Form Approved OMB No: 0920-0445 Expiration Date: 11/30/2008 Health Education Classroom Questionnaire Health Education Classroom Questionnaire Questions General Course Characteristics and Content 1 - 5 Alcohol or Other Drug Use Prevention 6 - 9 Tobacco Use Prevention 10 - 13 Nutrition and Dietary Behavior 14 - 18 Physical Activity and Fitness 19 - 22 Human Sexuality 23 - 33 Emotional and Mental Health 34 - 37 Suicide Prevention 38 - 39 Violence Prevention 40 - 43 Injury Prevention and Safety 44 - 47 Personal Health and Wellness 48 Teaching Techniques 49 - 56 Respondent Background 57 - 71 Public reporting burden for this collection of information is estimated to average 50 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-74, Atlanta, GA 30333; Attention PRA (0920-0445). NOTE: THROUGHOUT THIS QUESTIONNAIRE, TEXT THAT APPEARS IN ALL CAPITAL LETTERS WILL NOT BE READ ALOUD TO RESPONDENTS. THIS QUESTIONNAIRE WILL BE ADMINISTERED USING COMPUTER ASSISTED PERSONAL INTERVIEW TECHNOLOGY. THE INTERVIEWER WILL READ THE QUESTIONS ALOUD AND TYPE RESPONSES TO THE QUESTIONS INTO THE LAPTOP COMPUTER. THE INTERVIEW PROGRAM WILL 1) DISPLAY THE CORRECT TENSE OF VERBS, 2) PROVIDE ALTERNATE ANSWERS TO QUESTIONS (E.G., NOT APPLICABLE, “I DON’T KNOW”), 3) NAVIGATE COMPLEX SKIP PATTERNS, AND 4) PERFORM OTHER USEFUL FUNCTIONS. THE PROGRAMMING SPECIFICATIONS FOR THE INTERVIEW ARE NOT INCLUDED IN THIS PRINTED VERSION OF THE QUESTIONNAIRE. NOTE: PRIOR TO THE INTERVIEW, HEALTH EDUCATION COURSES, TEACHERS, AND SECTIONS WERE RANDOMLY SELECTED AT EACH SCHOOL.  IN ELEMENTARY SCHOOLS, THE SCHOOL CONTACT PROVIDED A LIST OF ALL GRADES IN WHICH REQUIRED HEALTH EDUCATION IS TAUGHT.  TWO GRADES WERE RANDOMLY SELECTED FROM THIS LIST (UNLESS THERE WERE ONLY TWO OR FEWER GRADES, IN WHICH CASE ALL WERE SELECTED).  FOR EACH SELECTED GRADE, ONE TEACHER WAS RANDOMLY SELECTED TO BE INTERVIEWED.  WHEN NECESSARY, A SECTION (E.G. MORNING KINDERGARTEN CLASS) WAS RANDOMLY SELECTED FOR THE TEACHER TO FOCUS ON THROUGHOUT THE INTERVIEW.  IN MIDDLE OR JUNIOR HIGH SCHOOLS AND SENIOR HIGH SCHOOLS, THE SCHOOL CONTACT PROVIDED A LIST OF ALL REQUIRED HEALTH EDUCATION COURSES FOR THE 2005–06 SCHOOL YEAR WITH A CORRESPONDING LIST OF TEACHERS FOR EACH COURSE.  IF THE NUMBER OF REQUIRED HEALTH EDUCATION COURSES WAS EIGHT OR FEWER, ALL THE COURSES WERE SELECTED.  IF THE NUMBER OF REQUIRED HEALTH EDUCATION COURSES EXCEEDED EIGHT, EIGHT COURSES WERE RANDOMLY SELECTED.  FOR EACH SELECTED COURSE, ONE TEACHER WAS RANDOMLY SELECTED TO BE INTERVIEWED AND ONE SECTION OF THAT TEACHER’S COURSE (E.G. 2ND PERIOD HEALTH 101) WAS RANDOMLY SELECTED FOR HIM/HER TO FOCUS ON THROUGHOUT THE INTERVIEW. The first questions I am going to ask you are about the general characteristics and content of a required health education course or class that you teach. Throughout this interview, please think about what took place when you taught ______________ section of this course. ANSWER Q1 FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO Q2. SHOW CARD 1 Please use this card for your reference during my next question. 1. Which one of the statements listed on this card best describes the class? Was this class... Devoted to health topics, such as alcohol or other drug use prevention, 1 A combined health education and physical education class, or 2 Mainly about some subject other than health education, such as science, social studies, or English? 3 2. At the end of the class, how many students were enrolled in the class? _____ Students SHOW CARD 2 As I read the list of topics on this card, please tell me if you taught about each one in the class. By teach, I mean some advanced planning on your part was involved; the subject was not just brought up in class. 3. Did you teach about... Yes No a. Alcohol or other drug use prevention? 1 2 b. Tobacco use prevention? 1 2 c. Nutrition and dietary behavior? 1 2 d. Physical activity and fitness, that is classroom instruction, not a physical education period? 1 2 e. Pregnancy prevention? 1 2 f. HIV or human immunodeficiency virus prevention? 1 2 g. Other STD or sexually transmitted disease prevention? 1 2 h. Human sexuality? 1 2 i. Emotional and mental health? 1 2 j. Suicide prevention? 1 2 k. Violence prevention, for example bullying, fighting, or homicide? 1 2 l. Injury prevention and safety? 1 2 m. Asthma awareness? 1 2 n. Foodborne illness prevention? 1 2 4. When planning to teach or teaching the class, did you use... Yes No a. The National Health Education Standards? 1 2 b. The Health Education Curriculum Analysis Tool or HECAT from the Centers for Disease Control and Prevention or CDC? 1 2 c. Any state-, district- or school-developed curriculum or guidelines for health education? 1 2 d. A commercially-developed curriculum? 1 2 e. A commercially-developed student textbook? 1 2 f. A commercially-developed teacher's guide? 1 2 g. Health education performance assessment materials? 1 2 h. Any materials from health organizations, such as the American Heart Association or the American Cancer Society? 1 2 5. Did students use a textbook for the class? Yes 1 No 2 IF ALCOHOL OR OTHER DRUG USE PREVENTION WAS TAUGHT IN THIS CLASS (Q3A IS “YES”), ANSWER Q6 - Q9. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q10. Now I’m going to ask you about instruction on alcohol or other drug use prevention in this class. SHOW CARD 3 As I read the topics listed on this card, please tell me if you taught about each one in the class. 6. When you taught about alcohol or other drug use prevention, did you teach about... Yes No a. Short-term health consequences of alcohol use and addiction? 1 2 b. Long-term health consequences of alcohol use and addiction? 1 2 c. Benefits of not using alcohol? 1 2 d. Drink equivalents and blood alcohol content? 1 2 e. Short-term health consequences of illegal drug use and addiction? 1 2 f. Long-term health consequences of illegal drug use and addiction? 1 2 g. Benefits of not using illegal drugs? 1 2 h. Distinguishing between medicinal and non-medicinal drug use? 1 2 i. Effects of alcohol or other drug use on decision-making? 1 2 SHOW CARD 4 As I read the topics listed on this card, please tell me if you taught about each one. 7. Did you teach about... Yes No a. How many young people use alcohol or other drugs? 1 2 b. The influence of families on alcohol or other drug use? 1 2 c. The influence of the media on alcohol or other drug use? 1 2 d. Social or cultural influences on alcohol or other drug use? 1 2 e. How to find valid information or services related to alcohol or other drug use prevention or cessation? 1 2 f. Resisting peer pressure to use alcohol or other drugs? 1 2 g. Making a personal commitment not to use alcohol or other drugs? 1 2 h. How students can influence or support others in efforts to prevent alcohol or other drug use? 1 2 i. How students can influence or support others in efforts to quit using alcohol or other drugs? 1 2 8. Did you provide students with the opportunity to practice communication, decision-making, or goal-setting skills related to alcohol or other drug use prevention, for example through role playing? Yes 1 No 2 9. How many hours did you spend teaching about alcohol or other drug use prevention? Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF TOBACCO USE PREVENTION WAS TAUGHT IN THIS CLASS (Q3B IS “YES”), ANSWER Q10 - Q13. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q14. The next questions ask about instruction on tobacco use prevention in this class. SHOW CARD 5 As I read the topics listed on this card, please tell me if you taught about each one in the class. 10. When you taught about tobacco use prevention, did you teach about... Yes No a. Short-term health consequences of cigarette smoking? 1 2 b. Long-term health consequences of cigarette smoking? 1 2 c. Benefits of not smoking cigarettes? 1 2 d. Short-term health consequences of cigar smoking? 1 2 e. Long-term health consequences of cigar smoking? 1 2 f. Benefits of not smoking cigars? 1 2 g. Short-term health consequences of using smokeless tobacco? 1 2 h. Long-term health consequences of using smokeless tobacco? 1 2 i. Benefits of not using smokeless tobacco? 1 2 j. Risks of using other tobacco and tobacco-like products, such as pipes, kreteks, or bidis? 1 2 k. Importance of quitting tobacco use? 1 2 l. Addictive effects of nicotine in tobacco products? 1 2 m. Health effects of environmental tobacco smoke (ETS) or second-hand smoke? 1 2 SHOW CARD 6 As I read the topics listed on this card, please tell me if you taught about each one. 11. Did you teach about... Yes No a. How many young people use tobacco? 1 2 b. The influence of families on tobacco use? 1 2 c. The influence of the media on tobacco use? 1 2 d. Social or cultural influences on tobacco use? 1 2 e. How to find valid information or services related to tobacco use prevention or cessation? 1 2 f. Resisting peer pressure to use tobacco? 1 2 g. Making a personal commitment not to use tobacco? 1 2 h. How students can influence or support others to prevent tobacco use? 1 2 i. How students can influence or support others in efforts to quit using tobacco? 1 2 j. How to avoid environmental tobacco smoke (ETS) or second-hand smoke? 1 2 12. Did you provide students with the opportunity to practice communication, decision-making, or goal-setting skills related to tobacco prevention, for example through role playing? Yes 1 No 2 13. How many hours did you spend teaching about tobacco use prevention? Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF NUTRITION AND DIETARY BEHAVIOR WAS TAUGHT IN THIS CLASS (Q3C IS “YES”), ANSWER Q14 - Q18. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q19. The next questions ask about instruction on nutrition and dietary behavior in this class. SHOW CARD 7 As I read the topics listed on this card, please tell me if you taught about each one in the class. 14. When you taught about nutrition and dietary behavior, did you teach about... Yes No a. The benefits of healthy eating? 1 2 b. Food guidance using MyPyramid? 1 2 c. Using food labels? 1 2 d. Eating a variety of foods? 1 2 e. Balancing food intake and physical activity? 1 2 f. Eating more fruits, vegetables, and grain products? 1 2 g. Choosing foods that are low in fat, saturated fat, and cholesterol? 1 2 h. Using sugars in moderation? 1 2 i. Eating more calcium-rich foods? 1 2 j. Preparing healthy meals and snacks? 1 2 k. Risks of unhealthy weight control practices? 1 2 l. Accepting body size differences? 1 2 m. Food safety? 1 2 n. The importance of water consumption? 1 2 o. The importance of eating breakfast? 1 2 p. Making healthy choices while eating at restaurants? 1 2 ANSWER Q, R, AND S FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO Q15. q. The Dietary Guidelines for Americans? 1 2 r. Using salt and sodium in moderation? 1 2 s. Eating disorders? 1 2 15. When you taught about nutrition and dietary behavior, did students have opportunities to taste new, healthful foods as part of a lesson? Yes 1 No 2 SHOW CARD 8 As I read the topics listed on this card, please tell me if you taught about each one. 16. Did you teach about... Yes No a. The influence of families on dietary behavior? 1 2 b. The influence of the media on dietary behavior? 1 2 c. Social or cultural influences on dietary behavior? 1 2 d. How to find valid information or services related to nutrition and dietary behavior? 1 2 e. Resisting peer pressure related to unhealthy dietary behavior? 1 2 f. How students can influence or support others’ healthy dietary behavior? 1 2 17. Did you provide students with the opportunity to practice communication, decision-making, or goal-setting skills related to nutrition and dietary behavior, for example through role playing? Yes 1 No 2 18. How many hours did you spend teaching about nutrition and dietary behavior? Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF PHYSICAL ACTIVITY AND FITNESS TOPICS WERE TAUGHT IN THIS CLASS (Q3D IS “YES”), ANSWER Q19 - Q22. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q23. Now I’m going to ask you about instruction on physical activity and fitness in this class. SHOW CARD 9 As I read the topics listed on this card, please tell me if you taught about each one in the class. 19. When you taught about physical activity and fitness, did you teach about... Yes No a. The physical, psychological, or social benefits of physical activity? 1 2 b. Health-related fitness, that is cardiovascular endurance, muscular endurance, muscular strength, flexibility, and body composition? 1 2 c. The difference between physical activity, exercise, and fitness? 1 2 d. Phases of a workout, that is warmup, workout, and cool down? 1 2 e. Overcoming barriers to physical activity? 1 2 f. Decreasing sedentary activities, such as TV watching? 1 2 g. Opportunities for physical activity in the community? 1 2 h. Preventing injury during physical activity? 1 2 i. Weather-related safety, for example avoiding heat stroke, hypothermia, and sunburn while physically active? 1 2 ANSWER J, K, L, AND M FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO THE INTRODUCTION TO Q20. j. How much physical activity is enough, that is determining frequency, intensity, time, and type of physical activity? 1 2 k. Developing an individualized physical activity plan? 1 2 l. Monitoring progress toward reaching goals in an individualized physical activity plan? 1 2 m. Dangers of using performance-enhancing drugs, such as steroids? 1 2 SHOW CARD 10 As I read the list of topics on this card, please tell me if you taught about each one. 20. Did you teach about... Yes No a. The influence of families on physical activity? 1 2 b. The influence of the media on physical activity? 1 2 c. Social or cultural influences on physical activity? 1 2 d. How to find valid information or services related to physical activity and fitness? 1 2 e. Resisting peer pressure that discourages physical activity? 1 2 f. How students can influence or support others to engage in physical activity? 1 2 21. Did you provide students with the opportunity to practice communication, decision-making, or goal-setting skills related to physical activity, for example through role playing? Yes 1 No 2 22. How many hours did you spend in the classroom teaching about physical activity? Please do not include time students spent actually being active. Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF HUMAN SEXUALITY WAS TAUGHT IN THIS CLASS (Q3E, Q3F, Q3G, OR Q3H IS “YES”), ANSWER Q23 - Q25. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q26. The next section asks about instruction on human sexuality in this class. SHOW CARD 11 You mentioned that when you taught the class, you taught about human sexuality topics. As I read the topics listed on this card, please tell me if you taught about each one. 23. When you taught about human sexuality, did you teach about... Yes No a. Abstinence as the most effective method to avoid pregnancy, HIV, and other STDs? 1 2 b. Dating and relationships? 1 2 c. Marriage and commitment? 1 2 d. Human development issues, such as reproductive anatomy and puberty? 1 2 ANSWER E, F, G, AND H FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO THE INRODUCTION TO Q24. e. Risks associated with having multiple sexual partners? 1 2 f. Condom efficacy, that is, how well condoms work and don’t work? 1 2 g. How to correctly use a condom? 1 2 h. Sexual identity and sexual orientation? 1 2 SHOW CARD 12 As I read the topics listed on this card, please tell me if you taught about each one. 24. Did you teach about... Yes No a. The influence of families on sexual behavior? 1 2 b. The influence of the media on sexual behavior? 1 2 c. Social or cultural influences on sexual behavior? 1 2 d. Resisting peer pressure to engage in sexual behavior? 1 2 e. How students can influence or support others to make healthy decisions related to sexual behaviors? 1 2 25. Did you provide students with the opportunity to practice communication, decision-making, or goal-setting skills related to human sexuality, for example through role playing? Yes 1 No 2 IF PREGNANCY PREVENTION WAS TAUGHT IN THIS CLASS (Q3E IS “YES”) ANSWER Q26 - Q27. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q28. 26. When you taught about pregnancy prevention, did you teach about... Yes No ANSWER A FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO B. a. Methods of contraception? 1 2 b. Risks associated with teen pregnancy? 1 2 c. The educational and social impact of teen pregnancy? 1 2 d. How to find valid information or services related to pregnancy or pregnancy testing? 1 2 27. How many hours did you spend teaching about pregnancy prevention? Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF HIV PREVENTION WAS TAUGHT IN THIS CLASS (Q3F IS “YES”), ANSWER Q28 - Q29. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q30. 28. When you taught about HIV prevention, did you teach about... Yes No a. How to prevent HIV infection? 1 2 b. Signs and symptoms of HIV and AIDS? 1 2 c. How HIV is transmitted? 1 2 d. How HIV affects the human body? 1 2 e. Compassion for persons living with HIV or AIDS? 1 2 f. How to find valid information or services related to HIV or HIV counseling and testing? 1 2 g. How HIV is diagnosed and treated? 1 2 29. How many hours did you spend teaching about HIV prevention? Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF STD PREVENTION WAS TAUGHT IN THIS CLASS (Q3G IS “YES”), ANSWER Q30 - Q31. OTHERWISE, SKIP TO Q32. 30. When you taught about STD prevention, did you teach about... Yes No a. How to prevent STDs? 1 2 b. How STDs, other than HIV, are transmitted? 1 2 c. Signs and symptoms of STDs? 1 2 d. How to find valid information or services related to STDs or STD screening? 1 2 e. How STDs are diagnosed and treated? 1 2 f. Long-term health consequences of STDs? 1 2 31. How many hours did you spend teaching about STD prevention? Please do not include hours spent teaching about HIV prevention. Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF PREGNANCY PREVENTION, HIV PREVENTION, STD PREVENTION, AND HUMAN SEXUALITY WERE NOT TAUGHT (Q3E, Q3F, Q3G, Q3H ARE “NO”) THEN SKIP TO THE INSTRUCTIONS BEFORE Q34. 32. Were any students excused by a parent’s or guardian’s request from attending the class when topics related to pregnancy prevention, HIV prevention, other STD prevention, or human sexuality were presented? Yes 1 No 2 -->SKIP TO THE INSTRUCTIONS BEFORE Q34 33. How many students were excused by a parent’s or guardian’s request from attending class when topics related to pregnancy prevention, HIV prevention, other STD prevention, or human sexuality were presented? _____ Students IF EMOTIONAL AND MENTAL HEALTH WAS TAUGHT IN THIS CLASS (Q3I IS “YES”), ANSWER Q34 - Q37. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q38. The next section asks about instruction on emotional and mental health in this class. SHOW CARD 13 As I read the topics listed on this card, please tell me if you taught about each one in the class. 34. When you taught about emotional and mental health, did you teach about... Yes No a. Feelings and emotions associated with loss and grief? 1 2 ANSWER B FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO C. b. How emotions change during adolescence? 1 2 c. Appropriate ways to express and deal with emotions and feelings? 1 2 d. Causes, signs, and effects of stress? 1 2 e. Positive and negative ways of dealing with stress? 1 2 f. Causes, signs, and effects of depression? 1 2 g. When to seek help for mental health problems? 1 2 h. Interrelationship of physical, mental, emotional, social, and spiritual health? 1 2 i. Strategies for controlling impulsive behaviors? 1 2 j. Being sensitive to the feelings of others? 1 2 k. Establishing and maintaining healthy relationships? 1 2 l. Healthy ways to express affection, love, friendship, and concern? 1 2 m. How mental illness is diagnosed and treated? 1 2 SHOW CARD 14 As I read the topics listed on this card, please tell me if you taught about each one. 35. Did you teach about... Yes No a. The influence of families on emotional and mental health? 1 2 b. The influence of the media on emotional and mental health? 1 2 c. Social or cultural influences on emotional and mental health? 1 2 d. How to find valid information or services related to emotional and mental health? 1 2 e. How students can influence or support others to promote emotional and mental health? 1 2 36. Did you provide students with the opportunity to practice communication, decision-making, or goal-setting skills related to emotional and mental health, for example through role playing? Yes 1 No 2 37. How many hours did you spend teaching about emotional and mental health? Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF EMOTIONAL AND MENTAL HEALTH OR SUICIDE PREVENTION WERE TAUGHT IN THE CLASS (Q3I OR Q3J IS “YES”), ANSWER Q38 – Q39. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q40. Now I’m going to ask you about instruction on suicide prevention in this class. SHOW CARD 15 As I read the topics listed on this card, please tell me if you taught about each one. 38. Did you teach about... Yes No a. The influence of families on suicidal behaviors? 1 2 b. The influence of the media on suicidal behaviors? 1 2 c. Social or cultural influences on suicidal behaviors? 1 2. d. How to find valid information or services to prevent suicidal behaviors? 1 2 e. Resisting peer pressure that would increase risk of suicidal behaviors? 1 2 f. How students can influence or support others to prevent suicidal behaviors? 1 2 g. The relationship between alcohol or other drug use and suicidal behaviors? 1 2 39. How many hours did you spend teaching about suicide prevention? Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF VIOLENCE PREVENTION WAS TAUGHT IN THE CLASS (Q3K IS “YES”), ANSWER Q40 – Q43. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q44. SHOW CARD 16 The next several questions are about instruction on the prevention of violence and intentional injuries, including topics such as bullying, fighting, homicide, or suicide. As I read the topics listed on this card, please tell me if you taught about each one in the class. 40. When you taught about the prevention of violence and intentional injuries, did you teach about... Yes No a. Anger management? 1 2 b. Bullying? 1 2 c. Techniques to resolve interpersonal conflicts without fighting? 1 2 d. Prosocial behaviors such as cooperation, praise, or showing support for others? 1 2 e. Gun safety? 1 2 ANSWER F, G, H, AND I FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE J. f. Personal safety, for example avoiding becoming a victim of a crime? 1 2 g. Sexual harassment? 1 2 h. Dating violence? 1 2 i. Sexual assault and rape? 1 2 ANSWER J AND K FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO L. j. Personal safety, for example, dealing with strangers? 1 2 k. Inappropriate touching? 1 2 l. Recognizing signs and symptoms of people who are in danger of hurting themselves? 1 2 m. Recognizing signs and symptoms of people who are in danger of hurting others? 1 2 n. What to do if someone is thinking about hurting himself? 1 2 o. What to do if someone is thinking about hurting others? 1 2 p. Prejudice, discrimination, and bias? 1 2 q. Empathy, that is, identification with and understanding of another person’s feelings, situation, or motives? 1 2 r. Perspective-taking, that is, taking another person’s point of view? 1 2 s. Short-term consequences of violence? 1 2 t. Long-term consequences of violence? 1 2 SHOW CARD 17 As I read the topics listed on this card, please tell me if you taught about each one. 41. Did you teach about... Yes No a. The influence of families on behaviors related to violence? 1 2 b. The influence of the media on behaviors related to violence? 1 2 c. Social or cultural influences on behaviors related to violence? 1 2 d. How to find valid information or services to prevent violence? 1 2 e. Resisting peer pressure that would increase risk of violence? 1 2 f. How students can influence or support others to prevent violence? 1 2 g. The relationship between alcohol or other drug use and violence? 1 2 42. Did you provide students with the opportunity to practice communication, decision-making, or goal-setting skills related to violence prevention, for example through role playing? Yes 1 No 2 43. How many hours did you spend teaching about violence prevention? Please do not include hours spent teaching about suicide prevention. Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 IF INJURY PREVENTION AND SAFETY WERE TAUGHT IN THE CLASS (Q3L IS “YES”), ANSWER Q44 - Q47. OTHERWISE, SKIP TO THE INTRODUCTION TO Q48. SHOW CARD 18 Next, I am going to ask about instruction on ways to prevent unintentional injuries like those from car crashes, fires, or drownings. As I read the topics listed on this card, please tell me if you taught about each one in the class. 44. When you taught about injury prevention and safety, did you teach about... Yes No a. Fire safety? 1 2 b. Water safety? 1 2 c. Emergency preparedness? 1 2 d. Pedestrian safety? 1 2 e. Motor vehicle occupant safety such as seatbelt use? 1 2 f. Use of protective equipment for biking, skating, or other sports? 1 2 g. First aid? 1 2 h. Cardiopulmonary resuscitation (CPR)? 1 2 i. Gun safety? 1 2 j. Poisoning prevention? 1 2 ANSWER K FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO THE INTRODUCTION TO Q45. k. Playground safety? 1 2 SHOW CARD 19 As I read the topics listed on this card, please tell me if you taught about each one. 45. Did you teach about... Yes No a. The influence of families on behaviors related to safety? 1 2 b. The influence of the media on behaviors related to safety? 1 2 c. Social or cultural influences on behaviors related to safety? 1 2 d. How to find valid information or services to prevent injuries? 1 2 e. Resisting peer pressure that would increase risk of injuries? 1 2 f. How students can influence or support others to prevent injuries? 1 2 g. The relationship between alcohol or other drug use and injuries? 1 2 46. Did you provide students with the opportunity to practice communication, decision-making, or goal-setting skills related to injury prevention and safety, for example through role playing? Yes 1 No 2 47. How many hours did you spend teaching about injury prevention and safety? Less than 1 hour 0 1 Hour 1 2 Hours 2 3 Hours 3 4 Hours 4 5 Hours 5 6 Hours 6 7 Hours 7 8 Hours 8 9 Hours 9 10 Hours 10 11 or more hours 11 Now I’d like to ask you a few questions about instruction on personal health and wellness in this class. SHOW CARD 20 As I read the topics listed on this card, please tell me if you taught about each one in the class. 48. Did you teach about... Yes No a. Hand washing or hand hygiene? 1 2 b. Dental and oral health? 1 2 c. Consumer health, such as choosing sources of health-related information, products, and services wisely? 1 2 d. Environmental health, such as how air and water quality can affect health? 1 2 e. Growth and development? 1 2 f. Immunizations? 1 2 g. Sun safety or skin cancer prevention? 1 2 h. The difference between infectious and chronic diseases? 1 2 i. How common infectious illnesses like the flu are transmitted? 1 2 j. Benefits of rest and sleep? 1 2 k. Ways to prevent vision and hearing loss? 1 2 l. The importance of health screenings and checkups? 1 2 m. How positive health behaviors can benefit people throughout the life span? 1 2 n. Potential health and social consequences of popular fads and trends? 1 2 Now, I would like to ask a few more general questions about the class. Please remember to answer these questions about this class only. The next questions ask about the use of various teaching methods. 49. How often did you use... Almost Some- Always or Never Rarely times Always a. Audiovisual media, such as videos? 1 2 3 4 b. Group discussions? 1 2 3 4 c. Cooperative group activities? 1 2 3 4 d. Role play, simulations, or practice? 1 2 3 4 e. Visual, performing, or language arts? 1 2 3 4 f. Pledges or contracts for changing behavior or abstaining from a behavior? 1 2 3 4 g. Guest speakers? 1 2 3 4 h. Peer teaching? 1 2 3 4 i. The Internet? 1 2 3 4 j. Computer-assisted instruction? 1 2 3 4 k. Health education programs available through videoconferencing or other distance learning methods?1 2 3 4 The next questions ask about the use of methods to highlight diversity or the values of various cultures. 50. When teaching the class did you... Yes No N/A a. Use textbooks or curricular materials reflective of various cultures? 1 2 b. Use textbooks or curricular materials designed for students with limited English proficiency? 1 2 3 c. Ask students or families to share their own cultural experiences related to health topics? 1 2 d. Teach about cultural differences and similarities? 1 2 e. Modify teaching methods to match students’ learning styles, health beliefs, or cultural values? 1 2 51. Did you ask students to... Yes No a. Perform volunteer work at a hospital, a local health department, or any other local organization that addresses health issues? 1 2 b. Participate in or attend a community health fair? 1 2 c. Gather information about health services that are available in the community, such as health screenings? 1 2 d. Visit a store to compare prices of health products? 1 2 e. Identify potential injury sites at school, home, or in the community? 1 2 f. Identify advertising in the community designed to influence health behaviors? 1 2 g. Advocate for a health-related issue? 1 2 52. Did you... Yes No a. Provide families with information on the class? 1 2 b. Give students homework or projects that involve family members? 1 2 c. Invite family members to attend the class? 1 2 ANSWER Q53 AND Q54 FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO THE INTRODUCTION TO Q55. 53. Did you make time for students to wash their hands using instant hand sanitizers or a bathroom or classroom sink ... Yes No N/A a. Before lunch? 1 2 3 b. Before snacks? 1 2 3 c. After recess? 1 2 3 54. Does the classroom supply list for students include hand cleaning products? Yes 1 No 2 My next questions ask about teaching students with long-term physical, medical, or cognitive disabilities. Examples of such disabilities include Down’s Syndrome, learning disabilities, and conditions that require permanent use of a wheelchair. 55. Were there any students with long-term physical, medical, or cognitive disabilities in the class? Yes 1 No 2 -->SKIP TO THE INTRODUCTION TO Q57 56. Was there... Yes No a. A special education teacher with whom you coordinated assignments for students with disabilities? 1 2 b. A teacher or aide who came in to assist with the students with disabilities? 1 2 c. Assigned note takers or readers for class work? 1 2 d. Simplified instructional content or variations in the amount or difficulty of material taught? 1 2 e. More skill modeling, practicing, or repetition? 1 2 f. Preferential seating for the students with disabilities? 1 2 g. Modified assessment criteria? 1 2 My last set of questions asks about your teaching experience and educational background. 57. Counting this year as a full year and including years spent teaching health education topics or courses at any other schools, how many years of experience do you have teaching health education topics or courses? _____ Years 58. Do you coach an interscholastic sport? Yes 1 No 2 59. Do you have an undergraduate degree? Yes 1 No 2 -->SKIP TO Q65 60. What did you major in? MARK ALL THAT APPLY Health education 1 Physical education 2 Other education 3 Kinesiology, exercise physiology, or exercise science 4 Nursing 5 Nutrition 6 Public health 7 Biology or other science 8 Home economics or family and consumer science 9 Other 10 61. Did you have an undergraduate minor? Yes 1 No 2 -->SKIP TO Q63 62. What did you minor in? MARK ALL THAT APPLY Health education 1 Physical education 2 Other education 3 Kinesiology, exercise physiology, or exercise science 4 Nursing 5 Nutrition 6 Public health 7 Biology or other science 8 Home economics or family and consumer science 9 Other 10 63. Do you have a graduate degree? Yes 1 No 2 -->SKIP TO Q65 64. In what area or areas? MARK ALL THAT APPLY Health education 1 Physical education 2 Other education 3 Kinesiology, exercise physiology, or exercise science 4 Nursing 5 Nutrition 6 Public health 7 Biology or other science 8 Home economics or family and consumer science 9 Other 10 65. Currently, are you certified, endorsed, or licensed by the state to teach health education in... Yes No N/A a. Elementary school? 1 2 3 b. Middle or junior high school? 1 2 3 c. Senior high school? 1 2 3 ANSWER Q66 FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO THE INTRODUCTION TO Q67. 66. Are you a Certified Health Education Specialist or CHES? Yes 1 No 2 Now I’d like to ask you about staff development you may have received or would like to receive. Staff development might include workshops, conferences, continuing education, graduate courses, or any other kind of in-service. SHOW CARD 21 As I read the list of topics on this card, please tell me if you received any staff development on each topic. 67. During the past two years, did you receive any staff development on... Yes No a. Alcohol or other drug use prevention? 1 2 b. Tobacco use prevention? 1 2 c. Nutrition and dietary behavior? 1 2 d. Physical activity and fitness? 1 2 e. Pregnancy prevention? 1 2 f. HIV or human immunodeficiency virus prevention? 1 2 g. Other STD or sexually transmitted disease prevention? 1 2 h. Human sexuality? 1 2 i. Emotional and mental health? 1 2 j. Suicide prevention? 1 2 k. Violence prevention, for example bullying, fighting, or homicide? 1 2 l. Injury prevention and safety? 1 2 m. Asthma awareness? 1 2 n. Foodborne illness prevention? 1 2 68. Which of these topics would you like to receive further staff development on? MARK ALL THAT APPLY Alcohol or other drug use prevention 1 Tobacco use prevention 2 Nutrition and dietary behavior 3 Physical activity and fitness 4 Pregnancy prevention 5 HIV or human immunodeficiency virus prevention 6 Other STD or sexually transmitted disease prevention 7 Human sexuality 8 Emotional and mental health 9 Suicide prevention 10 Violence prevention, for example bullying, fighting, or homicide 11 Injury prevention and safety 12 Asthma awareness 13 Foodborne illness prevention 14 None of these 15 SHOW CARD 22 As I read the list of topics on this card, please tell me if you received any staff development on each one during the past two years. 69. During the past two years, did you receive any staff development on... Yes No a. Teaching students with physical, medical, 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 g. Classroom management techniques, such as social skills training, environmental modification, conflict resolution and mediation, and behavior management? 1 2 h. Assessing or evaluating students in health education? 1 2 70. Which of these topics would you like to receive further staff development on? MARK ALL THAT APPLY Teaching students with physical, medical, or cognitive disabilities 1 Teaching students of various cultural backgrounds 2 Teaching students with limited English proficiency 3 Using interactive teaching methods, such as role plays or cooperative group activities 4 Encouraging family or community involvement 5 Teaching skills for behavior change 6 Classroom management techniques, such as social skills training, environmental modification, conflict resolution and mediation, and behavior management 7 Assessing or evaluating students in health education 8 None of these 9 71. My supervisor may wish to call you to ask about how I conducted this interview. Would you please tell me a telephone number where we might reach you starting with the area code? ( ) - 1) Daytime or 2) Evening/Weekend Thank you very much for taking the time to complete this interview.