OMB No. 0990-0299
Exp. Date XX/XX/XXXX
Adolescent Family Life Prevention Demonstration Project
End of Year Report
Grant Number (Example APH PA 2000): |
Applicant Organization: |
Title of Project: |
Project Period: (Example September 1, 2008- August 31, 2009): |
Project Year (1-5): |
Program Director*: Title: Street Address: Line 1: Line 2: City: State (2 Characters): 9-Digit ZIP: E-mail: Telephone: Fax:
Program Coordinator: (if different from Program Director): Title: E-mail: Telephone: Fax: |
* A Resume or Curriculum Vitae must be mailed to OPHS Grants Management and to your OAPP project officer if this is a new project director.
Project Evaluator: Title: University/Organizational Affiliation:
Street Address: Line 1: Line 2: City: State (2 Characters): 9-Digit ZIP: E-mail: Telephone: Fax: |
* A Resume or Curriculum Vitae must be mailed to your OAPP project officer if this is a new project evaluator.
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 for this information collection is 0990-0299, expiration date XXXX. The time required to complete this information collection is estimated to average 65 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services OS/OCIO/PRA; 200 Independence Ave., S.W., Suite 531-H; Washington D.C. 20201. Attention: PRA Reports Clearance Officer.
Adolescent Family Life Prevention Demonstration Project
End of Year Report
Please note: For more information regarding specific details of the Title XX legislation (i.e. prevention services, parental consent, etc. please refer to http://www.hhs.gov/opa/about/legislation/index.html.)
Executive Summary (Abstract)
II. Detailed description of the demonstration model for the previous year.
A. Description of program/intervention for the prevention demonstration project including:
Grantee organization (school, state agency, voluntary agency, etc.)
Geographic area served (urban, rural, suburban)
Setting(s) (i.e., in school, after school, summer)
Curricula and other educational materials used
Theoretical review – Brief review of the rationale for use of the project intervention based upon theory, previous practice, review of the literature and/or evaluation findings.
Describe the demonstration model being implemented (brief description of the demonstration model should include intervention and comparison group breakdown and the services each receives). Include the target numbers for the project and the comparison group.
Specific intervention strategies and activities (i.e., how services are provided to pre-adolescents, adolescents, and their families to delay the onset of adolescent sexual activity, how services enable adolescents to acquire good life skills). This needs to include sufficient detail so that someone not familiar with the program will have reasonable understanding of what is being implemented. This section should include a description of the overall activities designed and the specific activities and intervention for the actual program year being reported on. Include actual numbers of clients served.
Intensity of intervention(s): duration and frequency (e.g. one hour, once a week, for 12 weeks). Include target dosage for clients.
Description of how the grantee provides, directly or by referral, any one or more prevention services (see list in sec. 2002(a)(8)) in addition to educational services relating to family life and adolescent premarital sexual relations. Describe how these additional prevention services support or promote the educational component.
Description of how the project implements interventions consistent with AFL policies and the Title XX statute.
Description of how the project involves parents, guardians, and other family members in the program activities. Description of the process for obtaining parental consent (sec. 2006(a)(21)(A) and (13)).
Description of how the grantee incorporates the youth development (developmental assets) model into the project. Discuss specific assets being addressed in the project and program activities that are relevant.
B. Logic Model. Description and diagram of the project logic model. This should be created with the project director and evaluator during the early part of the first year and updated as necessary in subsequent project years. The Logic Model should cover each of the following points:
Logic model is specific about program inputs and activities.
Logic model depicts clear relationships between inputs, activities, and specific outcomes.
A “theory of change” is embodied in the logic model.
The logic model clearly delineates which intervention activities are hypothesized to be associated with which short-term outcomes, and which short-term outcomes are associated with which longer-term outcomes.
The logic model includes discrete pathways (boxes and arrows) to depict the hypothesized relationships.
The narrative should describe the Logic Model with attention focused on the pathways.
C. Describe challenges encountered while implementing the program and proposed solutions.
D. Describe any significant changes in the project since the continuation proposal, and how these changes affected the number of clients served.
E. Describe the unique features or accomplishments of the project in the previous year.
Grantee’s financial sustainability plan and activities that support continuation of services at the termination of this Federal funding.
Describe any grants management, program or evaluation issues not otherwise addressed.
Evaluation
A. Research Objectives and Hypotheses: describe the outcome-based objectives, with a clear statement of results or benefits expected (or achieved). Objectives should be specific, measurable, achievable, realistic, and time-framed (S.M.A.R.T.).
Address each of the following points in your narrative:
The questions/hypotheses that the evaluation is addressing are clearly stated.
The questions/hypotheses are closely tied to the SMART objectives.
The evaluation goals and objectives are aligned with the activities that are being conducted. The outcomes are reasonable, given the level, type, and intensity of the intervention activities.
The objectives are written in SMART (Specific, Measurable, Achievable, Realistic, Time-framed) terminology.
The endpoints are behavioral, meaningful, and related to the program’s theory of change.
B. Process Evaluation: provide a description of the process or implementation evaluation plan.
Address each of the following points in your narrative:
Describe the measures that are being used for the process evaluation.
Address each of the following points in your narrative
The process evaluation measures and reports on the key intervention activities and objectives.
The process measures provide sufficient detail to indicate whether implementation is occurring as expected.
The measures have been used consistently across intervention conditions.
3. Measurement of dosage.
Address each of the following points in your narrative
Address any inconsistencies between numbers or participants served by the project and those included in the analysis of program objectives and outcome evaluation.
Exposure to intervention (e.g., number of sessions offered and attendance) for each component is included.
Include target dosage for clients.
Describe any modifications in the program/evaluation.
Address each of the following points in your narrative
A description of findings from the process evaluation that led to modifications in the program or the outcome evaluation is included.
The numbers served in the program match the numbers in the evaluation (i.e., address any inconsistencies between numbers or participants served by the project and those included in the analysis of program objectives and outcome evaluation).
C. Outcome Evaluation Research Design: provide a detailed statement, and possibly a diagram, of the research design. For example, “the evaluation is a quasi-experimental study which includes pretests, post-tests and six month follow-ups of students in the xy school and comparison group…”
1. Comparison Strategy: Describe who is being evaluated, from where they are recruited.
Address each of the following points in your narrative
The study is characterized as an experimental (randomized) or a quasi-experimental (non-randomized) design. Evidence is given as to why this strategy makes sense in the context of the treatment program.
The comparison group or groups are clearly specified.
Members of the comparison group are similar to members of the treatment group.
Threats to validity have been controlled or discussed.
Other factors that could explain program effects have been discussed.
Sampling Strategy: describe, how many are in each group, and how is this determined, etc; the sample size and whether it is sufficient to ensure that any observed differences between groups are significant; the comparison group and how they are recruited/ sampled, or in the absence of a comparison group, comparison data or strategy.
Address each of the following points in your narrative
A power analysis supports the sample size and indicates that it is sufficient to detect statistically significant differences in outcomes between treatment and control/comparison groups. If the sample size is not sufficient, this will need to be discussed.
A description of client recruitment and retention method is included. The description of the method of selecting sample participants from the population is detailed and provides a reasonable basis for generalization of program effects to the broader population of people ‘like those’ in the study.
If needed, a description is provided of steps to be taken by project staff to increase the likelihood of participation in the program. Reasons for recruitment rates below 70% - 80% are clearly explained.
Instrumentation: describe the data collection instruments (surveys, interviews, focus groups) used including information on reliability and validity of instruments and how intervention dosage is measured. Include the instruments used for data collection in the report appendix the first time this report is submitted, and subsequently reference the data collection instruments as submitted in the out years’ reports.
Address each of the following points in your narrative
The outcome measures assess actual behavior change.
The outcome measures map onto research objectives/hypotheses.
A description of the measures’ validity and reliability is included.
Scales as opposed to single items are used.
Data collection process and schedule
Address each of the following points in your narrative
The timing of the data collection is aligned with program activities.
The data collection schedule is realistic and achievable.
The data collection for the intervention and comparison group participants is similar. If there is a difference, there is a justification provided for the difference.
Quality assurance procedures to improve data validity and reliability are described.
A description of the data collectors and the training that they received is included.
Challenges or logistical issues in administering data collection that could affect the interpretation of results are described.
Management Information System: describe what type of management information system is available and the entire data process, including how the survey is administered, who collects the data and enters them into the system, and who analyzes the data. State how the evaluator and program staff ensure confidentiality of the data.
Address each of the following points in your narrative
Data confidentiality issues are discussed (e.g., how names of participants and their data are maintained).
6. Describe the follow-up assessment and longitudinal tracking of program participants during and after the intervention, if applicable.
7. Data analysis procedures
Address each of the following points in your narrative
Statistical methods used to assess the program’s impact are clearly described (e.g., type of design, statistics used).
Analytic procedures are appropriate for the research design and data being collected.
A description of the baseline comparability of groups is included, preferably in tabular form, with statistical comparisons.
Subgroup analyses are described.
Proposed methods for handling attrition bias are discussed. If longitudinal data were collected, these analyses are reported.
Proposed methods for handling missing data are described. If there is missing data, these analyses are reported.
Discuss the design limitations
Address each of the following points in your narrative
Identify the specific limitations of the overall design and of the actual implementation for the program year being reported on.
A description of the threats to validity (e.g., selection bias, maturation, history, and cohort effects) is described along with explanations for change over time (e.g., secular trending).
9. Describe how the evaluation fits in with the program particularly how data is used for mid-course corrections and ongoing program improvements.
D. Results: describe the findings of the study using numbers, percentages, means and standard deviations, and results from other statistical analyses that are appropriate for the selected design.
1. Tables: provide tables or graphs showing demographics, proportion of participants receiving a given dosage/ intensity level, statistical analysis
Address each of the following points in your narrative
The report includes a table with the number of participants in the intervention group(s) and comparison group, as well as those recruited to the intervention, enrolled/completing baseline screening or pre-test, completing the intervention and/or the post-test, and completing follow-up surveys at subsequent follow-up intervals.
Address any inconsistencies between numbers or participants served by the project and those included in the analysis of program objectives and outcome evaluation.
Address each of the following points in your narrative
Findings are provided for each question and objective.
Appropriate analyses are used to assess program effects and are adequately described in the narrative.
Subgroup analyses that were performed are presented for primary outcomes.
Address each of the following points in your narrative
The report provides data on missing data at each round of data collection, and the results of analyses for handling for missing are included.
Attrition Analysis
Address each of the following points in your narrative
The report provides data on attrition at each round of data collection and the results of analyses for handling attrition bias are included.
E. Discussion
Interpretation of the results for each evaluation question, including relevant information from the process evaluation component.
Issues that affected the outcome evaluation and how they were addressed.
Problems encountered during the implementation and evaluation process and proposed solutions.
A statement of the extent to which the program reached or is approaching its objectives (that is, to what extent are both the process and outcome objectives being met).
Implications of findings
F. Recommendations from the evaluator based on the process and outcome evaluation results.
G. List of any professional presentations or publications from the AFL demonstration project.
V. Appendices
A. Enclosure A: Numbers and types of program participants
B. Enclosure B: Data supporting the AFL Prevention Performance Measures
C. Enclosure C: Data regarding the AFL Efficiency Measure
D. Enclosure D: Process evaluation
Enclosure A - Prevention
Special Note: Please count EVERY participant involved in your AFL program regardless of how long or the level of involvement in your program's activities. To the best of your ability, provide unduplicated numbers of clients seen this year. The numbers of participants in the table for ethnicity should be the same as the numbers of participants in the table for race, for females and males respectively.
Participants Served in the AFL Project:
Ethnicity |
12 years and under |
13-14 years |
15-17 years |
18 Years and Older |
Total |
Hispanic or Latino |
|
|
|
|
|
Not Hispanic or Latino |
|
|
|
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Unknown/unreported |
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Total |
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Race |
12 years and under |
13-14 years |
15-17 years |
18 Years and Older |
Total |
American Indian or Alaska Native |
|
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|
|
Asian |
|
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Black or African American |
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Native Hawaiian or Other Pacific Islander |
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White |
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More than one race |
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Unknown/unreported |
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Total |
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Count of Male Youth Participants in the AFL Project*
Ethnicity |
12 years and under |
13-14 years |
15-17 years |
18 Years and Older |
Total |
Hispanic or Latino |
|
|
|
|
|
Not Hispanic or Latino |
|
|
|
|
|
Unknown/unreported |
|
|
|
|
|
Total |
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|
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|
|
Race |
12 years and under |
13-14 years |
15-17 years |
18 Years and Older |
Total |
American Indian or Alaska Native |
|
|
|
|
|
Asian |
|
|
|
|
|
Black or African American |
|
|
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|
|
Native Hawaiian or Other Pacific Islander |
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White |
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|
|
More than one race |
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Unknown/unreported |
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Total |
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Other Clients Served, including parents and guardians:
Parents/Guardians |
Other Clients Served (Siblings, other Family Members, Etc.) |
Total |
|
Total |
|
|
|
Other Presenters Trained including counselors and teachers:
Counselors Trained |
Teachers Trained |
Other Presenters Trained |
Total |
|
Total |
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|
|
|
Enclosure B-Prevention
Performance Measures for AFL Prevention Demonstration Projects
All grantees should complete Performance Measures 1-2 using the AFL Core Instruments. A separate Enclosure B should be completed for participants at 12 and 24 month follow-up data points. Please only report on participants in the intervention group for the performance measures. If there are 2 intervention groups, report on all participants in intervention groups.
PREVENTION LONG TERM MEASURE #1: Increase communication among parents and adolescents on topics relating to puberty, pregnancy, abstinence, alcohol, and/or drug.
Baseline Survey Question 13
Number of respondents selecting categories “2-3 times” or “4 times or more” to Prevention Core Baseline Question 13: “How often in the last 3 months have you talked to one or both of your parents about any of these things?” ______
Total number of respondents to Baseline Question 13 ______
Follow-up Survey Question 13
Number of respondents selecting categories “2-3 times” or “4 times or more” to Prevention Core Follow-up Question 13: “How often have you talked to one or both of your parents about any of these things?” ______
Total number of respondents to Follow-Up Question 13 ______
AND
Baseline Survey Question 14
Number of respondents selecting “a little easy” or “very easy” to Prevention Core Baseline Question 14: “How easy is it for you to talk to your parents about these things?” ______
Total number of respondents to Baseline Question 14 ______
Follow-up Survey Question 14
Number of respondents selecting “a little easy” or “very easy” to Prevention Core Follow-up Question 14: “How easy is it for you to talk to your parents about these things?” ______
Total number of respondents to Follow-Up Question 14 ______
PREVENTION LONG TERM MEASURE #2: Increase adolescents' understanding of the positive health and emotional benefits of abstaining from premarital sexual activity.
Baseline Survey Question 24
Number of respondents selecting “quite important” or “very important” to Prevention Baseline Question 24:“Think about the future. How important is it for you to not to have sex until marriage?” ______
Total number of respondents to Baseline Question 24 ______
Follow-up Survey Question 17
Number of respondents checking “quite important” or “very important” to Prevention Follow-up Question 17:“Think about the future. How important is it for you to not to have sex until marriage?” ______
Total number of respondents to Follow-Up Question 17 ______
This Enclosure B is for data collected at 12 months _____ or 24 months _____.
Enclosure C-Prevention
Efficiency Measure for AFL Prevention Demonstration Projects
All projects reporting for years 2-5 should complete the efficiency measure. Please review the instructions carefully prior to completing the measure.
EFFICIENCY MEASURE: Sustain the cost to encounter ratio in Title XX Prevention Demonstration Projects.
Numerator
Program costs: FSR Line 10D (Net outlays) minus Evaluation costs allotted in the budget (Total program costs should include Federal and non-Federal monies)
_____
Denominator
Individual Client Service Hours delivered this year _____
Group/ Family Client Service Hours delivered this year _____
Total Client Service Hours delivered this year _____
Enclosure D-Prevention
Prevention Cross-Site Process Evaluation Data Collection Form
A. INTERVENTION SETTING AND POPULATION
The following questions are about your AFL demonstration project and target population characteristics. If your demonstration project involves a treatment group and a comparison group, these questions are about the treatment group.
A1.How many treatment groups does your project have?
Mark one response
1 One
2 More than onePlease complete a separate Enclosure D for each treatment group
A2. Which of the following best describes where your AFL project activities are primarily delivered?
Mark one response
1 Faith-based organization(s)
2 Health clinic(s)
3 Hospital(s)
4 Other community-based organization(s)
(a. Describe: |
|
) |
5 Participants’ homes
6 School(s)
7 Other (a. Describe: |
|
) |
A3. At what age(s) do adolescents typically begin participating in your AFL demonstration project?
Mark one response
1 13 years old or younger (a. Specify: _______________________________________)
2 14 years old
3 15 years old
4 16 years old
5 17 years old or older (a. Specify: _______________________________________)
B. PROJECT CONTENT AND DELIVERY
The following questions are about your AFL demonstration project components and activities. If your demonstration project evaluation involves a treatment group and a comparison group, these questions are about the treatment group. Unless directed otherwise, think about all of the project activities that benefit adolescents in the treatment group in your AFL demonstration project.
B1. Which of the following would you identify as the primary goal(s) of your AFL demonstration project?
Mark all that apply
1 Improve parent-child communication
2 Life planning
3 Prevent alcohol/other drug use
4 Prevent human immunodeficiency virus (HIV)
5 Prevent other sexually transmitted infections (STIs)
6 Prevent sexual initiation
7 Prevent school dropout
8 Prevent teen pregnancy
9 Promote discontinuation of sexual activity
10 Other (a. Describe: |
|
) |
B2. Does your project implement any of the following activities to recruit adolescents?
Mark all that apply |
1. Implement activities at times convenient for adolescents |
2 Invite adolescents to attend the project |
3 Pass out flyers about the project |
4 Provide child care |
5 Provide food for participants during activities |
6 Provide other incentives (e.g., gift certificates) |
7 Provide a telephone number adolescents can call 8 Other (a. Describe: ___________________________________________________)
|
B3. Which of the following best describes your project activities?
Mark one response
1 This project includes only group activities
2 This project includes both group and one-on-one activities
3 Something else (a. Describe: ____________________________________________)
B4. What is the average number of participants and staff per group or classroom in the project?
a. participants per b. staff
B5. Which of the following best describe major components of your project?
Mark all that apply |
1. Academic support, remediation, and/or tutoring |
2 Community service or other volunteer experience |
3 Education about alcohol, tobacco, or other drugs |
4 Education about healthy relationships |
5 Education about abstinence from sexual activity |
6 Education about STI prevention |
7 Family activities |
8 Job skills training |
9 Life skills classes |
10 Parent support group |
11 Parent workshop |
12 Summer project/activities 13 Other (a. Describe: ___________________________________________________)
|
B6. Does your AFL demonstration project use peer leaders to conduct activities with adolescents?
1 Yes
0 No If your AFL demonstration project does not use peer leaders to conduct activities with adolescents, skip to item B12 on page 9
Remember, if your demonstration project evaluation involves a treatment group and a comparison group, the following questions refer to your treatment group.
B7. How are peer leaders selected?
Mark all that apply
1 Chosen by peers
2 Chosen by teachers/other adult
3 Volunteers
4 Other (a. Describe: |
) |
) |
B8. Which of the following best describes the ages of peer leaders?
Mark one response
1 Peer leaders are typically older than participants
2 Peer leaders are typically younger or about the same age as participants
B9. Which of the following best describes when training for peer leaders occurs?
Mark one response
3 Both before and after peer-led activities begin
2 Before only
1 After only
0 There is no specific training for peer leaders
B10. Which of the following are true for your project?
Mark all that apply |
1. Boundaries for peer leader-participant relationships are established prior to program implementation |
2. Prospective peer leaders are screened (for example, a background check or an interview) |
3. Peer leaders alternate between being educators and recipients of program activities |
4. There are structured activities for peer leaders and project participants |
B11. Which of the following activities do peer leaders conduct?
Mark all that apply |
1. Make referrals to other services |
2. Provide individual counseling |
3. Provide mentoring |
4. Provide tutoring |
5. Teach curriculum 6 Other (a. Describe:___________________________________________________)
|
B12. Does your demonstration project provide mentoring for adolescents?
1 Yes
0 No If your demonstration project does not provide mentoring for adolescents, skip to
item B20 on page 11
Remember, if your demonstration project evaluation involves a treatment group and a comparison group, the following questions refer to your treatment group.
B13. Which of the following best describes the mentoring activities?
Mark one response
1 Group mentoring
2 One-on-one mentoring If the mentoring activities are one-on-one, skip to item B15 on page 10
3 Other (a. Describe: |
) |
) |
B14. What is the average number of mentors and mentees per group?
a. mentees per b. mentors
B15. Where do mentors and mentees typically meet?
Mark all that apply
1 In person at a school
2 In person at a community center or other community location
3 In person at the mentee’s home
4 By telephone
5 Other (a. Describe: |
) |
) |
B16. Which of the following best describes when training for mentors occurs?
Mark one response
0 There is no specific training for mentors
1 Before the mentor and mentee are matched
2 After the mentor and mentee are matched
3 Both before and after the mentor and mentee are matched
B17. Which of the following best describes mentors’ employment status?
Mark one response
1 Mentors are paid staff
2 Mentors are volunteers
3 Other (a. Describe: |
) |
) |
B18. Which of the following best describes the way mentors are assigned to mentees?
Mark one response
1 Mentors are assigned to mentees based on specific criteria (such as gender, race, mutual interests, etc.)
2 Mentors are matched to mentees based on availability
3 Other (a. Describe: |
) |
) |
B19. Which of the following are true for your project?
Mark all that apply |
1. Mentor-mentee relationship is monitored by an AFL project supervisor |
2. Mentoring is provided by adult mentors |
3. Mentoring is provided by peer mentors |
4. Prospective mentors are screened (e.g., a background check or an interview) |
5. The mentoring component seeks support from the parent or guardian of the mentee |
6. There are clear expectations for frequency of mentor/mentee contact |
7. There are clear expectations for the length of the mentor/mentee relationship |
8. There are structured activities for mentors and mentees |
B20. Is parental participation (beyond consent) a component of the intervention?
1 Yes
0 No If parental participation (beyond consent) is not a component of the intervention, skip to item B23
B21. What is the parental participation component of your AFL demonstration project
(i.e., what activities involve parental participation)?
|
|
|
B22. To increase parent-child communication about sexuality, does your project include any of the following? Please mark whether the activity is provided for parents only, for parents and adolescents, or neither. If you conduct activities for both parents only and for parents and adolescents, be sure to mark both options.
Mark at least one response for each item: |
Yes, for parents and adolescents together |
Yes, for parents only |
Neither |
||
a. Role play activities |
2 |
1 |
0 |
||
b. Small group discussions |
2 |
1 |
0 |
||
c. Videos to watch at home |
2 |
1 |
0 |
||
d. Workshops or training sessions |
2 |
1 |
0 |
||
e. Other techniques (a. Describe: |
|
) |
2 |
1 |
0 |
B23. Are messages about sexual behavior tailored in any of the following ways?
Mark all that apply
1 Yes—To the age of the adolescents
2 Yes—To the sexual experience of the adolescents
3 Yes—To the gender of the adolescents
4 Yes—To the culture of the adolescents
5 Yes—Other (a. Describe: |
) |
) |
98 No—Standardized messages are provided to all adolescents
B24. Does your project cover the following topics?
Mark all that apply |
a Basic information about HIV/STIs or pregnancy |
b Behaviors to reduce vulnerability to HIV/STIs or pregnancy, including use of contraception (if applicable) |
c Barriers to behaviors to reduce vulnerability to HIV/STIs or pregnancy |
d Knowledge about behaviors to reduce vulnerability to HIV/STIs or pregnancy |
e Skills to reduce vulnerability to HIV/STIs or pregnancy |
f Values and/or attitudes about behaviors to reduce vulnerability to HIV/STIs or pregnancy |
g Information about susceptibility to and/or severity of HIV/STIs or pregnancy |
B25. For
all topics you marked in B24,
please indicate the order in which your project covers these topics.
For example, if you marked “yes” to “b. Behaviors
to reduce vulnerability to HIV/STIs or pregnancy,” “c.
Barriers to behaviors to reduce vulnerability to HIV/STIs or
pregnancy,” and “e. Skills to reduce vulnerability to
HIV/STIs or pregnancy,” and your project covers behaviors
first, then skills, then barriers, you would respond:
b,
e, c
If a topic is covered multiple times throughout your program, it can be listed multiple times. (For example: b, e, b, c )
Write the order of the topics you marked in B24 (if any): __________
B26. Which of the following teaching methods does your project employ?
Mark all that apply |
1 Assignments for adolescents to speak with parents or other adults |
2 Classroom discussions |
3 Competitive games |
4 Homework assignments |
5 Live skits |
6 Motivational interviewing |
7 Problem-solving activities |
8 Role plays |
9 Short lectures |
10 Small group work |
11 Stories |
12 Surveys of participant attitudes for teaching purposes |
13 Surveys of participant intentions for teaching purposes |
14 Anonymous presentations of participant survey results |
15 Videos |
16 Worksheets |
17 Voting activities to force participants to choose among responses |
B27. To increase perceptions of risk (susceptibility and/or severity), does your project provide any of the following?
Mark all that apply |
1 Discussion of negative consequences of sexual behavior |
2 Data on prevalence of STIs or pregnancy |
3 Speakers or videos of HIV-positive or pregnant people |
4 Other (a. Describe:__________________________________________________) |
B28. To change personal values and attitudes about sex, does your project include any of the following?
Mark all that apply |
1 Discussion about parental influence on values and attitudes about sex |
2 Discussions that emphasize the advantages of abstinence |
3 Discussions that emphasize that anti-abstinence attitudes are irresponsible |
4 Survey data to demonstrate peer support for abstinence |
5 Voting activities to demonstrate peer support for abstinence |
6 Other (a. Describe:__________________________________________________) |
B29. To teach adolescents to refuse unwanted or unintended sex, does your project use any of the following?
Mark all that apply |
||
1 More than one role play for each adolescent to participate in |
||
2 More than one role play for each adolescent to watch |
||
3 Opportunities for participants to practice refusing sexual pressure |
||
4 Videos so participants can observe refusals 6 Other (a. Describe:___________________________________________________)
|
||
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|
|
B30. Does the project include activities that address media influences on sexual behaviors?
1 Yes
0 No
B31. Is your project based on a specific behavioral theory or theories?
1 Yes (a. Which one[s]? |
) |
) |
0 No
B32. Does your project use any evidence-based curricula, programs, or strategies? (Evidence-based curricula, programs, or strategies have been proven to be effective through evaluation.)
1 Yes (a. Which one[s]? |
) |
) |
0 No If your project does not use any evidence-based curricula, programs, or strategies, skip to Section C on page 15
97 Not sure If you are not sure whether your project uses any evidence-based curricula, programs, or strategies, skip to Section C on page 15
B33. We’d like to learn more about your evidence-based curriculum, program, or strategies. Can you provide a Web site, article(s), publisher, or other source of information we could use to read more about evidence of effectiveness?
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B34. We want to learn about what makes your project a demonstration project or an innovation. Does your project:
Mark all that apply
1 Adapt or make changes to an evidence-based curriculum
2 Deliver an existing project to a previously underserved population
3 Add or change one or more project components to modify an existing project
4 Employ a new approach
5 Other
98 None of the above If none of the above applies to your project, skip to Section C
B35. Please explain your answer to Question B34:
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C. INTERVENTION EXPOSURE
The following questions are about participant exposure to your project and the amount of time participants receive project activities. If your demonstration project evaluation involves a treatment group and a comparison group, these questions are about your treatment group.
C1. On average, how many hours does each participant receive project activities?
Mark one response
1 6 hours or less (a. Specify: |
) |
hours) |
2 7–13 hours
3 14–20 hours
4 21–30 hours
5 31–50 hours
6 51–75 hours
7 76–100 hours
8 More than 100 hours (a. Specify: |
) |
hours) |
C2. Over what period of time does each participant receive project activities?
Mark one response
1 One time only
2 A few days
3 1–3 weeks
4 1–3 months
5 4–6 months
6 7–9 months
7 10–12 months
8 More than 12 months (a. Specify: |
) |
) |
C3. How often do participants receive project activities?
Mark one response
5 Daily
4 Several times a week
3 Once a week
2 Once every two weeks
1 Less than once every two weeks (a. Specify:_______________________________)
C4. Generally, what proportion of participants enrolled in the project completes the intervention in its entirety?
Mark one response
4 All
3 Many
2 About half
1 Some
0 None
D. ORGANIZATIONAL CONTEXT
D1. For how many years has this project been in place? If this project was in place prior to the current AFL funding, please be sure to count those years. If this project has been adapted from a past project within your organization but still has similar goals, please be sure to count those years.
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year(s) |
D2. Which of the following best describes how permanent this project is within your organization?
Mark one response
1 Not at all permanent
2 Somewhat permanent
3 Permanent
D3. Which of the following is true for your AFL demonstration project?
Mark all that apply |
1 The project’s goals and objectives have been put into writing |
2 Plans and procedures used for implementing this project have been put into writing |
3 A schedule (e.g., timetable, plan of action) used for implementing project activities has been put into writing |
4 Strategies for implementing this project have been adapted to fit local circumstances |
5 Formalized job descriptions have been written for staff involved with this project |
6 Permanent staff have been assigned to implement this project |
7 An administrative-level individual within your organization has been actively involved in advocating for this project’s continuation |
8 Staff in your organization other than those actually implementing this project actively contribute to the project’s operations |
D4. Have you involved any of the following external stakeholders in your AFL demonstration project?
Mark all that apply |
1 Community organizations |
2 Faith community |
3 Health care sector (e.g., pediatricians, health clinics, hospital representatives) |
4 Local government (e.g., town or city government) |
5 Private, non-profit social service provider (e.g., family services, drug treatment center) |
6 School district(s) 7 Other (a. Describe:___________________________________________________)
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E. PROJECT STAFF
E1. How many different individuals at your organization are paid (either part-time or full-time) to work on the AFL demonstration project?
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staff persons |
E2. What is the total number of full-time equivalent paid staff (FTEs) who work on your AFL demonstration project? For example, if two paid staff individuals each work at 50% time on AFL demonstration project activities, they would equal 1 FTE.
|
FTEs |
E3. How many volunteers work on the AFL demonstration project?
|
Volunteers |
The next questions ask about individuals who deliver AFL demonstration project activities to participants.
E4. Please indicate how many individuals in each of the following age ranges deliver project activities?
1 Younger than 18 years old
2 18–25 years old
3 26–35 years old
4 36–45 years old
5 46–55 years old
6 56–65 years old
7 Older than 65
E5. What is the gender of the individuals delivering AFL project activities?
Mark one response
1 All female
2 Mostly female
3 Evenly split male and female
4 Mostly male
5 All male
E6. Please indicate how many individuals who completed each of the following levels of education deliver AFL project activities?
1 Some high school
2 High school diploma or GED
3 Some college, but no degree
4 2-year college degree
5 Bachelor’s degree
6 Master’s degree or higher
E7. Which of the following best describes the educational background or experience (prior to working on the AFL demonstration project) of the individuals delivering project activities to AFL demonstration project participants?
Mark all that apply
1 Adolescent medicine
2 Adolescent reproductive health
3 Case management
4 Counseling
5 Education (e.g., school teacher)
6 Health education
7 Nursing
8 Nutrition
9 Public health
10 Pediatric medicine
11 Sex education or HIV education
12 Social work
13 Other (a. Describe: |
) |
) |
E8. On average, how long have individuals delivering project activities worked in the field of preventing adolescent sexual risk behavior, not including their time with this AFL demonstration project?
Mark one response
1 Not at all – the average individual delivering project activities has never worked to prevent adolescent sexual risk behavior beyond their work on this AFL demonstration project
2 Less than 6 months
3 6 months or more, but less than 1 year
4 1 to 3 years
5 4 to 6 years
6 7 or more years (a. How many? _______years)
E9. Are there individuals delivering project activities who are Hispanic or Latino?
1 Yes
0 No
E10. Which of the following best describes the race of individuals delivering project activities?
Mark all that apply
1 White
2 Black or African American
3 Asian
4 Native Hawaiian, or Other Pacific Islander
5 American Indian or Alaska Native
6 Other (a. Describe: |
) |
) |
E11. What proportion of individuals delivering project activities receive training to do this (other than training provided by OAPP)?
Mark one response
4 All
3 Many
2 About half
1 Some
0 None If none of the individuals delivering project activities receive training, skip to item E13
E12. Of those who receive training, how much training do they receive (other than training provided by OAPP)?
Mark one response
1 7 hours or less (a. How many? |
) |
hours) |
2 8 to 15 hours
3 16 to 23 hours
4 24 to 31 hours
5 32 to 39 hours
6 40 hours or more (a. How many? |
) |
hours) |
E13. On average, how long have individuals delivering project activities served in their current roles?
Mark one response
1 1 year or less
2 2 years
3 3 years
4 4 years
5 5 years or more (a. How many? |
) |
years) |
| File Type | application/msword |
| File Title | End of the Year Report Template |
| Author | Leslie Raneri |
| Last Modified By | ARICHMON |
| File Modified | 2009-08-13 |
| File Created | 2009-08-13 |