Teacher 5th and 9th Session Mid-Implementation Survey

Attachment W

Teacher Fifth Session

Mid-implementation Survey

Form Approved

OMB No. 0920-0783

Exp. Date: 06/30/2011

Teacher Fifth Session

Mid-Implementation Survey

Introduction

This survey is part of a research study for the Centers for Disease Control and Prevention (CDC). The survey is being collected by RTI International, a nonprofit research organization in North Carolina. RTI is conducting this study for CDC.

Purpose

The purpose of the survey is to allow the CDC to gather some important information concerning the effectiveness of Safe Dates and how best to address teen dating violence within schools. About 100 teachers are expected to complete it.

Your perspective is very important to us.

You have been selected for this study because of your school’s involvement in the “Evaluation of the Safe Dates” project. Because of your background and experience as a teacher, your opinions and impressions are particularly important to us. This is the first of two mid-implementation surveys you will receive. It is expected to take about 15 minutes to complete. We know that your time is valuable, so we’ve limited our questions to those we consider the most important.

Privacy:

All answers you provide will be kept private. Findings will be summarized in aggregated form to protect the identity of participating individuals and schools.

Possible Risks or Discomforts:

You should not experience any risks from taking the survey.

Benefits:

There are no direct benefits to participating in this study.

Your Questions

Questions may be directed to Eric Finkelstein at RTI (1-800-RTI-1958 x8074) or Olivia Ashley at RTI (1-800-RTI-1958 x6427). If you have any questions about your rights as a participant, you may call RTI’s Human Research Protections Office (1-866-214-2043). If you have questions about the survey or experience technical difficulties, you may contact Kiersten Strombotne at RTI (1-800-RTI-1958 x6743).

Consent:

Your participation in this survey is voluntary. Selecting the consent to participate link below indicates that you have read the information provided above and have freely decided to participate in this research. By agreeing to participate in this research, you are not giving up any of your legal rights.

Please select the appropriate option below.

__ I consent to participate in the study.

__ I DO NOT consent to participate in the study.

[If consent is given, continue with survey]

[If no consent is given, screen reads “Thank you for your consideration”]

We thank you for your willingness to participate in the evaluation of the Safe Dates program. You are taking a leading role in helping us increase our knowledge about the Safe Dates program and how best to address teen dating violence within schools.

We are seeking your first impressions and reactions.

Please provide responses based on what you know or what you think. Feel free to use the ‘don’t know’ option as needed. There are no “right” or “wrong” answers.

We recommend that you work quickly without puzzling or worrying about your responses to individual questions. We are aware that some questions may appear to be repetitive, but it is necessary to ask a variety of questions to obtain reliable and accurate information about the topics addressed in the questionnaire.

Background Information: Please provide the following information so that we a) can match your answers to this survey with those on follow-up surveys b) describe study participants, and c) group responses according to title, school, etc. The confidentiality of the information you provide is guaranteed.

12. Your title: _______________________	12a. Duration of a health class period: ______ minutes.

	13.	Which of the following options best describes how the Safe Dates (SD) Program is being incorporated into your school's broader health or prevention curriculum? ____ The lessons in the Safe Dates course are taught as an intact unit (e.g., the 9 lessons presented consecutively) ____The lessons in the Safe Dates course are NOT taught as an intact unit (e.g., individual lessons will not be presented consecutively) ____There are no set plans about whether the Safe Dates course will be taught as an intact unit.
	14. 15.	The Safe Dates program is designed to be taught in the form of nine, 50-minute lessons. Please indicate the actual kickoff date and a likely completion date for teaching the 9- session Safe Dates program. The actual kick-off date for the Safe Dates program was (mm/dd/yy): _______________ The estimated completion date for the Safe Dates program is (mm/dd/yy): ____________
	16.	Thinking back to the first five lessons in the Safe Dates program, for how many of those lessons did you follow the curriculum guide to the letter? ____ None of the first five Safe Dates lessons ____ 1 of the first 5 ____ 2 of the first 5 ____ 3 of the first 5 ____ 4 of the first 5 ____ All five of the first 5 Safe Dates lessons

Instructions: Using the scale provided below, please indicate the extent to which you agree or disagree with each of the following statements. Enter the number that most closely reflects your response in the space provided next to each phrase. Enter “dk” if you don’t know.

17. Strongly Disagree	Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Agree	Strongly Agree		Don’t Know
    1	2	3	4	5	6	7		dk

The Safe Dates program must be implemented precisely in the manner described in the curriculum guide in order to be effective.

_______

In my view, formal training is needed in order for teachers to do a good job implementing the Safe Dates program.

_______

The Safe Dates program is complicated to implement correctly.

_______

I have implemented the Safe Dates program exactly as it has been recommended by its developers.

_______

I followed the curriculum guide to the letter in the process of teaching the Safe Dates program.

_______

The only reason that I am teaching the Safe Dates program is because I have to.

_______

I added classroom activities to one or more Safe Dates lesson.

_______

The district office has been very supportive of this school's efforts to implement the Safe Dates program.

_______

It is not clear who is leading this school's efforts to implement the Safe Dates program.

_______

If needed, teachers have access to experts who know how to implement the Safe Dates program.

_______

Clear and specific goals have been established pertaining to the implementation of the Safe Dates program during the course of the study.

_______

School administrators adequately address the concerns of teachers charged with implementing the Safe Dates program.

_______

This school has the resources necessary to support the ongoing implementation of Safe Dates.

_______

Teachers involved in implementing the Safe Dates program get recognition from their supervisors.

_______

The administration monitors how things are going with the implementation of the Safe Dates program.

_______

Teachers are not speaking up although they harbor serious doubts about the effectiveness of Safe Dates.

_______

Overall, students seem to like the Safe Dates program.

_______

Instructions: Using the scale provided below, please indicate the extent to which you agree or disagree with each of the following statements. Enter the number that most closely reflects your response in the space provided next to each phrase. Enter “dk” if you don’t know.

Strongly Disagree	Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Agree	Strongly Agree		Don’t Know
1	2	3	4	5	6	7		dk

Most students seemed interested in the material presented in the Safe Dates program.

_______

Adaptations can be made in how the Safe Dates program is implemented without jeopardizing its effectiveness.

_______

The curriculum guide is sufficient to prepare the average teacher to do a good job implementing the Safe Dates program.

_______

It is easy to prepare teachers to implement the Safe Dates program as recommended by experts.

_______

I have made modifications in the Safe Dates program while teaching one or more of the first five lessons.

_______

I rarely followed the curriculum guide in the process of teaching Safe Dates lessons.

_______

I am teaching the Safe Dates program because I want to.

_______

I added material to one or more of the first five Safe Dates lessons.

_______

The school board has been very supportive of this school's efforts to implement the Safe Dates (prevention) program.

_______

There was not enough time to adequately plan for the implementation of the Safe Dates program at this school.

_______

Training is available to any teacher who needs guidance in order to implement Safe Dates as prescribed by experts.

_______

The school administration has clearly communicated its expectations pertaining to the implementation of the Safe Dates program during the course of the study.

_______

School administrators insure that everything necessary for the implementation of Safe Dates is made available to teachers.

_______

The school has the manpower necessary to support the ongoing implementation of Safe Dates.

_______

Teachers are given positive feedback for contributing to the implementation of the Safe Dates program.

_______

The administration holds meetings with teachers to review how the implementation of Safe Dates is going.

_______

Teachers are encouraged to speak openly about the strengths and weaknesses of the Safe Dates program from the Prevention Coordinator and/or teachers.

_______

The Prevention Coordinator seems to like the Safe Dates program.

_______

Overall, students seemed engaged in Safe Dates classroom activities.

_______

Some components of the Safe Dates program have to be implemented as prescribed but others do not.

_______

In my view, the average teacher is likely to need follow-up training or coaching in order to do a good job implementing the Safe Dates program.

_______

There are one or more reasons why it’s difficult for teachers to implement the Safe Dates program at this school.

_______

I have implemented the most important elements of the Safe Dates curriculum as it has been described in the manual.

_______

Instructions: Using the scale provided below, please indicate the extent to which you agree or disagree with each of the following statements. Enter the number that most closely reflects your response in the space provided next to each phrase. Enter “dk” if you don’t know.

Strongly Disagree	Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Agree	Strongly Agree		Don’t Know
1	2	3	4	5	6	7		dk

I taught the material exactly as specified in the Safe Dates program guide.

_______

I made modifications in the course of teaching the Safe Dates program.

_______

Parents generally have been very supportive of this school's efforts to implement the Safe Dates program.

_______

The implementation of the Safe Dates program has not been well coordinated at this school.

_______

If questions arise about implementing the Safe Dates program, teachers have ready access to needed information.

_______

Teachers who are responsible for implementing the Safe Dates program have a clear understanding of their roles and responsibilities.

_______

Teachers responsible for implementing Safe Dates believe they are given the tools and resources they need to do so effectively.

_______

We do not have the resources necessary to implement the Safe Dates program on a long-term basis.

_______

Teachers responsible for implementing the Safe Dates program know their efforts are appreciated by this school.

_______

The administration gets regular progress reports about the implementation of the Safe Dates program.

_______

Often teachers feel pressured not to “rock the boat” by speaking their minds about the pros and cons of the Safe Dates program.

_______

School administrators appear to like the Safe Dates program.

_______

Students frequently asked questions during Safe Dates classes.

_______

Teaching Safe Dates exactly as it was developed by experts is critical to getting expected results.

_______

After reviewing the curriculum guide, the average teacher will be well-equipped to do a good job implementing the Safe Dates program.

_______

It is easy to implement the Safe Dates program correctly on a consistent basis.

_______

The way I am implementing Safe Dates departs significantly from what is recommended by its developers.

_______

I made modifications in the activities used to teach the Safe Dates program.

_______

The School principal has been very supportive of this school's efforts to implement the Safe Dates program.

_______

The individual in charge of leading the effort to implement the Safes Dates program lacked some important skills.

_______

Technical assistance is available to teachers who are responsible for teaching Safe Dates.

_______

School administrators do a good job removing barriers that interfere with teaching the Safe Dates program exactly as recommended.

_______

This school has the resources necessary to support the initial implementation of Safe Dates.

_______

Top administrators provide encouragement to teachers involved in implementing the Safe Dates program.

_______

Strongly Disagree	Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Agree	Strongly Agree		Don’t Know
1	2	3	4	5	6	7		dk

Instructions: Using the scale provided below, please indicate the extent to which you agree or disagree with each of the following statements. Enter the number that most closely reflects your response in the space provided next to each phrase. Enter “dk” if you don’t know.

The administration pays close attention to the progress being made related to implementing the Safe Dates program.

_______

Overall, parents seem to like the Safe Dates program.

_______

Student comments suggested there was genuine interest in the topics presented in the Safe Dates program.

_______

17. (

The Prevention Coordinator has been very supportive of this school's efforts to implement the Safe Dates program.

_______

One class period provides enough time to implement an entire Safe Dates lesson as recommended by program developers

_______

The existing violence-prevention policies at this school are very effective.

_______

There is a substantial amount of scientific evidence that indicates Safe Dates is effective in reducing dating violence.

_______

Little effort has been directed to overcoming obstacles that got in the way of implementing the Safe Dates program as recommended.

_______

The school has the resources to support the implementation of the Safe Dates program BUT ONLY during the course of the study.

_______

Students have been very supportive of this school's efforts to implement the Safe Dates program.

_______

One class period is sufficient to complete the activities recommended for one Safe Dates lesson.

_______

The existing violence-prevention policies at this school are very effective.

_______

The scientific evidence is strong that supports the effectiveness of Safe Dates.

_______

Not enough attention was given to monitoring the early stages of implementing the Safe Dates program at this school.

_______

95.

The school does not have the resources necessary to support the implementation of the Safe Dates program during the course of the study.

_______

There was not enough time to adequately prepare for teaching individual lessons in the Safe Dates program

_______

One class period is sufficient to present the material associated with one Safe Dates lesson

_______

The violence-prevention programs and classes at this school are very effective.

_______

There is convincing scientific evidence which suggests that Safe Dates is effective in reducing dating violence.

_______

This school takes a comprehensive approach to reducing the incidence of violence among our students

_______

INSTRUCTIONS: The Safe Dates program addresses the topic of dating violence and recommends approaches for reducing its occurrence. Whether or not you have had the chance to review the Safe Dates Teacher Manual/Curriculum guide, please carefully read each statement and indicate how much confidence you have that you could accomplish each of these tasks using the 5-point shown below. Enter “dk” if you don’t know.

No confidence at all	Very little confidence	Some confidence	A lot of confidence	Complete confidence		Don’t Know
1	2	3	4	5		dk

HOW MUCH CONFIDENCE DO YOU HAVE THAT YOU CAN:

	Teach the 9 lessons in the Safe Dates program after reading the teacher manual/curriculum guide	_______
	See to it that the recommended Safe Dates student poster contest is implemented for students in your class.	_______
	See to it that the recommended Safe Dates student play is performed by students in your class.	_______
	Persuade students in your Safe Dates class to actively participate in role-playing exercises.	_______
	Persuade students in your Safe Dates class to work together as a group on Safe Dates group exercises.	_______
	Persuade students in your class to participate in classroom discussions about the topic of dating violence.	_______
	Teach the lessons in the Safe Dates program in strict accordance with the curriculum guide.	_______
	Implement the activities in the Safe Dates program in strict accordance with the curriculum guide.	_______
	Comfortably present information to your students about preventing sexual violence.	_______

Instructions: Using the scale provided below, please indicate the extent to which each of the following describes the implementation of the Safe Dates program at this school. Enter the number that most closely reflects your response in the space provided next to each phrase. Enter “dk” if you don’t know.

No Extent/ Not at all	Very Small Extent	Small Extent	Moderate Extent	Considerable Extent	Great Extent	Very Great Extent		Don’t Know
1	2	3	4	5	6	7		dk

To what extent…

	…have changes in school leadership hindered the implementation of the Safe Dates program?	_______
	…has teacher turnover hindered the implementation of the Safe Dates program?	_______
	…has lack of clarity about goals and plans hindered the implementation of the Safe Dates program?	_______
	…has lack of clarity about how to implement parts of the Safe Dates program hindered its overall implementation?	_______
	…has lack of resources hindered the implementation of the Safe Dates program?	_______
	…have internal coordination problems hindered the implementation of the Safe Dates program?	_______
	…has interference by outside groups hindered the implementation of the Safe Dates program?	_______
	…has resistance from students hindered the implementation of the Safe Dates program?	_______

Instructions: Using the scale provided below, please indicate the extent to which each of the following describes the implementation of the Safe Dates program at this school. Enter the number that most closely reflects your response in the space provided next to each phrase. Enter “dk” if you don’t know.

No Extent/ Not at all	Very Small Extent	Small Extent	Moderate Extent	Considerable Extent	Great Extent	Very Great Extent		Don’t Know
1	2	3	4	5	6	7		dk

To what extent…

	…have scheduling problems hindered the implementation of the Safe Dates program?	_______
	…has resistance from key school personnel hindered the implementation of the Safe Dates program?	_______
	…does this school continue to require technical assistance from outside experts in order to implement Safe Dates as described?	_______
	….is this school capable of continuing to implement the Safe Dates program as designed without technical assistance from outside experts?	_______
	…does this school possess the expertise needed to continue to implement Safe Dates program without help form outside experts?	_______