Attachment 5

Partner survey (for pretesting)

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EPA would like to evaluate your experience with teaching the SunWise Program. Can you kindly take a few minutes to answer the following questions? Your answers will go a long way toward helping us improve SunWise.

Information collection via this form is authorized by OMB Control No. 2060-0439.

required item   optional item

About You

To establish that you are a partner registered with the SunWise Program, please enter:

Your Name:
Your Organization:

Your Participation in SunWise

Please select: Did you teach SunWise activities to any children this past year (2010)?

Yes	Please estimate how many children received SunWise teaching: What ages did you teach: How much activity time was spent on SunWise: (total minutes per year)
No	In the interest of improving SunWise, can you tell us why not? Skip to the Suggestions section

How do you typically use the SunWise resources?

How many years have you been teaching the SunWise Program?

Do you plan on teaching SunWise next year?

Yes

No

If not, why not?

Did you order or download any SunWise resources besides the Tool Kit activities?

Yes

No

If so, which ones?

Were you aware of the “Don’t Fry Day” Pledge this past year?

Yes

No

If yes, did you take the “Don’t Fry Day” Pledge this past year?

Yes

No

And if yes, which activities did you participate in for your pledge? (check all that apply)

a. Taught at least one SunWise activity during Spring/Summer.

b. Included the UV Index forecast or a sun safety tip in daily announcements.

c. Other. Please describe:

I. Overall Satisfaction:

1. Please rank the children's overall satisfaction with the SunWise program.

Use a scale of 1 to 5, with 1 being the least satisfied and 5 being the most satisfied.

Least Satisfied						Most Satisfied
	1	2	3	4	5

 

2. Please rank your overall satisfaction with the SunWise program.

Use a scale of 1 to 5, with 1 being the least satisfied and 5 being the most satisfied.

Least Satisfied						Most Satisfied
	1	2	3	4	5

II. Cross-Curricular Lessons (SunWise Tool Kit)

3. Overall the instructional level of the Tool Kit was:

   Too easy	About right	Too advanced

4.  Please indicate how many activities you completed in each of the following subject area in the past year:

 

Science
	0	1	2	3	4	5	6+
Mathematics
	0	1	2	3	4	5	6+
Physical Education
	0	1	2	3	4	5	6+
English
	0	1	2	3	4	5	6+
Social Studies
	0	1	2	3	4	5	6+
Health
	0	1	2	3	4	5	6+

5. What were the children's two favorite activities?

1:
2:

 

6. Do you think that the SunWise Tool Kit help children learn how to protect themselves from overexposure to the sun?

Use a scale of 1 to 5, with 1 being the least helpful and 5 being the most helpful.

Not helpful						Very helpful
	1	2	3	4	5

 

7. Did the SunWise Tool Kit help you learn about the risk of overexposure to the sun?

Use a scale of 1 to 5, with 1 being the least helpful and 5 being the most helpful.

Not helpful						Very helpful
	1	2	3	4	5

8. How many other members of your organization did you share your materials with?

1	2	3	4	5	5+

9. To the best of your knowledge, how many members of your organization are currently using the SunWise curriculum?

1	2	3	4	5	5+

10. Would you recommend the SunWise Tool Kit to other staff?

Yes

No

III. UV Index/Frisbee Use

11. Did you use the SunWise Web site with children to gather and/or input UV Index data?

Yes

No

 

12. Was the UV Frisbee an effective teaching tool?

Yes

No

I did not use the UV Frisbee

Please describe:

IV. Infrastructure Enhancements

13. Did you organize any organization-wide sun safety activities (out of the classroom)?

Yes

No

If yes, please describe:

14. Please indicate if any of your organization’s policies changed as a result of your efforts with SunWise. (Check all that apply.)

	Before SunWise?	After SunWise?
a. Were notes about sunscreen sent home to parents?
b. Was sunscreen available at your organization?
c. Were more shade structures added at your facility/community?
d. Were more trees added at your facility/community?
e. Was an organization-wide sun safety policy formalized?
f. Were announcements about sun protection made (e.g., on sunny days or before field trips)?

15. What challenges have you experienced in trying to change sun safety policies at your organization?

(Check all that apply.)

a. Organization does not allow the use of sunscreen.
b. Children use sunscreen inappropriately (e.g., smear it on surfaces).
c. Children cannot afford sunscreen.
d. There is not enough time to apply sunscreen to all children.
e. Children are not allowed to wear hats.
f. Shade structures are too expensive.
g. Other (please describe):

16. Since teaching the SunWise Program, have you talked to your family or friends about being sun safe more often?

Yes

No

V. Suggestions

17. What information, materials, or resources would you suggest we add, delete or change?

18. Have you developed any enhancement activities/lessons for use with SunWise that you would be willing to share?

Yes

No

If yes, please describe

VI. Future Participation

19. Would you like to continue your participation in SunWise for the next year? (You automatically stay enrolled in SunWise, and you do not need to re-register.)

Yes

No

20. How receptive would you be to new units on:

	Not very receptive	Somewhat receptive	Very receptive
a. Dangers of tanning beds?
b. Helping children resist need for tanning?
c. Educating parents about sun protection?

 

or

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THANK YOU

The public reporting and record-keeping burden for this collection of information is estimated to average 30 minutes per response. Burden means the total time, effort, or financial resources expended by persons to generate maintain, retain, disclose, or provide information to or for a federal agency. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. (This collection is OMB control number 2060-0439.) Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, OIC/OEI, U. S. Environmental Protection Agency (2822), 1200 Pennsylvania Ave., NW, Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, 725 17th Street, NW, Washington, DC 20503, Attention: Desk Officer for EPA. Include the OMB control number in any correspondence

OMB Control No. 2060-0439

Available online at https://cfpub.epa.gov/sunwise/index.cfm?do=data.edsurvey