Prevalence Questionnaire

Study of the Implementation of the
Safe and Drug-Free Schools and
Communities Act Program State Grants
Sponsored by:
The U.S. Department of Education
Conducted by:
Westat

Prevalence Questionnaire
We would like to learn more about the programs in place at your school during the 2008-09
school year that included a focus on youth alcohol, tobacco, and other drug (ATOD) use or
school crime. This questionnaire should be completed by the person who is most knowledgeable
about such programs at your school.
You can complete this survey online at https://www.sdfs-evaluation.org. You will need the ID
and password for your school, which can be found on the attached gold Web Information Sheet.
If you prefer, you may complete this paper version. If you complete the paper version, please
provide the following information, keep a copy of the completed survey for your files, and return
the original to Westat at the address shown below. We have enclosed a postage-paid envelope
for your convenience.
Name of person completing form: ____________________ Telephone: _________________
Title/position: ____________________________________ E-Mail: ____________________
Name of School: ______________________________________________________________
Best days and times to reach you (in case of questions): _______________________________
Return form to:
Attn: Debbie Alexander (#8622.09.01)
Westat
1650 Research Boulevard, TA 2100
Rockville, Maryland 20850
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number of this information collection is XXXX-XXXX. The
time required to complete this information collection is estimated to average 30 minutes per response, including the time to
review instructions, search existing data resources, gather the data needed, and complete and review the information collected. If
you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education, Washington, DC 20202-4651. If you have comments or concerns regarding the status of your
individual submission of this form, write directly to: Debbie Alexander, Westat, 1650 Research Boulevard, TA 2100, Rockville,
MD 20850-3129.

Study of the Implementation of the Safe and Drug-Free Schools and
Communities Act Program State Grants
Instructions and Frequently Asked Questions

General Instructions
This questionnaire asks about general security practices and specific prevention programs that
include a focus on youth alcohol, tobacco, and other drug (ATOD) use or school crime
prevention AND that were implemented during the 2008-09 school year. Please review the
following study definitions before you begin the survey.
ATOD – Includes alcohol, tobacco, illegal drugs, inhalants, and inappropriate use of
prescription and over-the-counter medications.
School crime – Includes illegal, violent, or disruptive behaviors that result in damage,
pain, injury, or fear, or result in disruptions of the school environment. Violent behaviors
include bullying, verbal aggression, physical aggression, possession or use of weapons,
and sexual harassment.
Security practice – An activity or set of activities intended to prevent youth ATOD use
or school crime (e.g., requiring identification cards or badges and visitor check-in; school
resource officer; use of cameras, metal detectors and drug-sniffing dogs; drug testing;
locker searches; etc.). Security practices may or may not be supported by an
implementation manual.
Program – An integrated set of activities intended to achieve one or more goals and
objectives. Only programs that are supported by an implementation manual or other
similar documentation should be considered.

Frequently Asked Questions
Who should complete this questionnaire? This questionnaire should be completed by the
person who is most knowledgeable about programs in place at your school during the 2008-09
school year that included a focus on youth ATOD use or school crime.

Will my responses be confidential? Responses to this data collection will be used only for
statistical purposes. The reports prepared for this study will summarize findings across the
sample and will not associate responses with a specific district, school, or individual. We will
not provide information that identifies the district, school, or respondent to anyone outside the
study team, except as required by law. One exception is that we will report responses on the
prevention programs operating in your school to your district.
2

Who can I contact if I have questions? If you have questions about the completion of this
survey, please contact a Westat study representative, toll-free at 1-888-XXX-XXXX, or by email
at [email protected].

What should I do when I have completed the questionnaire? If you are completing this
survey online at https://www.sdfs-evaluation.org, it will be automatically submitted to Westat
when you select the final “Submit Completed Survey” button. We encourage you to print out a
copy of your completed survey before submitting your completed survey. If you are completing
this paper version of this survey, please make a copy of the completed questionnaire for your
records and return the original in the enclosed postage-paid envelope within 3 weeks, or send it
to: Debbie Alexander (#8622.09.01), Westat, 1650 Research Boulevard, TA 2100, Rockville,
MD 20850-3195.

3

A. Security Practices
For questions 1 and 2, please use the table below to tell us which security practices were used in your school during the 2008-09 school year
and whether these practices received any funding from the federal SDFSCA program.
1.

During the 2008-09 school year, what security practices did your school use? (Check the box in Column B if your school used the
security practice listed.)

2.

For each security practice used in your school during the 2008-09 school year, indicate whether the practice was supported in
part or in full by any funds from the federal SDFSCA program. You may want to consult with your district prevention
coordinator or a school staff member who is knowledgeable about security practices if you are not sure. (Select one response
for each row in Column C.)
(Column B)
Check if security
practice was
used

(Column A)
Type of
security practice

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.

o.
p.
q.
r.
s.
t.
u.

Alarm system of any type (e.g., alarms on exterior doors, panic bars,
sensors, motion detectors) ....................................................................
Confidential ways to report crimes, problem behavior, or potential
problems ...............................................................................................
Drug testing students ............................................................................
Drug, gun, or bomb-sniffing dogs ........................................................
Fences/locked gates around the school property ..................................
Identification badges or cards (including photo IDs) for students........
Inspection of book bags or purses ........................................................
Intervention in potential disputes or actions to prevent escalation .......
Locker searches ....................................................................................
Locking exterior doors during the school day allowing people to exit
but not enter..........................................................................................
Metal detectors .....................................................................................
Surveillance or patrolling by a person of halls, grounds, and/or other
places in and around the school............................................................
Police in the school (e.g., School Resource Officer)............................
Procedures for visitors, including parents, in the school (e.g., signing in
at the office, obtaining an ID badge or visitor sticker to wear on
clothing) ..............................................................................................
Removing locker or restroom doors .....................................................
Security cameras ..................................................................................
Security personnel in the school...........................................................
Telephone or intercoms in classrooms .................................................
Security drills .......................................................................................
Crisis response team.............................................................................
Other security practices (Please specify)..............................................
______________________________________________________
______________________________________________________

4

(Column C)
SDFSCA
funding received?
Don’t
Know

Yes

No

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

1

1

2

3

B. Funding Source Information—Security Practices
3.

Schools and districts maintain information on security practices funding in various forms. In answering the preceding
questions about funding for security practices, what sources of information did you use? (Select Yes or No for each item
shown below.)
If your school did not use any of the security practices listed in this questionnaire during the 2008-09 school year, check this
box
and leave Questions 3a through 3d blank.
Yes

No

Communication with the district prevention coordinator (e.g., SDFSCA coordinator, Title
IV coordinator, federal programs coordinator, student services director, etc.)...........................

1

2

b.

Communication with program providers ....................................................................................

1

2

c.

Records or other documentation maintained by the school ........................................................

1

2

d.

Other (please specify) ________________________________________________________

1

2

a.

5

C. Prevention Programs
For questions 4, 5 and 6, please use the table below to tell us which prevention programs were implemented in part or in full in your school
during the 2008-09 school year and whether these programs received any funding from the federal SDFSCA program. We have included a
Program Glossary to consult if more information is needed about any of the programs listed in Column A.
4.

During the 2008-09 school year, what programs have been implemented in your school to prevent or reduce youth ATOD use
or school crime? (Check the box in Column B if your school used the program listed in Column A. If you do not see the name of a
program used in your school, please go to the end of the list, check the “other” box, and write in the name of the program.)

5.

For each program implemented in your school during the 2008-09 school year, please provide the first and last names of up
to two school staff members who can describe its implementation at your school. (For each program, write your response in
Column C.)

6.

For each program that has been implemented in your school during the 2008-09 school year, indicate whether the program at
your school was supported in part or in full by funds from the federal SDFSCA program. You may want to consult with your
district prevention coordinator or a school staff member who is knowledgeable about funding if you are not sure. (Select one
response in Column D for each program.)

(Column A)
Program name

(Column B)
Check if
your school
used this
program

(Column C)
Contact names

(Column D)
SDFSCA funding
received
Yes

Don’t
know

No

1) ________________________________
Across Ages

Adolescent Alcohol Prevention
Trial (AAPT)/All Stars

Adolescent Transitions Program

Aggression Replacement Training
(ART)
Aggressors, Victims &
Bystanders: Thinking & Acting to
Prevent Violence
Al’s Pals: Kids Making Healthy
Choices

1

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

6

(Column A)
Program name

(Column B)
Check if
your school
used this
program

Alcohol Misuse Prevention

1

All Children Excel

1

Alternatives to Gang Membership
(more recent version of Gang
Resistance Is Paramount)
Anger Coping Program (earlier
version of Coping Power
Program)
Athletes Training and Learning to
Avoid Steroids (ATLAS)
Bicultural Competence Skills
Approach
Bilingual/Bicultural Counseling
and Support Services
Boys and Girls Club Gang
Prevention Through Targeted
Outreach
Brainpower Program
(Attributional Intervention)
Broader Urban Involvement and
Leadership Development
Program (BUILD)
Bry’s Behavioral Monitoring and
Reinforcement
Program/Behaviorally-Based
Prevention Program/Preventive
Intervention/

(Column C)
Contact names

(Column D)
SDFSCA funding
received
Yes

1) ________________________________

Don’t
know

No

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1) ________________________________
2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________
1) ________________________________

1

2) ________________________________

7

(Column A)
Program name

Bullying Prevention
Program/Olweus Bullying
Prevention Program (also known
as The Intervention Campaign
Against Bully/Victim Problems)
CAPSLE
Caring School Community
(updated version of the Child
Development Project?)
CASASTART

Chicago Child-Parent Center and
Expansion Program (CPC)
Child Development Project
(previous version of Caring
School Community?)
Children in the Middle

Children of Divorce Intervention
Program (CODIP)
Classroom-Centered (CC) and
Family-School Partnership (FSP)
Intervention
Club Hero

Comer School Development
Program

(Column B)
Check if
your school
used this
program

(Column C)
Contact names

(Column D)
SDFSCA funding
received
Yes

Don’t
know

No

1) ________________________________
1

1

2) ________________________________

1) ________________________________

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

8

(Column A)
Program name

Communities in Schools
(Formerly Cities in Schools)
Communities Mobilizing for
Change on Alcohol
Consistency Management and
Cooperative Discipline (CMCD)

Continuous Progress Instruction
Coping Power Program (updated
version of Anger Coping
Program)
Creating Lasting Family
Connections
Drug Abuse Resistance Education
(DARE)
Earlscourt Social Skills Group
Program (earlier version of SNAP
Under 12 Outreach Project)
Early Risers "Skills for Success"
Program
East Texas Experimental
Learning Center
Families and Schools Together
(FAST)

(Column B)
Check if
your school
used this
program
1

(Column C)
Contact names

(Column D)
SDFSCA funding
received
Yes

1) ________________________________

Don’t
know

No

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

FAST Track

1

First Step to Success

1

1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________

9

(Column A)
Program name

(Column B)
Check if
your school
used this
program

Friendly PEERsuasion

1

Gang Prevention Curricula

1

Gang Resistance Education and
Training (G.R.E.A.T.)
Gang Resistance Is Paramount
(GRIP) (earlier version of
Alternatives to Gang
Membership)
Get Real About Violence

Good Behavior Game/Baltimore
Mastery Learning

1

Improving Social AwarenessSocial Problem Solving

1) ________________________________

1) ________________________________

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1) ________________________________
1

2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

I Can Problem Solve
(Interpersonal Cognitive Problem
Solving)

1

2) ________________________________

Growing Healthy

Healthy for Life

1) ________________________________

Don’t
know

No

2) ________________________________

1

HeadOn: Substance Abuse
Prevention for Grades 6–8

Yes

2) ________________________________

Great Body Shop (GBS)

Guiding Good Choices (later
version of Preparing for the Drug
Free Years)

(Column C)
Contact names

(Column D)
SDFSCA funding
received

1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

10

(Column A)
Program name

(Column B)
Check if
your school
used this
program

Incredible Years

1

Keep A Clear Mind (KACM)

1

Keepin It REAL (Refuse,
Explain, Avoid, Leave)
Kentucky Adolescent Tobacco
Prevention Project

1

1

Life Skills Training (Botvin)

1

Lions-Quest Working Toward
Peace/Working Toward Peace
(WTP)
Mass Media Smoking Prevention
Program

2

3

1) ________________________________

1

2

3

1) ________________________________

1

2

3

1) ________________________________

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________

1

Lions-Quest Skills for
Adolescence/Skills for
Adolescence (SFA)

1

2) ________________________________

Leadership and Resiliency (LRP)

Linking the Interests of Family
and Teachers (LIFT)

1) ________________________________

Don’t
know

No

2) ________________________________

1

Life Skills/Basic Living Skills
(e.g, personal grooming;
balancing a check book; setting
up a budget; setting career goals)

Yes

2) ________________________________

Know Your Body

Life Skills Training Booster
Program

(Column C)
Contact names

(Column D)
SDFSCA funding
received

1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________
1) ________________________________

1

2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

11

(Column A)
Program name

Metropolitan Area Child Study
Michigan Model for
Comprehensive School Health
Education
Midwestern Prevention (Project
STAR)
Minnesota Smoking Prevention
Program (MSPP)
Native American Prevention
Project Against AIDS and
Substance Abuse (NAPPASA)

(Column B)
Check if
your school
used this
program
1

Yes

1) ________________________________

Don’t
know

No

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

North Karelia

1

Peace Works

1

PeaceBuilders

1

Peaceful Conflict Resolution and
Violence Prevention Curriculum

(Column C)
Contact names

(Column D)
SDFSCA funding
received

1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

Peacemakers Program

1

Peer Coping Skills Training

1

Peers Making Peace

1

1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________

12

(Column A)
Program name

Positive Action

Positive Adolescent Choices
Training (PACT)
Positive Youth Development
Program
Preparing for the Drug Free Years
(earlier version of Guiding Good
Choices)
Preventing School Vandalism and
Disruptive Behavior
Preventive Alcohol Education
Program
Preventive Treatment Program
(Montreal Longitudinal
Experimental Study)
Proactive Classroom
Management
Project ACHIEVE/The Stop &
Think Social Skills Program

(Column B)
Check if
your school
used this
program
1

(Column C)
Contact names

(Column D)
SDFSCA funding
received
Yes

1) ________________________________

Don’t
know

No

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

Project ALERT

1

Project ALERT Plus

1

Project Back-on-Track

1

1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________

13

(Column A)
Program name

Project Northland

Project PACE (Participation And
Cooperation in Education)
Project PATHE (Positive Action
Through Holistic Education)
Project RAISE (Raising Ambition
Instills Self-Esteem)

Project SUCCESS

Promoting Alternative Thinking
Strategies (PATHS)

(Column B)
Check if
your school
used this
program
1

1

1

1

2

3

1) ________________________________

1

2

3

1) ________________________________

1

2

3

1) ________________________________

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

Rural Education Achievement
Project (REAP) (includes All
Stars, Jr., Camp GUTS and Duke
Family Coping Power)

1

2) ________________________________

Reconnecting Youth Program

Responsive Classroom

1) ________________________________

Don’t
know

No

2) ________________________________

1

Responding in Peaceful and
Positive Ways (RIPP)/Richmond
Youth Against Violence Project

Yes

2) ________________________________

Protecting You/Protecting Me

Resolving Conflicts Creatively
Program

(Column C)
Contact names

(Column D)
SDFSCA funding
received

1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________
1) ________________________________

1

2) ________________________________

14

(Column A)
Program name

(Column B)
Check if
your school
used this
program

Safe Dates

1

Say It Straight (SIS)

1

SCARE Program (StudentCreated Aggression Replacement
Education)
School Crime Prevention through
Environmental Design

School Safety Program

School Violence Prevention
Demonstration Program
School-based Smoking
Prevention Program
Schools and Families Educating
Children (SAFE Children)
Seattle Social Development
Project/Skills, Opportunities, and
Recognition (SOAR)
Second Step: A Violence
Prevention Curriculum

Sembrando Salud
SHOUT (Students Helping Others
Understand Tobacco)/Project
SHOUT

(Column C)
Contact names

(Column D)
SDFSCA funding
received
Yes

1) ________________________________

Don’t
know

No

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1) ________________________________
2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

15

(Column A)
Program name

SMART Leaders
SMART Moves (i.e., Stay
SMART + SMART Leaders +
Family Advocacy Network Club)
SMART Team / Students
Managing Anger and Resolution
Together
SNAP™ Under 12 Outreach
Project (ORP) (more recent
version of Earlscourt Social Skills
Group Program)
Social Competence Promotion
Program for Young Adolescents
(SCPPYA)
Social Relations Program

Socio-moral Reasoning
Development Program

Spit Tobacco Intervention

STARS (Start Taking Alcohol
Risks Seriously) for Families
Steps to Respect®: A Bullying
Prevention Program
Strengthening Families Program
(SFP)

(Column B)
Check if
your school
used this
program
1

(Column C)
Contact names

(Column D)
SDFSCA funding
received
Yes

1) ________________________________

Don’t
know

No

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________
1) ________________________________

1

2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

16

(Column A)
Program name

Strengthening Families Program:
For Parents and Youth 10–14
(Formerly Iowa SFP)
Strengthening Hawaii Families
Student Training Through Urban
Strategies (STATUS)/Project
STATUS
Success for All

Success in Stages: Build Respect,
Stop Bullying
Teams-Games-Tournaments
(TGT) Alcohol Prevention
Teenage Health Teaching
Modules (THTM)
The Teaching Students to Be
Peacemakers (TSP)

(Column B)
Check if
your school
used this
program
1

(Column C)
Contact names

(Column D)
SDFSCA funding
received
Yes

1) ________________________________

Don’t
know

No

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

Think First

1

Think Time Strategy

1

Too Good For Drugs (TGFD)

1

Too Good for Violence (TGFV)

1

1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________
1) ________________________________
2) ________________________________

17

(Column A)
Program name

Towards No Drug Abuse
(TND)/Project Towards No Drug
Abuse (TND)
Towards No Tobacco Use
(TNT)/Project Towards No
Tobacco Use (TNT)
Urban Women Against Substance
Abuse
Violence Prevention Curriculum
for Adolescents (VPC) (part of
the Teenage Health Teaching
Modules)
Washington (DC) Community
Violence Prevention Program
Woodrock Youth Development
Project

(Column B)
Check if
your school
used this
program
1

Yes

1) ________________________________

Don’t
know

No

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

2) ________________________________
1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________
1) ________________________________

1

2) ________________________________

1

1) ________________________________
2) ________________________________

1

1) ________________________________
2) ________________________________

Other program to prevent or
reduce youth ATOD use or school
crime (please specify)
____________________________

1

Other program to prevent or
reduce youth ATOD use or school
crime (please specify)
____________________________

1

Other program to prevent or
reduce youth ATOD use or school
crime (please specify)
____________________________

(Column C)
Contact names

(Column D)
SDFSCA funding
received

1) ________________________________
2) ________________________________

1) ________________________________
2) ________________________________

1) ________________________________
1

2) ________________________________

18

D. Funding Source Information—Prevention Programs
7.

Schools and districts maintain information on prevention program funding in various forms. In answering the preceding
questions about funding for prevention programs, what sources of information did you use? (Select Yes or No for each item
shown below.)
If your school did not use any of the prevention programs listed in this questionnaire during the 2008-09 school year and you
did not write in any other program(s), check this box
and leave Questions 7a through 7d blank.
Yes

No

Communication with the district prevention coordinator (e.g., SDFSCA coordinator, Title
IV coordinator, federal programs coordinator, student services director, etc.)...........................

1

2

b.

Communication with program providers ....................................................................................

1

2

c.

Records or other documentation maintained by the school ........................................................

1

2

d.

Other (please specify) ________________________________________________________

1

2

a.

E. Background Information
8.

During the 2008-09 school year, what was your primary role in this school? (Select one response.)
Principal or other school administrator .............................................

1

School-based planning team member ...............................................

2

Teacher .............................................................................................

3

School social worker/psychologist/counselor ...................................

4

Other professional staff member.......................................................

5

Paraprofessional................................................................................

6

Security staff member .......................................................................

7

Other (Please specify): __________________________________

8

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Thank you for completing the survey. Please keep a copy for your records. We encourage you
to submit your data on the web at www.sdfs-evaluation.org. Otherwise, you can return the
completed questionnaire to:
Attn: Debbie Alexander (#8622.09.01)
Westat
1650 Research Boulevard, TA 2100
Rockville, Maryland 20850
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