Form 4 D-2-Indicators for School Health Programs: HIV Preventio

Indicators of the Performance of Local and State Education Agencies in HIV Prevention and Coordinated School Health Program Activities for Adolescent and School Health Programs

Attachment D-2 (HIV LEA - FY2008-FY2010)

D-1-Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2007)

OMB: 0920-0672

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0672 can be found here:

2011-04-12 - Revision of a currently approved collection

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Attachment D-2
Indicators for School Health Programs: HIV Prevention, Local Education Agencies
(FY2008-FY2010)

Form Approved
OMB No. 0920-0672
Exp. Date xx/xx/xxxx

Indicators for School Health Programs:
HIV Prevention
Local Education Agencies
Fiscal Year: March 1, 2008 – February 28, 2009
Division of Adolescent and School Health
Funding Opportunity Number: CDC-RFA-DP08-801:
Improving Health and Education Outcomes of Young People
Instructions
This set of indicators describes the performance in seven areas of your HIV prevention project: (1) project
planning; (2) policy; (3) curricula and instruction; (4) assessment of student performance; (5) external
collaboration; (6) reducing disparities among populations of youth at disproportionate risk for HIV
transmission; and (7) other information and activities.
A glossary of terms is included at the end of the Indicators.
Activities to be reported are those for which any amount of DASH funds were used, or in which staff
time to develop, implement, or evaluate activities was funded in any amount by DASH. These questions
apply only to priority health risk behaviors addressed in Funding Opportunity Announcement DP08-801.
Do not include HIV prevention activities funded through supplements to DP08-801.
Please answer each question carefully and accurately. Not all items or activities may reflect the
emphasis of your HIV Prevention Project for the current fiscal year, and therefore you may report
that you have not performed activities in those areas by entering zeros. Additionally, you may not
currently collect information about some activities. If so, please leave the answer blank. Please be
sure to include materials for those items requesting attachments.
Public reporting burden of this collection of information is estimated to average 7.2 hours per response, including the time
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 current 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, MS-D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0672).

For further questions or assistance with completing this report
please contact your CDC project officer.
Person completing the Indicators:
Name:____________________________________________________________________________
Title:_____________________________________________________________________________
State:_____________________________________ Phone:________________________________
Email:____________________________________________________________________________

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
CENTERS FOR DISEASE CONTROL AND PREVENTION

FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

I. PROJECT PLANNING
1.

How many schools do you have in your district? ______ TOTAL

During FY 2008, did your HIV prevention project identify or maintain an HIV point of contact in
selected schools?
{
{

YES
NOÆ Skip to 3

If YES, provide total:
A.

Number of schools with an identified HIV point of contact ______

In FY 2008, which of the following planning and evaluation activities did your project carry out?
YES
NO
A. Conduct or review Program Inventory
{
{
B. Develop or revise a five-year strategic plan
{
{
C. Conduct formative evaluation
{
{
D. Create or revise a logic model
{
{
E. Write SMART objectives
{
{
F. Conduct process evaluation
{
{
G. Conduct outcome evaluation
{
{
H. Develop success stories
{
{
I. Other
{
{
Please specify____________________________________

In FY 2008, did you integrate your HIV prevention activities into any of the following school
health program components?
YES
NO
{
{
A.
Counseling/psychological/social services
B.
Health education
{
{
C.
Health services
{
{
D.
Healthy school environment/policy
{
{
E.
Nutrition services
{
{
F.
Parent/community involvement
{
{
G.
Physical education
{
{
H.
Staff health promotion
{
{

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HIV PREVENTION, LOCAL EDUCATION AGENCIES

II. POLICY
5.

During FY 2008, did your HIV prevention project DEVELOP (or revise or assist in developing)
model policies, policy guidance, or other policy materials for school staff on the following topics?
NO—we have
such policies
but did not
develop (or
revise or
assist in
developing)
them during
FY 2008

NO—we
do not
have
such
policies

{
{

{

{
{

Policy topic
(Choose one for each policy topic)
YES

A.
B.
C.
D.
E.
F.
G.
H.

HIV prevention education for students
Infection control/universal precautions for all school
staff
Maintaining confidentiality of HIV-infected students
and staff
Professional development requirements for teachers of
HIV prevention education
Confidential counseling for HIV-infected students
Procedures to protect HIV-infected students and staff
from discrimination
Attendance of students with HIV infection
Other model policies, policy guidance, or other policy
materials

During FY 2008, did your HIV prevention project DISTRIBUTE to school staff established or
model policies, policy guidance, or other policy materials on the following topics? (Choose one
for each topic.)
A.

HIV prevention education for students. (Choose one.)

{
{

YES
NO Æ Skip to 6B
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

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FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

Infection control/universal precautions for all school staff. (Choose one.)

{
{

YES
NO Æ Skip to 6C
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Maintaining confidentiality of HIV-infected students and staff. (Choose one.)

{
{

YES
NO Æ Skip to 6D
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Professional development requirements for teachers of HIV prevention education.
(Choose one.)

{
{

YES
NO Æ Skip to 6E
IF YES, provide the total:
1. Number of schools reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Confidential counseling for HIV-infected students. (Choose one.)

{
{

YES
NO Æ Skip to 6F
IF YES, provide the total:
1. Number of districts reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

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HIV PREVENTION, LOCAL EDUCATION AGENCIES

Procedures to protect HIV-infected students and staff from discrimination. (Choose
one.)

{
{

YES
NO Æ Skip to 6G
IF YES, provide the total:
1. Number of districts reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Attendance of students with HIV infection. (Choose one.)

{
{

YES
NO Æ Skip to 6H
IF YES, provide the total:
1. Number of districts reached directly ______
2. Number of hits on web site ______
3. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

Other established or model policies, policy standards, or other policy materials related to
HIV prevention. (Choose one.)

{
{

YES
NO Æ Skip to 7
IF YES,
1. Specify policy topic____________________
2. Number of districts reached directly ______
3. Number of hits on web site ______
4. Number of listservs, Internet mailing lists, or discussion boards used (do not list
number of e-mails posted but the number of electronic distribution lists used) ______

During FY 2008, did your HIV prevention project provide PROFESSIONAL
DEVELOPMENT (not to include presentations) to school staff that included information on
established or model policies, policy guidance, or other policy materials?
{
{

YES
NOÆ Skip to 8

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FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

If YES, provide the total:
A.
Number of professional development events focusing only on HIV policy ______
B.
Number of participants in professional development events focusing only on HIV policy
______
C.
Number of professional development events focusing only on HIV policy for which you
conducted follow-up support ______
D.
Number of professional development events that combined HIV policy with other
topic(s) (include only professional development in which activities or a portion of the
event focused specifically on HIV policy) ______
E.
Number of participants in professional development events that combined HIV policy
with other topics ______
F.
Number of professional development events that combined HIV policy with other
topic(s) for which you conducted follow-up support ______
G.
Number of schools reached directly ______
H.
Number of external agency partners reached directly ______
8.

During FY 2008, did your HIV prevention project provide TECHNICAL ASSISTANCE to
school staff on established or model policies, policy guidance, or other policy materials?
{
{

YES
NOÆ Skip to 9

If YES, provide the total:
A.
Number of schools reached directly ______
B.
Number of external agency partners reached directly ______
9.

If you directly reached external agency partners, to what types of external agency partners did
you DISTRIBUTE, provide PROFESSIONAL DEVELOPMENT on, or provide TECHNICAL
ASSISTANCE on established or model policies, policy guidance, or other policy materials?
(Mark all that apply.)
{
{
{
{
{
{
{
{
{
{
{
{
{
{

Not Applicable – We did not reach external agency partners
CDC-sponsored community planning group (CPG) for HIV prevention
Faith-based organizations
Health care providers/physicians
Legislators/lawmakers
Local- or county-level health agencies/departments of health
National non-governmental organizations (NGOs) (including local affiliates)
Parents/guardians/caregivers (including those reached through PTAs/PTOs)
Professional associations/organizations (e.g., NEA, AAHPERD, ASHA)
Social service agencies
State-level health agencies/departments of health
Universities/colleges/institutions of higher education
Youth-serving organizations
Other – Please specify type___________________________
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HIV PREVENTION, LOCAL EDUCATION AGENCIES

III. CURRICULA & INSTRUCTION
10.

During FY 2008, did your HIV prevention project DEVELOP (or revise or assist in developing)
any of the following on HIV prevention for school staff: exemplary curricula, health education
standards, frameworks, instructional strategies, or other guidance?
{
{
{

11.

YES
NO—we have such materials but did not develop them during FY 2008.
NO—we do not have such materials.

During FY 2008, did your HIV prevention project DISTRIBUTE to school staff any of the
following on HIV prevention: exemplary curricula, health education standards, frameworks,
instructional strategies, or other guidance? (Choose one.)
{
{

YES
NO Æ Skip to 12

If YES, provide the total:
A.
Number of schools reached directly ______
B.
Number of external agency partners reached directly ______
C.
Number of hits on web site ______
D.
Number of listservs, Internet mailing lists, or discussion boards used (do not list number
of e-mails posted but the number of electronic distribution lists used) ______
12.

During FY 2008, did your HIV prevention project provide PROFESSIONAL
DEVELOPMENT (not to include presentations) to school staff on exemplary HIV curricula or
instruction? (e.g., training on selected curricula; the importance of scientifically accurate
information; characteristics of effective HIV prevention programs; effective instructional
strategies; or aligning HIV prevention programs to meet health education standards.)
{
{

YES
NOÆ Skip to 13

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FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

If YES, provide the total:
A.
Number of professional development events focusing only on HIV curricula or
instruction ______
B.
Number of participants in professional development events focusing only on HIV
curricula or instruction ______
C.
Number of professional development events focusing only on HIV curricula or
instruction for which you conducted follow-up support ______
D.
Number of professional development events that combined HIV curricula or instruction
with other topic(s) (include only professional development in which activities or a portion
of the event focused specifically on exemplary HIV curricula or instruction) ______
E.
Number of participants in professional development events that combined HIV curricula
or instruction with other topics ______
F.
Number of professional development events that combined HIV curricula or instruction
with other topic(s) for which you conducted follow-up support ______
G.
Number of schools reached directly ______
H.
Number of external agency partners reached directly ______
13.

During FY 2008, did your HIV prevention project conduct PROFESSIONAL
DEVELOPMENT (not to include presentations) to school staff on any specific HIV prevention
education curricula and/or programs to deliver to youth? (Do not include textbook titles or
programs on general instructional strategies.)
{
{

YES
NOÆ Skip to 14

If YES, please provide the name of the curricula or programs:
A.
______________________________
B.
______________________________
C.
______________________________
D.
______________________________
E.
______________________________
14.

During FY 2008, did your HIV prevention project provide TECHNICAL ASSISTANCE to
school staff on HIV curricula or instruction? (e.g., help in reviewing, revising, developing,
selecting, or implementing instructional materials for HIV prevention)
{
{

YES
NOÆ Skip to 15

If YES, provide the total:
A.
Number of schools reached directly ______
B.
Number of external agency partners reached directly ______

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HIV PREVENTION, LOCAL EDUCATION AGENCIES

15.

If you directly reached external agency partners, to what types of external agency partners did
you DISTRIBUTE, provide PROFESSIONAL DEVELOPMENT on, or provide TECHNICAL
ASSISTANCE on HIV curricula or instruction? (Mark all that apply.)
{
{
{
{
{
{
{
{
{
{
{
{
{
{

16.

During FY 2008, which of the following topics were emphasized by your HIV prevention project
in curricula or instruction?
YES

A.
B.
C.

{
{
{

D.
E.
F.

{
{
{

{

Abstinence from sexual intercourse to prevent HIV transmission
Abstinence from IV drug use to prevent HIV transmission
Proper and consistent use of condoms among sexually active youth to
reduce the risk of HIV transmission
Influencing social norms to prevent HIV infection
Reducing number of partners
Developing individual and interpersonal skills to prevent HIV infection
(e.g., goal setting, decision making, refusal, negotiation, communication,
advocacy)
The relationship between HIV prevention and other STD prevention or
pregnancy prevention
The relationship between HIV prevention and prevention of alcohol or
other drug use
How to implement universal precautions

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FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

IV. ASSESSMENT OF STUDENT PERFORMANCE
17.

In FY 2008, did your HIV prevention project DEVELOP (or revise or assist in developing) for
school staff frameworks or guidance that focused on how to assess or measure, at the classroom
level, students’ knowledge and skills regarding HIV prevention?
{
{
{

18.

In FY 2008, did your HIV prevention project DISTRIBUTE to school staff frameworks or
guidance that focused on how to assess or measure, at the classroom level, students’ knowledge
and skills regarding HIV prevention? This does not include materials on how to conduct the
Youth Risk Behavior Survey (YRBS) or the School Health Profiles (Profiles). (Choose one.)
{
{

19.

YES
NO—we have such materials but did not develop them this fiscal year.
NO—we do not have such materials.

YES
NO

In FY 2008, did your HIV prevention project conduct PROFESSIONAL DEVELOPMENT
(not to include presentations) to school staff that focused on how to assess or measure, at the
classroom level, students' knowledge and skills regarding HIV prevention? This does not include
training on how to conduct the Youth Risk Behavior Survey (YRBS) or the School Health
Profiles (Profiles).
{
{

YES
NOÆ Skip to 20

If YES, provide the total:
A.
Number of professional development events focusing on health education assessment,
including HIV prevention (include only professional development in which activities or a
portion of the event focused specifically on assessing student performance related to HIV
prevention) ______
B.
Number of participants in professional development events focusing on health assessment
including HIV prevention (include only professional development in which activities or a
portion of the event focused specifically on assessing student performance related to HIV
prevention) ______
C.
Number of professional development events focusing on health education assessment,
including HIV prevention (include only professional development in which activities or a
portion of the event focused specifically on assessing student performance related to HIV
prevention) for which you conducted follow-up support? ______
D.
Number of professional development events focusing on health education assessment
______
E.
Number of participants from all professional development events focusing on health
education assessment ______
F.
Number of professional development events focusing on health education assessment for
which you conducted follow-up support? ______
G.
Number of schools reached directly ______
H.
Number of external agency partners reached directly ______
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HIV PREVENTION, LOCAL EDUCATION AGENCIES

20.

In FY 2008, did your HIV prevention project provide TECHNICAL ASSISTANCE to school
staff that focused on how to assess or measure, at the classroom level, students' knowledge and
skills regarding HIV prevention?
{
{

YES
NOÆ Skip to 21

If YES, provide the total:
A.
Number of schools reached directly ______
B.
Number of external agency partners reached directly ______
21.

If you directly reached external agency partners, to what types of external agency partners did
you DISTRIBUTE frameworks or guidance, provide PROFESSIONAL DEVELOPMENT on, or
provide TECHNICAL ASSISTANCE on how to assess or measure, at the classroom level,
students' knowledge and skills regarding HIV prevention? (Mark all that apply.)
{
{
{
{
{
{
{
{
{
{
{
{
{
{

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FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

V. EXTERNAL COLLABORATION
22.

During FY 2008, did your HIV prevention project COLLABORATE with any external agency
partners?
{
{

YES
NOÆ Skip to 23

If YES, choose YES or NO for each of the following external agency partners:
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
P.
Q.
R.
S.
T.
U.
V.
W.
X.
Y.
Z.
AA.

YES
Agencies serving primarily African-American youth
{
Agencies serving primarily Hispanic youth
{
Agencies serving primarily American Indian/Alaskan Native youth
{
Agencies serving primarily Asian/Pacific Islander youth
{
Agencies serving primarily sexual minority youth
{
AIDS service community organizations
{
Alcohol and drug rehabilitation facilities
{
CDC-funded local education agency HIV projects
{
Community organizations serving parents and families
(this does not include internal school parent groups such as the PTA)
{
Education organizations (e.g., advocacy, service, professional,
or membership associations)
{
Faith-based organizations
{
Health care providers/physicians
{
Health organizations (e.g., advocacy, service, professional,
or membership associations)
{
Juvenile corrections facilities
{
Legislators/lawmakers
{
Local- or county-level health agencies/departments of health
{
National non-governmental organizations (NGOs)
(including local affiliates)
{
Organizations that focus exclusively on abstinence
{
Parents/guardians/caregivers (including those reached through
PTAs/PTOs)
{
Professional associations/organizations (non-education)
{
Social service agencies
{
State-level health agencies/departments of health
{
State health coalitions or networks
{
Universities/colleges/institutions of higher education
{
Youth (representing schools or communities)
{
Youth-serving community organizations
{
Other types of external agency partners not listed above
{
Please specify ____________________________________________
________________________________________________________
(If additional space is needed to list “other types of external agency partners
not listed above,” please label them BB-EE.)

NO
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{
{

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HIV PREVENTION, LOCAL EDUCATION AGENCIES

23.

During FY 2008, which of the following descriptions best describes your local education agency's
relationship with the state CDC-sponsored Community Planning Group (CPG) for HIV
prevention? (Choose one.)
{
{
{
{
{

24.

No one from the LEA attends the meetings
An LEA staff member attends meetings to observe, but has no formal role
An LEA staff member attends and serves as a content expert or technical advisor, but
does not have any voting privileges
An LEA staff member attends meetings and has voting privileges
Other
Please specify______________________________________________________

During FY 2008, which of the following descriptions best describes your local education agency's
relationship with the local or regional CDC-sponsored Community Planning Group (CPG) for
HIV prevention? (Choose one.)
{
{
{
{
{
{

No one from the LEA attends the meetings
An LEA staff member attends meetings to observe, but has no formal role
An LEA staff member attends and serves as a content expert or technical advisor, but
does not have any voting privileges
An LEA staff member attends meetings and has voting privileges
There is no local or regional CPG in our area.
Other
Please specify______________________________________________________

VI. REDUCING DISPARITIES AMONG POPULATIONS OF YOUTH
AT DISPROPORTIONATE RISK FOR HIV TRANSMISSION
25.

What kinds of data has your project reviewed to identify youth at disproportionate risk for
HIV transmission?
YES
NO
{
{
A.
Youth Risk Behavior Survey (YRBS) data
B.
HIV/AIDS incidence and prevalence data for youth
{
{
C.
HIV/AIDS incidence and prevalence data for adults
{
{
D.
STD incidence and prevalence data (excluding HIV/AIDS)
{
{
E.
Pregnancy and live birth data for youth
{
{
F.
Comprehensive HIV Prevention Plan
{
{
G.
Other
{
{
Please specify_______________________________________

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FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

26.

Which populations of youth have you identified as being at disproportionate risk for HIV
transmission (including identifying areas where youth are at disproportionate risk for HIV
transmission, such as counties or zip codes)?
A._______________________
B._______________________
C._______________________
D._______________________
(If your project did NOT identify populations of youth at disproportionate risk for HIV
transmission, skip to 32.)

27.

During FY 2008, what activities did your project conduct to increase the capacity of schools to
reach the youth your project identified as being at disproportionate risk for HIV transmission?
(Mark all that apply.)
{
{
{
{
{
{

28.

Partnering with agencies to deliver programs within school settings to youth at
disproportionate risk for HIV transmission
Partnering with agencies to deliver programs outside school settings to youth at
disproportionate risk for HIV transmission
Partnering with health agencies to provide health services in or out of school settings to
youth at disproportionate risk for HIV transmission
Promoting student organizations that reach youth at disproportionate risk for HIV
transmission
Providing programs and services that reach youth at disproportionate risk for HIV
transmission
Other
Please specify______________________________________________________

For the activities conducted during FY 2008 to increase the capacity of schools to reach the youth
your project identified as being at disproportionate risk for HIV transmission, what topics were
included? (Mark all that apply.)
{
{
{
{
{
{

Identifying strategies to increase involvement of youth at disproportionate risk for HIV
transmission in programs and services
Providing culturally or linguistically competent educational programs or services for
youth at disproportionate risk for HIV transmission
Understanding the HIV prevention needs of youth at disproportionate risk for HIV
transmission
Building the skill of school administrators, faculty, or staff to address youth at
disproportionate risk for HIV transmission
Reaching families of youth at disproportionate risk for HIV transmission
Other
Please specify______________________________________________________

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HIV PREVENTION, LOCAL EDUCATION AGENCIES

29.

During FY 2008, describe the PROFESSIONAL DEVELOPMENT (not to include
presentations) to district or school staff that your HIV prevention project provided that focused on
improving the quality of HIV prevention for youth your project identified as being at
disproportionate risk for HIV transmission:
A.
B.
C.

D.
E.
30.

During FY 2008, describe the TECHNICAL ASSISTANCE to district or school staff that your
HIV prevention project provided to reach youth your project identified as being at
disproportionate risk for HIV transmission:
A.
B.

31.

Number of professional development events that focused on improving the quality of
HIV prevention for youth at disproportionate risk for HIV transmission ______
Number of participants in professional development events that focused on improving the
quality of HIV prevention for youth at disproportionate risk for HIV transmission ______
Number of professional development events that focused on improving the quality of
HIV prevention for youth at disproportionate risk for HIV transmission for which you
conducted follow-up support? ______
Number of schools reached directly ______
Number of external agency partners reached directly ______

Number of schools reached directly ______
Number of external agency partners reached directly ______

If you directly reached external agency partners, to what types of external agency partners did
you provide PROFESSIONAL DEVELOPMENT or TECHNICAL ASSISTANCE on improving
the quality of HIV prevention for youth your project identified as being at disproportionate risk
for HIV transmission? (Mark all that apply.)
{
{
{
{
{
{
{
{
{
{
{
{
{
{

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FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

VII. OTHER INFORMATION & ACTIVITIES
32.

In FY 2008, did you conduct INFORMATION SESSIONS (not to include professional
development) that focused on policy, curriculum, or student assessment related to HIV
prevention?
{
{

YES
NOÆ Skip to 33

If yes:
A.

How many information sessions did you conduct focused on policy, curriculum, or
student assessment related to HIV prevention? _________

How many information sessions did you conduct on HIV prevention in the context of
coordinated school health programs?______________

Please check all audiences for whom you conducted information sessions in FY 2008:
___ District-level staff or administrators
___ School-level staff or administrators
___ District school board members or superintendent
___ Staff or students at universities, colleges, or other institutions of higher education
___ Community-based organization staff
___ State health officer
___ State or local health agency staff
___ State education agency staff
___ Legislators/lawmakers
___ Parents/parent groups
___ School-aged youth
___ Other
Please specify____________________________________________

33.

In FY 2008, did you provide PRE-SERVICE LEARNING events that focused on policy,
curriculum, or student assessment related to HIV prevention?
{
{

YES
NOÆ Skip to 34

If yes:
A.

How many pre-service learning events did you provide focused on policy, curriculum, or
student assessment related to HIV prevention? _____________

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HIV PREVENTION, LOCAL EDUCATION AGENCIES

34.

Is there information that we asked for in this year’s Indicators that you estimated or guessed at?
{
{

YES
NOÆ Skip to 35

A. What kind of information did you estimate or guess at? (Mark all that apply.)
_____ Distribution of print materials
_____ Distribution of materials on web sites, listservs, Internet mailing lists, or discussion
boards
_____ Professional development events
_____ Follow-up support for professional development events
_____ Technical assistance
_____ Information sessions
_____ Pre-service learning events
B. On what topics did you estimate or guess at information? (Mark all that apply.)
_____
_____
_____
_____
_____
35.

Project Planning
Policies
Curricula and instruction
Assessment of student performance
Reducing disparities among youth at disproportionate risk for HIV transmission

Is there information that we asked for in this year’s Indicators that you did not collect at all?
{
{

YES
NOÆ Skip to 36

A. What kind of information did you not collect at all? (Mark all that apply.)
_____ Distribution of print materials
_____ Distribution of materials on web sites, listservs, Internet mailing lists, or discussion
boards
_____ Professional development events
_____ Follow-up support for professional development events
_____ Technical assistance
_____ Information sessions
_____ Pre-service learning events
B. On what topics did you not collect information at all? (Mark all that apply.)
_____
_____
_____
_____
_____

Project Planning
Policies
Curricula and instruction
Assessment of student performance
Reducing disparities among youth at disproportionate risk for HIV transmission
Please continue on the next page Æ

FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

36.

Please provide information about any additional activities not captured by the questions above.
In particular, please report on any additional activities to improve HIV policies, curriculum,
instruction, assessment, or collaborations and any activities for which you could not collect
information on participants or recipients of materials.

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

39.

Please provide any additional general comments or information in the space below.

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

THANK YOU FOR YOUR RESPONSES. PLEASE RETURN THE INDICATORS.

HIV PREVENTION, LOCAL EDUCATION AGENCIES

Glossary
Please refer to the following definitions when answering the questions:
ABSTINENCE – Voluntarily refraining from a specified behavior.
ASSESSMENT – Measuring the learning and performance of students or teachers. Different types of
assessment instruments include achievement tests, minimum competency tests, developmental screening
tests, aptitude tests, observation instruments, performance tasks, and authentic assessments.
COLLABORATE – Two or more partners actively engage in planning, implementing, and evaluating
programs, practices, and policy activities with defined roles and responsibilities.
COORDINATED SCHOOL HEALTH PROGRAM (CSHP) – A coordinated school health program is
a planned and organized set of courses, services, policies, and interventions designed to meet the health
and safety needs of K-12 students. Schools promote optimal physical, emotional, social, and educational
development of students by providing health education; physical education; health services; nutrition
services; counseling, psychological and social services; and a healthy and safe environment; and by
promoting parent/community involvement and staff wellness. A successful and well-coordinated school
health program is characterized by administrators, teachers, and school board members who view health
protection and promotion as an essential part of the school’s mission; a school health council comprised
of school, family, and community representatives to ensure a planning process for continuous
improvement; a school health coordinator responsible for organizing and managing the school health
program; and school staff who help plan and implement a full array of school health courses, services,
policies, and interventions.
CULTURAL COMPETENCE – Knowledge and skills that allow individuals to increase their
understanding and appreciation of cultural differences and similarities within, among, and between
groups.
CURRICULUM – An educational plan incorporating a structured, developmentally appropriate series of
intended learning outcomes and associated learning experiences for students; generally organized as a
related combination or series of school-based materials, content, and events.
DISTRIBUTE – Putting exemplary materials in the hands of appropriate personnel. Distribution may
occur in response to requests for materials or through proactive sharing of information.
EMPHASIZED – Curricula, instruction, and instructional activities are tailored to specific, primary HIV
prevention topics and are primary messages in policy, professional development, or technical assistance
by an HIV project. Do not include topics that are only mentioned in passing and are not primary
messages of curricula, instruction, or instructional activities.
EXEMPLARY – An evaluated curriculum or program with evidence of effectiveness, or a curriculum or
program that has used research-based or science-based strategies. An exemplary curriculum or program
is: (1) developmentally and culturally appropriate; (2) medically and scientifically accurate; (3)
consistent with scientifically researched evidence of effectiveness; and (4) built on a theoretic approach
based on proven principles for prevention.
EXTERNAL AGENCY PARTNERS – Agencies, organizations, and groups outside your own agency
with which you collaborate or associate to further the goals of your HIV project.

FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

FISCAL YEAR (FY) – March 1, 2008 to February 28, 2009, the budget period for the cooperative
agreement.
FOLLOW-UP SUPPORT – Assistance provided to enhance participants’ abilities to use skills, tools and
techniques learned through professional development offerings. Follow-up support leads to a more
significant outcome than training alone by addressing challenges and sharing successes through a variety
of media (e.g., e-mail, conference calls, webcasts, site visits).
FORMATIVE EVALUATION – Gathering information during the early stages of your project or
program, with a focus on finding out whether your efforts are unfolding as planned, uncovering any
obstacles or unexpected opportunities that may have emerged, and identifying adjustments and
corrections to your program.
FRAMEWORK – An outline or plan that presents both the content (e.g., important concepts, skills, and
generalizations) and the process for developing curricula, instruction, and assessment.
GUIDANCE – A set of strategies to apply frameworks to develop curricula, instruction, and assessment.
HEALTH EDUCATION – Includes planned sequential materials, instructions, and educational
experiences delivered in the classroom setting that provide students with opportunities to acquire the
knowledge and skills necessary for making health promoting decisions and achieving health literacy.
Quality health education is based on sound theories of development and behavior change or empirically
supportive practices that result in increased knowledge and positive behavior change.
HIV PREVENTION PROJECT – Any activities or personnel that are funded, in part or whole, through
DASH cooperative agreement funds for the HIV prevention project. It is the work of contract and
regional staff on DASH Funding Opportunity Announcement DP08-801, Priority #2.
INFORMATION SESSION – Workshop, presentation or other instructional activities delivered in a
short period of time taking at least 30 minutes and no more than 3 hours that focuses on a specific public
health, curricular or coordinated school health program topic. Information sessions are tailored to specific
audiences such as school administration, faculty, education and health professionals, adolescents, parents,
college students, legislators or community groups.
LINGUISTIC COMPETENCE – Knowledge and skills that allow individuals to increase their
understanding and appreciation of verbal and non-verbal communication differences and similarities
within, among, and between groups.
LOGIC MODEL – A logic model is a pictorial diagram that shows the relationship between your
program components and activities and desired health outcomes. A logic model is a planning tool that
might describe your entire program or a particular program objective or initiative.
MATERIALS – Resources approved by an HIV materials review committee, including written materials
(e.g., curricula, training materials, and pamphlets); audio visual materials (e.g., motion pictures and video
tapes); pictorials (e.g., posters and similar educational materials using photographs, slides, drawings, or
paintings); and electronic resources (e.g., web sites, PDF files, and PowerPoint files).

HIV PREVENTION, LOCAL EDUCATION AGENCIES

MODEL POLICY – Model policies provide a framework to assist school officials in developing their
own state or local policies. They are written as statements of best practice which can be adapted to fit
local circumstances. Model policies reflect state-of-the-art, scientifically reliable information on what
constitutes effective school health programs and the expert opinions of many reviewers. Included in
model policies are excerpts or references to actual national, state, and local policies; a purpose or goals;
rationale; and definitions.
MODEL PROGRAM – A packaged, promising, evidence-based or science-based program that results in
positive outcomes.
NUMBER OF DISTRICTS REACHED DIRECTLY – A district is reached directly when one or more
district level staff receives materials, training, or assistance from personnel funded by your HIV
prevention project. Each district reached is counted only once as being reached for a particular topic
regardless of the number of district staff from that district are reached or the number of times district staff
are reached.
NUMBER OF EXTERNAL AGENCY PARTNERS REACHED DIRECTLY – An external partner
is reached directly when one or more external partner’s staff receives materials, training, or assistance
from personnel funded by your HIV prevention project. Each external partner reached is counted only
once as being reached for a particular topic regardless of the number of external partner staff from that
external partner are reached or the number of times external partner staff are reached.
NUMBER OF REGIONAL SUPPORT UNITS REACHED DIRECTLY – A regional support unit is
reached directly when one or more regional support unit staff receives materials, training, or assistance
from personnel funded by your HIV prevention project. If you specifically fund a CBO or NGO to
provide regional support, report their activities ONLY under regional support units and not under external
agency partners. Each regional support unit reached is counted only once as being reached for a
particular topic regardless of the number of regional support unit staff from that regional support unit are
reached or the number of times regional support unit staff are reached.
NUMBER OF SCHOOLS REACHED DIRECTLY – A school is reached directly when one or more
school staff receives materials, training, or assistance from personnel funded by your HIV prevention
project. Each school reached is counted only once as being reached for a particular topic regardless of the
number of school staff from that school are reached or the number of times school staff are reached.
OUTCOME EVALUATION – Evaluation undertaken to determine if the changes ascribed to a program
(e.g., changes in systems, collaborations, policies, or knowledge, attitudes, or behavior among
administrators, teachers, school staff, community members, or youth) are associated with program
activities.
POLICY – Any mandate issued or policies adopted by school district boards of education, the state
school board, state legislature, or other district or state agencies that affect the environment in school
districts or throughout the state. These include policies developed by your state or those based on model
policies developed elsewhere. Sample model policies are available in Fit, Healthy, and Ready to Learn: A
School Health Policy Guide (March, 2000), developed by the National Association of State Boards of
Education (NASBE). Sample polices can be viewed at NASBE’s web site:
http://www.nasbe.org/healthy_schools/policy.htm.
PRE-SERVICE LEARNING – Pre-service learning provides pre-professionals serving youth (e.g.,
educators, nurses, counselors) with an understanding of the central concepts, tools of inquiry, and
structures of relevant disciplines.

FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

PROCESS EVALUATION – Collecting and analyzing data to determine who, what, when, and where,
and how much of program activities have been conducted. Process evaluation allows staff to assess how
well the program has been implemented.
PROFESSIONAL DEVELOPMENT – The systematic process used to strengthen the professional
knowledge, skills and attitudes of those who serve youth to improve the health, education, and well-being
of youth. Professional development is consciously designed to actively engage learners and includes the
planning, design, marketing, delivery, evaluation, and follow-up of professional development offerings
(events, information sessions, and technical assistance).
PROFESSIONAL DEVELOPMENT EVENT – A set of skill-building processes and activities
designed to assist targeted groups of participants in mastering specific learning objectives. Such events
are delivered in an adequate time span (at least 3 hours) and may include curriculum and other training,
workshops, conferences, and on-line or distance learning courses.
PROGRAM – A multi-faceted approach to decrease health risk behaviors that may include a
combination of strategies such as one-on-one interventions, policy and climate changes, advocacy, peer
interventions, mentoring programs, youth asset development, and outreach.
PROGRAM INVENTORY – A document that funded partners are required to fill out in the first and
fifth year of the 801 Cooperative Agreement that provides a snapshot of what their program currently is
doing or plans to do.
REGIONAL SUPPORT UNITS – A state-recognized agency or organization (e.g., universities, regional
education support agencies, regional offices of education, regional training centers, teacher centers,
county superintendent’s offices, etc.) that provides professional development, technical assistance, and
educational materials to school districts and schools within the state.
SCHOOL – A division of the public school system consisting of students in one or more grades or other
identifiable groups organized to give instruction of a defined type. One school may share a building with
another school or one school may be housed in several buildings. Each school usually has an
identification number assigned by the state department of education for tracking purposes. Public schools
include charter schools, magnet schools, vocational schools, and alternative schools.
SCHOOL DISTRICT – An education agency at the local level that exists primarily to operate public
schools or to contract for public school services. Synonyms include local basic administrative unit, local
education agency, parish, independent school districts, etc.
SERVING PRIMARILY – Agencies whose main focus is on providing services tailored to a specific,
identifiable population (e.g., by race, sexual orientation, etc.) or increasing the ability of others to provide
services to that population.
SEXUAL MINORITY YOUTH – Youth who identify as gay, lesbian, bisexual, transgender, or
questioning; or youth who engage in same gender sexual activity.

HIV PREVENTION, LOCAL EDUCATION AGENCIES

SMART OBJECTIVES – Objectives are statements that describe program results to be achieved and
how they will be achieved. Specific objectives include who will be targeted and what will be
accomplished. Measurable objectives include how much change is expected, specifically enough that
achievement of the objective can be measured through counting or documenting change. Achievable
objectives can be realistically accomplished given your program’s existing resources and constraints.
Realistic objectives address the scope of the health problem and propose reasonable programmatic steps.
Time-phased objectives provide a timeline indicating when the objective will be met.
SOCIAL NORMS – Behavioral patterns that are typical of specific groups.

STANDARDS – An established set of written expectations that describe what a student should know
(knowledge) and be able to do (skills) as a result of the instruction provided for a particular subject
(content area). Standards provide a framework for curriculum development and selection, instruction, and
assessment.
• Health Education Standards are written expectations for what students should know and be
able to do by grades 2, 5, 8, and 12 to promote personal, family, and community health. An
abbreviated version of the National Health Education Standards, Second Edition and Performance
Indicators for specific grade level groupings can be found at
http://www.cdc.gov/healthyyouth/sher/standards.
STRATEGIC PLAN – A program planning tool that provides a blueprint to strengthen program
activities, address areas for improvement, and move the program forward to new accomplishments.
SUCCESS STORIES – A narrative highlighting the achievements and progress of a program or

activity.
TECHNICAL ASSISTANCE – Tailored guidance to meet the specific needs of a site or sites through
collaborative communication between a specialist and the site(s). Assistance takes into account sitespecific circumstances and culture and can be provided through phone, mail, e-mail, Internet, or in-person
meetings.
UNIVERSAL PRECAUTIONS – A set of precautions designed to prevent transmission of human
immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens when providing
first aid or health care. Under universal precautions, blood and certain body fluids of all patients are
considered potentially infections for HIV, HBV, and other bloodborne pathogens.
YOUTH AT DISPROPORTIONATE RISK FOR HIV TRANSMISSION – Populations of youth for
whom the incidence, prevalence, mortality, and burden of HIV and prevalence of risky sexual behaviors
and IV drug use are greater than in a comparison population. Populations can be defined by race or
ethnicity, gender, education or income, disability, geographic location (i.e., rural or urban), or sexual
orientation.

FISCAL YEAR 2007 SCHOOL HEALTH PROGRAM INDICATORS

File Type	application/pdf
File Title	Microsoft Word - Attachment D-2 _HIV LEA - FY2008-FY2010_.doc
Author	fhh6
File Modified	2008-02-15
File Created	2008-02-15