Provider Questionnaire

Study of the Implemenation of the Safe and Drug-Free Schools and Communities Act (SDFSCA) State Grants

Att_Appendix A (3 of 4) - Provider Qx for 2nd OMB (01-23-09)

Provider Questionnaire

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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

Provider Questionnaire
This questionnaire is designed to be completed by the person who implements (or implemented)
the program identified on the label affixed to the cover of the questionnaire during the 2008-09
school year. If this person is not available to complete the questionnaire, the person most
knowledgeable about the implementation of the program should complete the questionnaire.
You can complete this survey online at https://www.sdfs-evaluation.org. You will need the ID
and password for your program, 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
Many items on this questionnaire have been modified and reproduced by special permission of the Publisher, Gottfredson
Associates, Inc. Further reproduction is prohibited without the Publisher’s written consent. 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, Rockville, MD 20850-3129.

1

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 focuses on the youth alcohol, tobacco, and other drug (ATOD) use and school
crime prevention curriculum, instruction, or training provided to students 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.
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.
As you answer the questions, please think about the program named on the label affixed to the
cover of the questionnaire that was related to these topics.

For this questionnaire, please consider aspects of the program that aimed to teach students
factual information, increase their awareness of social influences to engage in school crime,
expand their repertoires for recognizing and appropriately responding to risky or potentially
harmful situations, improve their moral character, etc.

These programs are sometimes delivered in a classroom format using teacher lectures,
demonstrations, and class discussion but may also be delivered in small group settings or
individually. Use may be made of audiovisual materials, worksheets or workbooks, textbooks,
handouts, and the like. Instruction may be brief (less than an hour) or extended (requiring
several years to complete).

2

Please consider the way the program named on the questionnaire label was actually
implemented, rather than on procedures that might be outlined in the program documentation. If
more than one version of this program was implemented in your school, please report ONLY on
the version that served the largest number of students the last time the program was
implemented. (For example, if your school implemented both the middle school version of
Program A as well as the high school version of Program A in Fall 2008 and more students were
served by the high school version of the program, all question responses should reflect the
implementation of the high school version of Program A.)

Frequently Asked Questions
Who should complete this questionnaire? This questionnaire is designed to be completed by
the person who implements (or implemented) the program identified on the label affixed to the
cover of the questionnaire during the 2008-09 school year. If this person is not available to
complete the questionnaire, the person most knowledgeable about the implementation of the
program should complete the questionnaire. Please feel free to involve other school staff if they
would also be knowledgeable about the program’s implementation, for example, if you are new
to the program this year and have limited knowledge regarding the program operations during
2008–09 school year.

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.

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].

3

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.

4

A. Program Objectives and Selection Criteria
THESE QUESTIONS ASK ABOUT THE FACTORS RELATED TO THE ORIGINAL SELECTION OF THE PROGRAM AND THE
OBJECTIVES OF THIS PROGRAM AS IMPLEMENTED DURING 2008-09 SCHOOL YEAR.

1.

How important was each of the following sources of information in the original selection of this
program for implementation at the school? (SELECT ONE RESPONSE FOR EACH ITEM.)
Very

Somewhat

A little

Not at all

important

important

important

important

a.

People with jobs similar to mine..............................

1

2

3

4

b.

Professional conferences or meetings inside my
school district...........................................................

1

2

3

4

2
2
2

3
3
3

4
4
4

c.

Professional conferences or meetings outside my
school district...........................................................

d.

Marketing brochures, videos, or other information .

e.

Results from an evaluation of the program..............

1
1
1

f.

Publications summarizing research on what works
to prevent problem behavior or to increase school
safety .......................................................................

1

2

3

4

Formal needs assessment (e.g. collection or
compilation of data to identify areas for
improvement) done specifically for the school........

1

2

3

4

Consultation with outside professionals (e.g. law
enforcement, ATOD education or treatment
specialist).................................................................

1

2

3

4

g.

h.

5

2.

How much did the following factors contribute to the original selection of this program for
implementation at the school? (SELECT ONE RESPONSE FOR EACH ITEM.)
Did not
Contributed

Contributed

contribute

very much

somewhat

at all



2



3

1
1
1
1
1
1
1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2
2
2
2
2
2
2

3
3
3
3
3
3
3
3
3
3
3
3
3
3

a. Cultural appropriateness.............................................................
b. Relevance to district objectives for youth ATOD use and
school crime prevention programs .............................................
c. Amount of total classroom time required ...................................
d. Fit with regular school operations .............................................
e. Feasibility of implementing program .........................................
f. Capacity of schools to implement programs effectively.............
g. Program cost...............................................................................
h. School staff interest in the program............................................
i. Research on program effectiveness ............................................
j. Amount of staff training required...............................................
k. Student interest in the program...................................................
l. District data on student needs.....................................................
m. School data on student needs......................................................
n. Other data on student needs (specify) _____________________
o. Other factors (specify)_________________________________

3.

1

How much responsibility did each of the following persons or groups have in originally getting this
program started at the school? (SELECT ONE RESPONSE FOR EACH ITEM.)

a.

Principal or other school administrators ..................

b.

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

c.

Teachers...................................................................

d.

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

e.

Other professional staff at the school.......................

f.

Paraprofessionals at the school ................................

g.

Security personnel ...................................................

h.

Other school staff ....................................................

i.

Parents .....................................................................

j.

School district staff ..................................................

k.

Other (Please specify): ______________________

6

Very much

Some

A little

No

responsibility

responsibility

responsibility

responsibility

1
1
1
1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2
2
2
2

3
3
3
3
3
3
3
3
3
3
3

4
4
4
4
4
4
4
4
4
4
4

4.

When the program was last implemented during the 2008-09 school year, was it intended to…(SELECT
YES OR NO FOR EACH ITEM.)

a.

Prevent or reduce student ATOD use ........................................

b.

Reduce school crime committed by students.............................

Yes

No


1

2
2

1

B. Program Implementation


5.

REMINDER: IF, DURING THE LAST TIME THE PROGRAM WAS IMPLEMENTED IN THE 2008-09 SCHOOL
YEAR, MORE THAN ONE VERSION OF THE PROGRAM WAS USED, PLEASE REPORT ONLY ON THE VERSION
THAT SERVED THE LARGEST NUMBER OF STUDENTS.
When the program was last implemented during the 2008-09 school year, was it a part of the regular
required curriculum at the school? (SELECT ONE RESPONSE.)
Yes ....................................................................................................
No......................................................................................................

6.

When the program was last implemented during the 2008-09 school year, how much time elapsed
between the first lesson and the last lesson? (SELECT ONE RESPONSE.)
An entire school year ........................................................................
7 to 8 months ....................................................................................
4 to 6 months ....................................................................................
1 to 3 months ....................................................................................
1 to 3 weeks ......................................................................................
1 to 6 days.........................................................................................
Less than 1 day .................................................................................

7.

1
2

1
2
3
4
5
6
7

When the program was last implemented during the 2008-09 school year, when did it occur? (SELECT
YES OR NO FOR EACH ITEM.)

a.

Before school begins..................................................................

b.

During the school day................................................................

c.

Immediately after school (2:00 – 6:00 p.m.) .............................

d.

In the early evening (6:00 –9:00 p.m.) ......................................

e.

Late in the evening (after 9:00 p.m.) .........................................

f.

On weekends..............................................................................

7

Yes

No


1
1
1
1
1

2
2
2
2
2
2

1

8.

When the program was last implemented during the 2008-09 school year, how often did most of the
students taking part in the program actually participate? (SELECT ONE RESPONSE.)
More than once a day........................................................................
Once a day ........................................................................................
2 to 6 times a week ...........................................................................
Once a week......................................................................................
2 or 3 times a month .........................................................................
Once a month....................................................................................
Less than once a month.....................................................................
Once or twice during a school year...................................................

9.

1
2
3
4
5
6
7
8

When the program was last implemented during the 2008-09 school year, how many lessons did most of
the students taking part in the program actually complete? (RECORD NUMBER.)

_______ Lessons

10.

When the program was last implemented during the 2008-09 school year, how many students typically
participated in each session of this program? (RECORD NUMBER.)

_______ Students

11.

When the program was last implemented during the 2008-09 school year, where was it held most of the
time? (SELECT ONE RESPONSE.)
Classroom .........................................................................................
Library or media center.....................................................................
Auditorium........................................................................................
School office.....................................................................................
Cafeteria............................................................................................
Outdoors on school grounds .............................................................
Other (Please specify) ___________________________________

8

1
2
3
4
5
6
7

12.

When the program was last implemented during the 2008-09 school year, which of the following topics
were actually taught by instructors for this program? (SELECT ONE RESPONSE FOR EACH ITEM.)
Not a

a.
b.
c.

General health or safety promotion.......................................................
Cultural or historical topics (e.g., race, class,
society)..................................................................................................
Alcohol, tobacco, or other drug information (e.g., facts vs. myths,
effects and consequences) ....................................................................

Not

program

Taught

taught

component



2



3

1

2

3

2
2

3
3

1

d.

Sex education........................................................................................

1
1

e.

Violence prevention (including victimization avoidance,
coping with victimization or loss experiences).....................................

1

2

3

1
1

2
2

3
3

1
1
1

2
2
2

3
3
3

Emotional control (e.g., anger management, stress control).................

1
1

2
2

3
3

m. Emotional perspective taking (e.g., anticipating the perspectives or
reactions of others, empathy training) ..................................................

1

2

3

Social influence (e.g., recognizing and resisting social
influences to engage in problem behavior, recognizing and resisting
risky situations, refusal or resistance skills
training, assertiveness training) ............................................................

1

2

3

Social problem-solving skills (e.g., identifying problem situations,
generating alternative solutions, evaluating
consequences, decision-making, applying good judgment)..................

1

2

3

Self-management (e.g., personal goal-setting, self-improvement, selfmonitoring, self-reinforcement, self-punishment) ................................

1

2

3

Attribution (e.g., attributing the cause of events or
circumstances to one’s own behavioras in teaching
students that poor grades are due to insufficient effort
on the part of the student rather than the task being too
difficult)................................................................................................

1

2

3

1
1

2
2

3
3

f.

Ethics, moral, or character education (e.g., personal
responsibility, male responsibility).......................................................

g.

Etiquette or manners education.............................................................

h.

Job skills, career education, work experience, career
exploration or development ..................................................................

i.

Academic study skills or test-taking .....................................................

j.

Self-confidence, self-esteem, or self-image..........................................

k.

Emotional inventory (e.g., recognizing and understanding feelings,
recognizing physical cues such as sweaty hands) .................................

l.

n.

o.

p.
q.

r.

s.

Communication skills (e.g., interpreting and processing
social cues, understanding nonverbal communication,
negotiating)...........................................................................................
Other topics (Please specify): _______________________________

9

13.

When the program was last implemented during the 2008-09 school year, did instructors use the
following instructional strategies in this program? (SELECT YES OR NO FOR EACH ITEM.)

a.

Cooperative learning (e.g., small group discussion and
activities) ...................................................................................

Yes

No

2
2
2
2
2

b.

Class discussions .......................................................................

c.

Story telling ...............................................................................

d.

Videos, films, or other audiovisual aids.....................................

e.

Use of props (e.g., puppets, dolls) .............................................

1
1
1
1
1

f.

Establishment and enforcement of ground rules (e.g.,
confidentiality, respect for different opinions) ..........................

1

2
2
2
2
2
2

g.

Behavioral modeling (e.g., use of peer models to demonstrate a
new skill) ...................................................................................

h.

Role-playing .............................................................................

i.

Skits, games, or other interactive exercises ...............................

j.

Rehearsal and practice of new skill ...........................................

k.

Applying program strategies to other settings or situations.......

1
1
1
1
1

l.

Use of cues to remind individual to display a behavior (e.g.,
posters) ......................................................................................

1

2

1
1
1

2
2
2

1
1
1
1
1
1

2
2
2
2
2
2

m. Coaching (e.g., directing or guiding students on the use of
skills, providing support as skills are practiced)........................
n.

Active or reflective listening......................................................

o.

Goal setting................................................................................

p.

Behavioral management/behavioral modification techniques
(e.g., gold stars, points, tokens, strikes, verbal praise, daily
report cards, validation).............................................................

q.

Peer teachers/leaders..................................................................

r.

Co-teaching/co-leadership .........................................................

s.

Parent involvement ....................................................................

t.

Homework .................................................................................

u.

Other (Please specify): _______________________________

10

14.

When the program was last implemented during the 2008-09 school year, how often did instructors of
the program … (SELECT ONE RESPONSE FOR EACH ITEM.)
Always or

15.

16.

a.

Drop topics from the curriculum................................................

b.

Add topics to the curriculum .....................................................

c.

Modify the curriculum topics (e.g., to make them more
culturally relevant, age-appropriate)..........................................

d.

Offer fewer sessions than the curriculum called for ..................

e.

Offer more sessions than the curriculum called for ...................

f.

Revise the order in which lessons were presented .....................

g.

Shorten the duration of the program ..........................................

h.

Lengthen the duration of the program .......................................

i.

Vary how often sessions are held (e.g., teach the program once
rather than twice a week)...........................................................

often

Sometimes

Seldom

Never

1


1

2


2

3


3

4
4

1
1
1
1
1
1

2
2
2
2
2
2

3
3
3
3
3
3

4
4
4
4
4
4

2
2

3
3

4
4

2

3

4

j.

Modify the instructional strategy called for in the curriculum...

1
1

k.

Target different populations than specified by the curriculum
implementation materials (e.g., intended for 6th graders, but
implemented with 8th graders). ..................................................

1

When the program was last implemented during the 2008-09 school year, were adaptations made to the
program for any of the following reasons? (SELECT YES OR NO FOR EACH ITEM BELOW.)

a.

Scheduling/time constraints? .....................................................

b.

Cultural or language needs?.......................................................

c.

School/district policies regarding content? ................................

d.

Cost/limited financial resources?...............................................

e.

Staff or instructor preferences?..................................................

f.

Other (Please specify)________________________________

Yes

No


1
1
1
1
1

2
2
2
2
2
2

1

When the program was last implemented during the 2008-09 school year, was the program developer
consulted before making changes to how the program was used? (SELECT YES OR NO FOR EACH ITEM.)

a.

Someone from the district consulted the developer ...................

b.

Someone from the school consulted the developer....................

11

Yes

No

1
1

2
2

Don’t know

3
3

If no one consulted the program developer about the changes, check this box , and go to Question 18.
17.

When the program was last implemented during the 2008-09 school year, to what extent did the
developer approve changes to how the program was implemented?
If you do not know the extent to which the developer approved changes, check this box , and go to
Question 18.
The developer….(SELECT ONE RESPONSE)
Approved all changes .......................................................................
Approved most changes....................................................................
Approved some changes ...................................................................
Did not approve any changes............................................................

18.

1
2
3
4

Which of the following describe the application of rewards for student learning when this program was
used? (SELECT YES OR NO FOR EACH ITEM.)
If no rewards were applied for student learning, check this box , and go to Question 20.

a.

19.

Groups were rewarded for the achievement of individual
group members ..........................................................................

b.

Groups were rewarded for group accomplishments...................

c.

Individuals were rewarded for their own achievements ............

Yes

No

1
1
1

2
2
2

When the program was last implemented in the 2008-09 school year, how often were the following
strategies used to recognize or reward students? (SELECT ONE RESPONSE FOR EACH ITEM.)
Very

a.

b.
c.
d.
e.

Students were recognized for the level of their performance so
that students with superior performance received rewards and
students with poor performance received few rewards................
Students were recognized for the effort they expended ..............
Students were recognized for their improvement over prior
levels............................................................................................
Students were recognized for successful competition against
students with similar levels of past performance .........................
Teachers avoided calling attention to the level of individual
student performance.....................................................................

12

often

Sometimes

Seldom

Never

1
1

2
2

3
3

4
4

1

2

3

4

1

2

3

4

1

2

3

4

20.

When the program was last implemented during the 2008-09 school year, how often did instructors…
(SELECT ONE RESPONSE FOR EACH ITEM.)
Very

a.
b.

Formally or informally assess student mastery of the lessons .....
Re-teach material that had not been mastered .............................

often

Sometimes

Seldom

Never


1


2


3

4
4

1

2

3

C. Program Evaluation


21.

REMINDER: IF, DURING THE LAST TIME THE PROGRAM WAS IMPLEMENTED IN THE 2008-2009 SCHOOL
YEAR, MORE THAN ONE VERSION OF THE PROGRAM WAS USED, PLEASE REPORT ONLY ON THE VERSION
THAT SERVED THE LARGEST NUMBER OF STUDENTS.
When the program was last implemented during the 2008-09 school year, (SELECT
EACH ITEM.)

a.
b.
c.
d.

22.

Yes

No

were instructors held accountable for ensuring that it was
provided at the school? ..............................................................

1

2

were the instructors required to keep records documenting the
delivery of specific lessons or content for this program? ..........

1

2

did a supervisor directly observe this program as it was
delivered? ..................................................................................

1

2

did the instructors’ personnel appraisals depend on the quality
of instruction or delivery of this program? ................................

1

2

ONE RESPONSE FOR

When the program was last implemented during the 2008-09 school year, how closely did the
instructors follow the plan and procedures documented in the manual? (SELECT ONE RESPONSE.)
If no manual was available for this program, check this box , and go to Question 24.
Very closely......................................................................................
Fairly closely ....................................................................................
Somewhat .........................................................................................
Not too closely..................................................................................

13

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2
3
4

23.

When the program was last implemented during the 2008-09 school year, to what extent was each of
the following factors an asset or barrier? (SELECT ONE RESPONSE FOR EACH ITEM.)
Neither an

a.
b.

24.

Fit between program and other school programs
and goals..................................................................
Cohesiveness and collaboration among all key
stakeholders .............................................................

c.

Support of parents....................................................

d.

Clarity of program goals and procedures.................

e.

Clear lines of authority ............................................

f.

Open lines of communication among district
administrators, school administrators, and
instructors ................................................................

g.

Structural stability (e.g., low staff turnover) ...........

h.

Program “champion” to garner widespread support
for programs and guide day-today operations..........................................................

Significant

Somewhat

asset nor

Somewhat

Significant

asset

of an asset

barrier

of a barrier

barrier

1

2

3

4

5

1
1
1
1

2
2
2
2

3
3
3
3

4
4
4
4

5
5
5
5

1
1

2
2

3
3

4
4

5
5

2
2

3
3

4
4

5
5

2

3

4

5

i.

Timely problem solving...........................................

1
1

j.

Persuading staff to embrace the values and ideals
of prevention programming .....................................

1

When the program was last implemented during the 2008-09 school year, which of the following best
describes the principal’s response to its provision at the school? (SELECT ONE RESPONSE.)
The principal worked hard to make sure this program ran smoothly
The principal generally supported this program ...............................
The principal neither helped nor hindered this program ..................
The principal generally did not support this program ......................
The principal often created problems for this program ....................

14

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2
3
4
5

D. Program Participant Characteristics
THE NEXT QUESTIONS ASK ABOUT THE EXPERIENCES AND CHARACTERISTICS OF THE STUDENTS WHO
PARTICIPATED IN THIS PROGRAM THE LAST TIME IT WAS IMPLEMENTED DURING THE 2008-09 SCHOOL YEAR.
PLEASE INCLUDE ALL STUDENTS WHO RECEIVED ANY OF THE PROGRAM CONTENT, REGARDLESS OF THEIR LEVEL
OF ATTENDANCE OR ENGAGEMENT IN THE LESSONS.



25.

REMINDER: IF, DURING THE LAST TIME THE PROGRAM WAS IMPLEMENTED IN THE 2008-2009 SCHOOL
YEAR, MORE THAN ONE VERSION OF THE PROGRAM WAS USED, PLEASE REPORT ONLY ON THE VERSION
THAT SERVED THE LARGEST NUMBER OF STUDENTS.

When the program was last implemented during the 2008-09 school year, what grade levels
participated? (SELECT YES OR NO FOR EACH ITEM.)

a.

Pre-kindergarten .......................................................................

b.

Kindergarten .............................................................................

c.

Grade 1 ......................................................................................

d.

Grade 2 ......................................................................................

e.

Grade 3 ......................................................................................

f.

Grade 4 ......................................................................................

g.

Grade 5 ......................................................................................

h.

Grade 6 ......................................................................................

i.

Grade 7 ......................................................................................

j.

Grade 8 ......................................................................................

k.

Grade 9 ......................................................................................

l.

Grade 10 ....................................................................................

m. Grade 11 ....................................................................................
n.
26.

Grade 12 ....................................................................................

Yes

No

1
1
1
1
1
1
1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2
2
2
2
2
2
2

When the program was last implemented in the 2008-09 school year, which of the following best
describes the students who participated? (SELECT ONE RESPONSE.)
All students in a participating grade or grades ..................................

1

Only students who are members of a population deemed at
heightened risk for ATOD use or school crime
(e.g., those living in a high crime neighborhood) .............................

2

Only individual students who already show evidence of having
problems with ATOD use or school crime
(e.g., experimented with drugs, suspended or arrested for violent
behavior) ...........................................................................................

3

15

27.

When the program was last implemented during the 2008-09 school year, how many different students
at the school participated? (RECORD NUMBER.)
___________ Different students

E. Program Instructor Characteristics

28.

When the program was last implemented during the 2008-09 school year, how many instructors
conducted this program? (RECORD NUMBER.)
___________ Instructors

29.

Think of the typical instructor who conducted this program at the school during the last time it was
implemented in the 2008-09 school year. How large a part of that instructors's job was his or her work
related to this program? (SELECT ONE RESPONSE.)

This was a major part of this instructor’s duties at the school ..........

1
2

This was a minor but expected part of this instructor’s duties at the
school................................................................................................

3

This instruction or training took place when other school duties
allowed..............................................................................................

4

This was the primary role of the instructor at the school ..................

30.

When the program was last implemented during the 2008-09 school year, did most of the program
instructors work full time or part time at the school? (SELECT ONE RESPONSE.)
Full time............................................................................................
Part time............................................................................................
They did not work at the school........................................................

31.

1
2
3

When the program was last implemented during the 2008-09 school year, did most of the instructors
who conducted this program do so as part of their normal paid job duties, were they paid specifically to
conduct this program, or were they unpaid volunteers? (SELECT ONE RESPONSE.)
Part of their normal paid job duties...................................................
Paid specifically to conduct this program .........................................
Unpaid volunteers .............................................................................

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2
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F. Program Training and Technical Support
THE NEXT FEW QUESTIONS ASK ABOUT TRAINING FOR INSTRUCTORS WHO CONDUCTED THIS PROGRAM THE FIRST
TIME IT WAS EVER CONDUCTED AT THE SCHOOL – REGARDLESS OF WHEN THAT MIGHT HAVE BEEN.

32.

How much training on this program was completed by most instructors the first time it was conducted
at the school? (SELECT ONE RESPONSE.)
If there was no initial training, check this box  and go to the instructions preceding Q35.
4 days or more ..................................................................................
2 – 3 days..........................................................................................
1 full day...........................................................................................
A half day .........................................................................................
Short demonstration or orientation only ...........................................
Don’t know .......................................................................................

33.

1
2
3
4
5
6

Who conducted the initial training for this program? (SELECT ONE RESPONSE.)
Staff from this school........................................................................
Staff from another school in this district...........................................
School district staff ...........................................................................
Trainer(s) from the program developer/publisher .............................
Other (Please specify) ___________________________________
Don’t know .......................................................................................

17

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2
3
4
5
6

34.

Which of the following describes the initial training for this program? (SELECT YES OR NO FOR EACH ITEM.)
If you did not attend the initial training, check this box  and go to the instructions preceding Q35.
Yes

No

2
2
2
2

a.

The presentation was clear and organized .................................

b.

Principles to be followed were presented ..................................

c.

Principles were illustrated with examples..................................

d.

Participants practiced applying the principles ...........................

1
1
1
1

e.

Participants received feedback on their performance in
applying the principles...............................................................

1

2

Participants’ questions and concerns about possible obstacles in
applying the principles were addressed .....................................

1

2

Trainers provided assistance to participants in solving problems
or implementing new practices following the training ..............

1

2

As part of training, participants made specific plans (or set
goals or standards) for the program ..........................................

1

2

Participants were asked to make public commitments to use
specific new methods as part of the training..............................

1

2

Participants were provided with manuals, notebooks,
workbooks, or recording forms to take back to the school or
classroom to assist in putting the program in place ...................

1

2

f.
g.
h.
i.
j.

INSTRUCTIONS: QUESTIONS 35-38 ASK ABOUT VARIOUS TYPES OF SUPPORT THAT MIGHT HAVE BEEN PROVIDED TO
PROGRAM INSTRUCTORS BY STAFF FROM THIS SCHOOL, THE DISTRICT, OR OTHER EXTERNAL SOURCES DURING THE
2008-09 SCHOOL YEAR. THESE TYPES OF SUPPORT INCLUDE FOLLOW-UP TRAINING, COACHING OR MENTORING, AND
PROGRAM GUIDANCE. AS YOU ANSWER THESE QUESTIONS, PLEASE USE THE STUDY DEFINITIONS PROVIDED.

35.

FOLLOW-UP TRAINING is typically delivered to a group of instructors and follows a curriculum,
lesson plan, or agenda. Occurring after an initial training, it can address instructors’ deficits or
refresh instructors’ memory of the program curriculum.
During the 2008-09 school year, how many times was formal follow-up training completed by most
instructors providing this program? (SELECT ONE RESPONSE.)
None .................................................................................................
Once..................................................................................................
Twice ................................................................................................
Three or more times..........................................................................

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36.

COACHING OR MENTORING is assistance provided to individual instructors in ways that will
improve their performance on implementing a program, for the purposes of improving instruction and
increasing effectiveness. It can include reviewing performance related to program delivery, tutoring on
aspects of instruction that need improvement, and offering feedback on the instructor’s strengths and
weaknesses.
During the 2008-09 school year, was ongoing coaching or mentoring available for instructors
conducting this program from the following sources? (SELECT YES OR NO FOR EACH ITEM.)

37.

a.

Staff from this school.................................................................

b.

Staff from another school in this district....................................

c.

School district staff ....................................................................

d.

Trainer(s) from the program developer/publisher......................

e.

Other source (Please specify) __________________________

Yes

No


1
1
1
1

2
2
2
2
2

1

PROGRAM GUIDANCE is operational or management assistance given to a school, for the purposes of
improving program operations and increasing effectiveness. It can include program planning and
implementation, and other aids to management.
During the 2008-09 school year, was program guidance on conducting this program available to the
school from the following external sources? (SELECT YES OR NO FOR EACH ITEM.)

38.

a.

Staff from another school in this district....................................

b.

School district staff ....................................................................

c.

Trainer(s) from the program developer/publisher......................

d.

Other external source (Please specify) ___________________

Yes

No


1
1
1

2
2
2
2

1

During the 2008-09 school year, how many times did the school receive program guidance on
conducting this program from an external source? (RECORD NUMBER.)
___________ Times

19

G. Background Information
39.

During the 2008-09 school year, what was your primary role in this school? (SELECT ONE RESPONSE.)
Principal or other school administrator.............................................
School-based planning team member ...............................................
Teacher .............................................................................................
School social worker/psychologist/counselor...................................
Other professional staff member.......................................................
Paraprofessional................................................................................
Security staff member.......................................................................
Other (Please specify):___________________________________

40.

During the 2008-09 school year, what was your role in relation to the program? (SELECT YES OR NO FOR
EACH ITEM.)

a.

Principal of the school ...............................................................

b.

Coordinator or organizer of this program .................................

c.

A person involved in this program , but not the coordinator or
organizer ....................................................................................

d.

41.

Other (Please specify): _______________________________

Yes

No

1


1

2
2

1
1

2
2

During the 2008-09 school year, how often did you work on a planning committee with other teachers,
administrators, or other staff members from the school? (SELECT ONE RESPONSE.)
Several times a month.......................................................................
About once a month..........................................................................
Less than once a month.....................................................................

42.

1
2
3
4
5
6
7
8

1
2
3

During the past 24 months, did you receive in-service training in… (SELECT YES OR NO FOR EACH ITEM.)

a.

Classroom management or instruction methods ........................

b.

Preventing student ATOD use or school crime .........................

20

Yes

No


1

2
2

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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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File Modified2009-01-23
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