HE_District - public use Form Approved OMB No: 0920-0445 Expiration Date: 11/30/2008 Health Education District Questionnaire Health Education District Questionnaire Questions Standards/Guidelines 1 - 7 Elementary School Instruction 8 - 18 Middle or Junior High School Instruction 19 - 30 Senior High School Instruction 31 - 42 Staffing and Staff Development 43 - 46 Collaboration 47 - 48 Promotion 49 Evaluation 50 Health Education Coordinator 51 - 60 Public reporting burden for this collection of information is estimated to average 30 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 TELEPHONE INTERVIEW TECHNOLOGY. THE INTERVIEWER WILL READ THE QUESTIONS ALOUD AND TYPE RESPONSES TO THE QUESTIONS INTO THE 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. 1. This questionnaire focuses on your district’s policies and practices regarding health education. 2. When I use the word “policy,” I mean any law, rule, regulation, administrative order, or similar kind of mandate issued by the local school board or other local agency with authority over schools in your district. I am most interested in what is required by the district, not what is recommended or contained in non-binding guidance documents, unless the question specifically asks about recommendations. 3. If a district policy is worded in such a way that it requires schools to develop and adopt their own policies on a given topic, for the purpose of this questionnaire please consider it the same as a district-wide requirement. 4. I recognize that the district may sometimes grant policy exceptions or waivers, but please answer each question based on what is considered the general policy and standard practice. 5. Please do not consider school practices or policies when answering the questions. We will ask about school practices and policies when we collect information from schools across the country. The first questions ask about your district’s standards or guidelines for teaching health education. These standards or guidelines might cover topics such as the goals and objectives of health education or expected student outcomes. 1. Has your district adopted a policy stating that schools will follow any national, state, or district health education standards or guidelines? Yes 1-->SKIP TO Q3 No 2 2. Has your district adopted a policy encouraging schools to follow any national, state, or district health education standards or guidelines? Yes 1 No 2-->SKIP TO THE INTRODUCTION TO Q8 3. Are these health education standards or guidelines based on the National Health Education Standards? Yes 1 No 2 The next questions ask about methods your district might use to improve school compliance with these health education standards or guidelines. 4. To improve compliance with health education standards or guidelines, does your district use staff development for health education teachers? Yes 1 No 2 5. Does your district use written reports from schools to document compliance with health education standards or guidelines? Yes 1 No 2 6. To improve compliance with health education standards or guidelines, does your district use teacher evaluations or classroom monitoring? Yes 1 No 2 7. To improve compliance with health education standards or guidelines, does your district use teachers to mentor other teachers? Yes 1 No 2 Now I’m going to ask you about elementary school instruction. 8. Has your district adopted goals, objectives, or expected outcomes for elementary school health education? Yes 1 No 2-->SKIP TO THE INTRODUCTION TO Q10 The next questions ask about student outcomes. 9. Do the goals and objectives adopted by your district for elementary school health education specifically address… Yes No a. Comprehending concepts related to health promotion and disease prevention? 1 2 b. Accessing valid health information and health promoting products and services? 1 2 c. Analyzing the influence of culture, media, technology, and other factors on health? 1 2 d. Practicing health-enhancing behaviors and reducing health risks? 1 2 e. Using interpersonal communication skills to enhance health? 1 2 f. Using goal-setting and decision-making skills to enhance health? 1 2 g. Advocating for personal, family, and community health? 1 2 The next questions ask about specific health topics. 10. Has your district adopted a policy stating that elementary schools will 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 IF STUDENTS RECEIVE INSTRUCTION ON HUMAN SEXUALITY TOPICS (Q10E, Q10F, Q10G, OR Q10H IS “YES”), ANSWER Q11 AND Q12. OTHERWISE, SKIP TO THE INTRODUCTION TO Q13. 11. Has your district adopted a policy stating that elementary schools will notify parents or guardians before students receive instruction on pregnancy prevention, HIV prevention, other STD prevention, or human sexuality? Yes 1 No 2 12. Has your district adopted a policy stating that elementary schools will allow parents or guardians to exclude their children from receiving instruction on pregnancy prevention, HIV prevention, other STD prevention, or human sexuality? Yes 1 No 2 The next questions ask about curricula used by elementary schools for health education. By curriculum, I mean a written course of study that generally describes what students will know and be able to do by the end of a single grade or multiple grades and for a particular subject area. It is often presented through a detailed set of directions, strategies, and materials to facilitate student learning and teaching of content. 13. Does your district require or recommend that schools use one particular curriculum for elementary school health education? Require 1 Recommend 2 Neither 3-->SKIP TO THE INTRODUCTION TO Q15 14. Who developed that curriculum? MARK ALL THAT APPLY State education agency 1 Other state agency 2 School district 3 Commercial company 4 Academic institution 5 State-level organization or coalition 6 Other 7 The next questions ask about information and materials that your district may have provided for elementary school health education. 15. During the past two years, has your district provided… Yes No a. A list of one or more recommended elementary school health education curricula? 1 2 b. A list of one or more recommended elementary school health education textbooks? 1 2 c. An elementary school health education curriculum? 1 2 d. A chart describing the scope and sequence of instruction for elementary school health education? 1 2 e. Lesson plans or learning activities for elementary school health education? 1 2 f. Plans for how to assess or evaluate students in elementary school health education? 1 2 16. Districts use many ways to describe how much health education students are required to receive while in elementary school. For example, districts may describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for health education at the elementary school level? Yes 1 No 2 The next questions ask about staffing for elementary school health education in your district. 17. Has your district adopted a policy stating that newly hired staff who teach health education at the elementary school level will have undergraduate or graduate training in health education? Yes 1 No 2 18. Has your district adopted a policy stating that newly hired staff who teach health eduation at the elementary school level will be certified, licensed, or endorsed by the state to teach health education? Yes 1 No 2 State does not offer certification, licensure, or endorsement to teach health education at the elementary school level 3 Now I’m going to ask you about middle or junior high school instruction. 19. Has your district adopted goals, objectives, or expected outcomes for middle or junior high school health education? Yes 1 No 2-->SKIP TO THE INTRODUCTION TO Q21 The next questions ask about student outcomes. 20. Do the goals and objectives adopted by your district for middle or junior high school health education specifically address… Yes No a. Comprehending concepts related to health promotion and disease prevention? 1 2 b. Accessing valid health information and health promoting products and services? 1 2 c. Analyzing the influence of culture, media, technology, and other factors on health? 1 2 d. Practicing health-enhancing behaviors and reducing health risks? 1 2 e. Using interpersonal communication skills to enhance health? 1 2 f. Using goal-setting and decision-making skills to enhance health? 1 2 g. Advocating for personal, family, and community health? 1 2 The next questions ask about specific health topics. 21. Has your district adopted a policy stating that middle or junior high schools will 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 IF STUDENTS RECEIVE INSTRUCTION ON HUMAN SEXUALITY TOPICS (Q21E, Q21F, Q21G, OR Q21H IS “YES”), ANSWER Q22 AND Q23. OTHERWISE, SKIP TO THE INTRODUCTION TO Q24. 22. Has your district adopted a policy stating that middle or junior high schools will notify parents or guardians before students receive instruction on pregnancy prevention, HIV prevention, other STD prevention, or human sexuality? Yes 1 No 2 23. Has your district adopted a policy stating that middle or junior high schools will allow parents or guardians to exclude their children from receiving instruction on pregnancy prevention, HIV prevention, other STD prevention, or human sexuality? Yes 1 No 2 The next questions ask about curricula used by middle or junior high schools for health education. 24. Does your district require or recommend that schools use one particular curriculum for middle or junior high school health education? Require 1 Recommend 2 Neither 3-->SKIP TO THE INTRODUCTION TO Q26 25. Who developed that curriculum? MARK ALL THAT APPLY State education agency 1 Other state agency 2 School district 3 Commercial company 4 Academic institution 5 State-level organization or coalition 6 Other 7 The next questions ask about information and materials that your district may have provided for middle or junior high school health education. 26. During the past two years, has your district provided… Yes No a. A list of one or more recommended middle or junior high school health education curricula? 1 2 b. A list of one or more recommended middle or junior high school health education textbooks? 1 2 c. A middle or junior high school health education curriculum? 1 2 d. A chart describing the scope and sequence of instruction for middle or junior high school health education? 1 2 e. Lesson plans or learning activities for middle or junior high school health education? 1 2 f. Plans for how to assess or evaluate students in middle or junior high school health education? 1 2 27. Districts use many ways to describe how much health education students are required to receive while in middle or junior high school. For example, districts may describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for health education at the middle or junior high school level? Yes 1 No 2 The next questions ask about staffing for middle or junior high school health education in your district. 28. Has your district adopted a policy stating that newly hired staff who teach health education at the middle or junior high school level will have undergraduate or graduate training in health education? Yes 1 No 2 29. Has your district adopted a policy stating that newly hired staff who teach health education at the middle or junior high school level will be Certified Health Education Specialists or CHES? Yes 1 No 2 30. Has your district adopted a policy stating that newly hired staff who teach health education at the middle or junior high school level will be certified, licensed, or endorsed by the state to teach health education? Yes 1 No 2 State does not offer certification, licensure, or endorsement to teach health education at the middle/junior high school level 3 Next I’m going to ask you about senior high school instruction. 31. Has your district adopted goals, objectives, or expected outcomes for senior high school health education? Yes 1 No 2-->SKIP TO THE INTRODUCTION TO Q33 The next questions ask about student outcomes. 32. Do the goals and objectives adopted by your district for senior high school health education specifically address… Yes No a. Comprehending concepts related to health promotion and disease prevention? 1 2 b. Accessing valid health information and health promoting products and services? 1 2 c. Analyzing the influence of culture, media, technology, and other factors on health? 1 2 d. Practicing health-enhancing behaviors and reducing health risks? 1 2 e. Using interpersonal communication skills to enhance health? 1 2 f. Using goal-setting and decision-making skills to enhance health? 1 2 g. Advocating for personal, family, and community health? 1 2 The next questions ask about specific health topics. 33. Has your district adopted a policy stating that senior high schools will 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 IF STUDENTS RECEIVE INSTRUCTION ON HUMAN SEXUALITY TOPICS (Q33E, Q33F, Q33G, OR Q33H IS “YES”), ANSWER Q34 AND Q35. OTHERWISE, SKIP TO THE INTRODUCTION TO Q36. 34. Has your district adopted a policy stating that senior high schools will notify parents or guardians before students receive instruction on pregnancy prevention, HIV prevention, other STD prevention, or human sexuality? Yes 1 No 2 35. Has your district adopted a policy stating that senior high schools will allow parents or guardians to exclude their children from receiving instruction on pregnancy prevention, HIV prevention, other STD prevention, or human sexuality? Yes 1 No 2 The next questions ask about curricula used by senior high schools for health education. 36. Does your district require or recommend that schools use one particular curriculum for senior high school health education? Require 1 Recommend 2 Neither 3-->SKIP TO THE INTRODUCTION TO Q38 37. Who developed that curriculum? MARK ALL THAT APPLY State education agency 1 Other state agency 2 School district 3 Commercial company 4 Academic institution 5 State-level organization or coalition 6 Other 7 The next questions ask about information and materials that your district may have provided for senior high school health education. 38. During the past two years, has your district provided… Yes No a. A list of one or more recommended senior high school health education curricula? 1 2 b. A list of one or more recommended senior high school health education textbooks? 1 2 c. A senior high school health education curriculum? 1 2 d. A chart describing the scope and sequence of instruction for senior high school health education? 1 2 e. Lesson plans or learning activities for senior high school health education? 1 2 f. Plans for how to assess or evaluate students in senior high school health education? 1 2 39. Districts use many ways to describe how much health education students are required to receive while in senior high school. For example, districts may describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for health education at the senior high school level? Yes 1 No 2 The next questions ask about staffing for senior high school health education in your district. 40. Has your district adopted a policy stating that newly hired staff who teach health education at the senior high school level will have undergraduate or graduate training in health education? Yes 1 No 2 41. Has your district adopted a policy stating that newly hired staff who teach health education at the senior high school level will be Certified Health Education Specialists or CHES? Yes 1 No 2 42. Has your district adopted a policy stating that newly hired staff who teach health education at the senior high school level will be certified, licensed, or endorsed by the state to teach health education? Yes 1 No 2 State does not offer certification, licensure or endorsement to teach health education at the senior high school level 3 43. Has your district adopted a policy stating that those who teach health education will earn continuing education credits on health education topics? Yes 1 No 2 44. Has your district adopted a policy stating that each school will have someone to oversee or coordinate health education at the school, for example, a lead health education teacher? Yes 1 No 2 My next questions are about staff development for those who teach health education. This might include workshops, conferences, continuing education, graduate courses, or any other kind of in- service. 45. During the past two years, has your district provided funding for or offered staff development to those who teach health education 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 46. During the past two years, has your district provided funding for or offered staff development to those who teach health education on… Yes No a. Teaching students with long-term 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. Using 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 Now I’m going to ask you about collaboration among health education staff and other staff in your district. 47a. During the past 12 months, have district-level health education staff worked on health education activities with district-level physical education staff? Yes 1 No 2 District does not have district-level physical education staff 3 47b. What about with district-level health services staff? Yes 1 No 2 District does not have district-level health services Staff 3 47c. What about with district-level mental health or social services staff? Yes 1 No 2 District does not have district-level mental health or social services staff 3 47d. What about with district-level nutrition or food service staff? Yes 1 No 2 District does not have district-level nutrition or food service staff 3 47e. What about with district-level general curriculum coordinators or supervisors? Yes 1 No 2 District does not have district-level general curriculum coordinators or supervisors 3 48. During the past 12 months, have district health education staff worked on health education activities with staff or members from… Yes No a. A local health department? 1 2 b. A local hospital? 1 2 c. A local mental health or social services agency? 1 2 d. A local law enforcement agency? 1 2 e. A local service club, such as the Rotary Club? 1 2 f. Local fire or emergency services? 1 2 g. A health organization, such as the American Heart Association or the American Cancer Society? 1 2 h. A local college or university? 1 2 i. A local business? 1 2 The next question asks about health education promotion that might occur in your district. 49. During the past 12 months, has your district… Yes No a. Provided families with information on school health education? 1 2 b. Offered any health education for families? 1 2 c. Provided district or school personnel—for example classroom teachers, administrators, or school board members—with information on school health education? 1 2 d. Sought positive media attention for school health education? 1 2 The next questions ask about different aspects of school health education that might have been evaluated during the past two years. 50. During the past two years, have the following aspects of health education in your district been evaluated? Yes No N/A a. Health education policies 1 2 3 b. Health education curricula 1 2 3 c. Health education staff development or in-service programs 1 2 3 51. Currently, does someone in your district oversee or coordinate health education? Yes 1 No 2-->That is the last question. Thank you very much for taking the time to complete this questionnaire. 52. 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. The last few questions ask about your educational background. 53. Do you have an undergraduate degree? Yes 1 No 2-->SKIP TO Q59A 54. 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 55. Did you have an undergraduate minor? Yes 1 No 2-->SKIP TO Q57 56. 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 57. Do you have a graduate degree? Yes 1 No 2-->SKIP TO Q59A 58. 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 59a. Are you certified, licensed, or endorsed by the state to teach health education at the elementary school level? Yes 1 No 2 State does not offer certification, licensure, or endorsement to teach health education at the elementary school level 3 59b. What about at the middle or junior high school level? Yes 1 No 2 State does not offer certification, licensure, or endorsement to teach health education at the middle/junior high school level 3 59c. What about at the senior high school level? Yes 1 No 2 State does not offer certification, licensure, or endorsement to teach health education at the senior high school level 3 60. Are you a Certified Health Education Specialist or CHES? Yes 1 No 2 Thank you very much for taking the time to participate in this study. If you would like more information about this study or would like clarification of any questions in this survey, please call 800-287-1815.