension 6095. Standards and Guidelines 1. Has your state adopted a policy stating that districts or schools will follow any national or state health education standards or guidelines? These might cover topics such as the goals and objectives of health education or expected student outcomes. Yes 1 ==> Skip to Question 3 No 2 2. Has your state adopted a policy encouraging (e.g., in memoranda or guidelines) districts or schools to follow any national or state health education standards or guidelines? Yes 1 No 2 ==> Skip to Question 5 3. Are these health education standards or guidelines based on the National Health Education Standards? HED013 Yes 1 No 2 Don’t Know 3 4. Which of the following methods does your state education agency use to improve district or school compliance with these health education standards or guidelines? HED010 Yes No a. Staff development for health education teachers 1 2 b. Monitoring student achievement 1 2 c. Submission of written reports by districts or schools 1 2 d. Teacher evaluations or classroom monitoring 1 2 e. Teachers mentoring other teachers 1 2 Elementary School Instruction 5. Has your state adopted goals, objectives, or expected outcomes for elementary school health education? Yes 1 No 2 ==> Skip to Question 7 6. Do these goals or objectives for elementary school health education specifically address each of the following student outcomes? HED018 Yes No a. Comprehension of concepts related to health promotion and disease prevention 1 2 b. Ability to access valid health information and health promoting products and services 1 2 c. Ability to analyze the influence of culture, media, technology, and other factors on health 1 2 d. Ability to practice health-enhancing behaviors and reduce health risks 1 2 e. Ability to use interpersonal communication skills to enhance health 1 2 f. Ability to use goal-setting and decision-making skills to enhance health 1 2 g. Ability to advocate for personal, family, and community health 1 2 7. Has your state adopted a policy stating that elementary schools will teach each of the following health topics? HED024 Yes No a. Personal hygiene 1 2 b. Dental and oral health 1 2 c. Nutrition and dietary behavior 1 2 d. Physical activity and fitness - classroom instruction, not a physical activity period 1 2 e. Growth and development 1 2 f. Human sexuality 1 2 g. Pregnancy prevention 1 2 h. Human immunodeficiency virus (HIV) prevention 1 2 i. Sexually transmitted disease (STD) prevention 1 2 j. Emotional and mental health 1 2 k. Suicide prevention 1 2 l. Death and dying 1 2 m. Tobacco use prevention 1 2 n. Alcohol or other drug use prevention 1 2 o. Violence prevention, for example bullying, fighting, or homicide 1 2 p. Accident or injury prevention 1 2 q. Cardiopulmonary resuscitation (CPR) 1 2 r. First aid 1 2 s. Immunizations or vaccinations 1 2 t. Sun safety or skin cancer prevention 1 2 u. Consumer health, such as choosing sources of health- related information, products, and services wisely 1 2 v. Environmental health, such as how air and water quality can affect health 1 2 8. Has your state education agency developed its own curricula for elementary school health education? HED029 Yes 1 No 2 9. During the past 2 years, has your state education agency provided the following information or materials for elementary school health education? HED034 Yes No a. A list of one or more recommended elementary school health education curricula 1 2 b. Elementary school health education curricula 1 2 c. A chart describing the scope and sequence of instruction for health education 1 2 d. Lesson plans or learning activities for health education 1 2 e. Plans for how to assess or evaluate students in health education 1 2 10. Based on policies adopted by your state, how much health education are students required to receive while in elementary school? States use many ways to describe these requirements, such as minutes per week, hours per quarter, or hours per year. If it is more convenient for you, please mark the “Requirements enclosed” box and include a copy of your requirements when you return this questionnaire. If your state does not have specified time requirements for elementary school students, mark this box ? and skip to Question 11. Requirements enclosed ? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Middle/Junior High School Instruction 11. Has your state adopted goals, objectives, or expected outcomes for middle/junior high school health education? Yes 1 No 2 ==> Skip to Question 13 12. Do these goals or objectives for middle/junior high school health education specifically address each of the following student outcomes? HED018 Yes No a. Comprehension of concepts related to health promotion and disease prevention 1 2 b. Ability to access valid health information and health promoting products and services 1 2 c. Ability to analyze the influence of culture, media, technology, and other factors on health 1 2 d. Ability to practice health-enhancing behaviors and reduce health risks 1 2 e. Ability to use interpersonal communication skills to enhance health 1 2 f. Ability to use goal-setting and decision-making skills to enhance health 1 2 g. Ability to advocate for personal, family, and community health 1 2 13. Has your state adopted a policy stating that middle/junior high schools will teach each of the following health topics? HED024 Yes No a. Personal hygiene 1 2 b. Dental and oral health 1 2 c. Nutrition and dietary behavior 1 2 d. Physical activity and fitness - classroom instruction, not a physical activity period 1 2 e. Growth and development 1 2 f. Human sexuality 1 2 g. Pregnancy prevention 1 2 h. HIV prevention 1 2 i. STD prevention 1 2 j. Emotional and mental health 1 2 k. Suicide prevention 1 2 l. Death and dying 1 2 m. Tobacco use prevention 1 2 n. Alcohol or other drug use prevention 1 2 o. Violence prevention, for example bullying, fighting, or homicide 1 2 p. Accident or injury prevention 1 2 q. CPR 1 2 r. First aid 1 2 s. Immunizations or vaccinations 1 2 t. Sun safety or skin cancer prevention 1 2 u. Consumer health, such as choosing sources of health- related information, products, and services wisely 1 2 v. Environmental health, such as how air and water quality can affect health 1 2 14. Has your state education agency developed its own curricula for middle/junior high school health education? HED029 Yes 1 No 2 15. During the past 2 years, has your state education agency provided the following information or materials for middle/junior high school health education? HED034 Yes No a. A list of one or more recommended middle/junior high school health education curricula 1 2 b. Middle/junior high school health education curricula 1 2 c. A chart describing the scope and sequence of instruction for health education 1 2 d. Lesson plans or learning activities for health education 1 2 e. Plans for how to assess or evaluate students in health education 1 2 16. Based on policies adopted by your state, how much health education are students required to receive while in middle/junior high school? States use many ways to describe these requirements, such as minutes per week, hours per quarter, or hours per year. If it is more convenient for you, please mark the “Requirements enclosed” box and include a copy of your requirements when you return this questionnaire. If your state does not have specified time requirements for middle/junior high school students, mark this box ? and skip to Question 17. Requirements enclosed ? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Senior High School Instruction 17. Has your state adopted goals, objectives, or expected outcomes for senior high school health education? Yes 1 No 2 ==> Skip to Question 19 18. Do these goals or objectives for senior high school health education specifically address each of the following student outcomes? HED018 Yes No a. Comprehension of concepts related to health promotion and disease prevention 1 2 b. Ability to access valid health information and health promoting products and services 1 2 c. Ability to analyze the influence of culture, media, technology, and other factors on health 1 2 d. Ability to practice health-enhancing behaviors and reduce health risks 1 2 e. Ability to use interpersonal communication skills to enhance health 1 2 f. Ability to use goal-setting and decision-making skills to enhance health 1 2 g. Ability to advocate for personal, family, and community health 1 2 19. Has your state adopted a policy stating that senior high schools will teach each of the following health topics? HED024 Yes No a. Personal hygiene 1 2 b. Dental and oral health 1 2 c. Nutrition and dietary behavior 1 2 d. Physical activity and fitness - classroom instruction, not a physical activity period 1 2 e. Growth and development 1 2 f. Human sexuality 1 2 g. Pregnancy prevention 1 2 h. HIV prevention 1 2 i. STD prevention 1 2 j. Emotional and mental health 1 2 k. Suicide prevention 1 2 l. Death and dying 1 2 m. Tobacco use prevention 1 2 n. Alcohol or other drug use prevention 1 2 o. Violence prevention, for example bullying, fighting, or homicide 1 2 p. Accident or injury prevention 1 2 q. CPR 1 2 r. First aid 1 2 s. Immunizations or vaccinations 1 2 t. Sun safety or skin cancer prevention 1 2 u. Consumer health, such as choosing sources of health- related information, products, and services wisely 1 2 v. Environmental health, such as how air and water quality can affect health 1 2 20. Has your state education agency developed its own curricula for senior high school health education? HED029 Yes 1 No 2 21. During the past 2 years, has your state education agency provided the following information or materials for senior high school health education? HED034 Yes No a. A list of one or more recommended senior high school health education curricula 1 2 b. Senior high school health education curricula 1 2 c. A chart describing the scope and sequence of instruction for health education 1 2 d. Lesson plans or learning activities for health education 1 2 e. Plans for how to assess or evaluate students in health education 1 2 22. Based on policies adopted by your state, how much health education are students required to receive while in senior high school? States use many ways to describe these requirements, such as minutes per week, hours per quarter, or hours per year. If it is more convenient for you, please mark the “Requirements enclosed” box and include a copy of your requirements when you return this questionnaire. If your state does not have specified time requirements for senior high school students, mark this box ? and skip to Question 23. Requirements enclosed ? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Student Assessment 23. Has your state adopted a policy stating that elementary school students will be tested on health topics? Yes 1 No 2 ==> Skip to Question 26 24. Is elementary school testing on health topics based on the National Health Education Standards? Yes 1 No 2 Don’t Know 3 25. Is elementary school testing on health topics based on the State Collaborative on Assessment and Student Standards (SCASS)? Yes 1 No 2 Don’t Know 3 26. Has your state adopted a policy stating that middle/junior high school students will be tested on health topics? Yes 1 No 2 ==> Skip to Question 29 27. Is middle/junior high school testing on health topics based on the National Health Education Standards? Yes 1 No 2 Don’t Know 3 28. Is middle/junior high school testing on health topics based on the State Collaborative on Assessment and Student Standards (SCASS)? Yes 1 No 2 Don’t Know 3 29. Has your state adopted a policy stating that senior high school students will be tested on health topics? Yes 1 No 2 ==> Skip to Question 32 30. Is senior high school testing on health topics based on the National Health Education Standards? Yes 1 No 2 Don’t Know 3 31. Is senior high school testing on health topics based on the State Collaborative on Assessment and Student Standards (SCASS)? Yes 1 No 2 Don’t Know 3 Staffing and Staff Development 32. Has your state adopted a policy stating that newly-hired staff who teach health education at each of the following levels will have undergraduate or graduate training in health education? HED074 Yes No a. Elementary school 1 2 b. Middle/junior high school 1 2 c. Senior high school 1 2 33. Has your state adopted a policy stating that newly-hired staff who teach health education at each of the following levels will be Certified Health Education Specialists (CHES)? Yes No a. Elementary school 1 2 b. Middle/junior high school 1 2 c. Senior high school 1 2 34. Does your state offer certification, licensure, or endorsement to teach health education? Yes 1 No 2 ==> Skip to Question 38 35. Which of the following types of certification, licensure, or endorsement does your state offer for health education teachers? HES082 Yes No a. Health education for grades K-12 1 2 b. Health education for elementary school 1 2 c. Health education for middle/junior school high 1 2 d. Health education for senior high school 1 2 e. Combined health education and physical education for grades K-12 1 2 f. Combined health education and physical education for elementary school 1 2 g. Combined health education and physical education for middle/junior high school 1 2 h. Combined health education and physical education for senior high school 1 2 36. Has your state adopted a policy stating that newly-hired staff who teach health education at each of the following levels will be certified, licensed, or endorsed by the state to teach health education? HED075 If your state does not offer certification, licensure, or endorsement to teach health education at a level, please mark the “Not offered” box in the last column. Not Yes No offered a. Elementary school 1 2 3 b. Middle/junior high school 1 2 3 c. Senior high school 1 2 3 37. Has your state adopted a policy stating that teachers will earn continuing education credits on health education topics to maintain state certification, licensure, or endorsement to teach health education? Yes 1 No 2 38. Has your state adopted a policy stating that each school will have someone to oversee or coordinate health education at the school (e.g., a lead health education teacher)? Yes 1 No 2 39. During the past 2 years, has your state education agency provided any funding for or offered staff development on each of the following topics to those who teach health education? HED076 This might include workshops, conferences, continuing education, graduate courses, or any other kind of in-service. Yes No a. Personal hygiene 1 2 b. Dental and oral health 1 2 c. Nutrition and dietary behavior 1 2 d. Physical activity and fitness - classroom instruction, not a physical activity period 1 2 e. Growth and development 1 2 f. Human sexuality 1 2 g. Pregnancy prevention 1 2 h. HIV prevention 1 2 i. STD prevention 1 2 j. Emotional and mental health 1 2 k. Suicide prevention 1 2 l. Death and dying 1 2 m. Tobacco use prevention 1 2 n. Alcohol or other drug use prevention 1 2 o. Violence prevention, for example bullying, fighting, or homicide 1 2 p. Accident or injury prevention 1 2 q. CPR 1 2 r. First aid 1 2 s. Immunizations or vaccinations 1 2 t. Sun safety or skin cancer prevention 1 2 u. Consumer health, such as choosing sources of health- related information, products, and services wisely 1 2 v. Environmental health, such as how air and water quality can affect health 1 2 40. During the past 2 years, has your state education agency provided any funding for or offered staff development on each of the following teaching methods to those who teach health education? HED076 Yes No a. Teaching students with permanent physical or cognitive disabilities 1 2 b. Teaching students of various cultural backgrounds 1 2 c. Teaching students with limited English proficiency 1 2 d. Using interactive teaching methods, such as role plays or cooperative group activities 1 2 e. Encouraging family or community involvement 1 2 f. Teaching skills for behavior change 1 2 Health Education Collaboration 41. During the past 12 months, have state health education staff worked on health education activities with the following groups? Yes No a. State physical education staff 1 2 b. State health services staff 1 2 c. State mental health or social services staff 1 2 d. State food service staff 1 2 42. During the past 12 months, have state health education staff worked on health education activities with staff or members from each of these organizations? Yes No a. State-level AAHPERD (American Alliance for Health, Physical Education, Recreation, and Dance) 1 2 b. State school health association 1 2 c. State-level health organization, such as the American Heart Association or the American Cancer Society 1 2 d. State health agency 1 2 e. State mental health or social services agency 1 2 f. Colleges or universities 1 2 g. Businesses 1 2 Health Education Evaluation 43. During the past 2 years, have the following aspects of your state health education program been evaluated? Yes No a. Student satisfaction with the health education program 1 2 b. Family satisfaction with the health education program 1 2 c. Health education policies 1 2 d. Health education curricula 1 2 e. Health education staff development or in-service programs 1 2 Health Education Coordinator 44. Currently, does someone in your state oversee or coordinate health education? HEB003 Yes 1 No 2 ==> That is the last question. Thank you very much for taking the time to complete this questionnaire. 45. Are you this person? Yes 1 No 2 ==> That is the last question. Thank you very much for taking the time to complete this questionnaire. 46. Do you have an undergraduate degree? Yes 1 No 2 ==> Skip to Question 52 47. What did you major in? Mark ? all that apply. Health education and physical education combined 1 Health education 2 Physical education 3 Other education 4 Kinesiology 5 Exercise physiology 6 Exercise science 7 Nursing 8 Nutrition 9 Public health 10 Biology or other science 11 Home economics 12 Other 13 48. Do you have an undergraduate minor?HEC059 Yes 1 No 2 ==> Skip to Question 50 49. What did you minor in? Mark ? all that apply. Health education and physical education combined 1 Health education 2 Physical education 3 Other education 4 Kinesiology 5 Exercise physiology 6 Exercise science 7 Nursing 8 Nutrition 9 Public health 10 Biology or other science 11 Home economics 12 Other 13 50. Do you have a graduate degree? Yes 1 No 2 ==> Skip to Question 52 51. In what area or areas? Mark ? all that apply. Health education and physical education combined 1 Health education 2 Physical education 3 Other education 4 Kinesiology 5 Exercise physiology 6 Exercise science 7 Nursing 8 Nutrition 9 Public health 10 Biology or other science 11 Home economics 12 Other 13 52. Are you certified, licensed, or endorsed by the state to teach health education at each of the following grade levels? If your state does not offer certification, licensure, or endorsement to teach health education at a level, please mark the “Not offered” box in the last column. Not Yes No offered a. Elementary school 1 2 3 b. Middle/junior high school 1 2 3 c. Senior high school 1 2 3 53. Are you a Certified Health Education Specialist or CHES? Yes 1 No 2 If you would like to provide any additional comments, please use the space below. Thank you very much for taking the time to participate in this study. Additional Comments Please return this questionnaire to: Don Evers Research Triangle Institute P.O. Box 12194 Research Triangle Park, NC 27709 Health Education State Questionnaire - Final Version — Revised: 10/26/99 Health Education State Questionnaire - Final Version — Revised: 10/26/99 5 Health Education State Questionnaire - Final Version — Revised: 10/26/99 Elementary School Instruction Middle/Junior High School Instruction 23 Health Education State Questionnaire - Final Version — Revised: 10/26/99 Senior High School Instruction Student Assessment Staffing and Staff Development Health Education Coordinator