Form Approved
OMB No: 0920-0445
Expiration Date: xx/xx/xxxx
Physical
Education and Activity
District Questionnaire
5 January 2011
§
Public reporting burden for this collection of information is estimated to average 40 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, Mailstop D-74, Atlanta, GA 30333; Attention PRA (0920-0445).
Physical Education and
Activity
District Questionnaire
Questions
MODULE 1
Standards 1–4
MODULE 2
Elementary School Instruction 5–31
MODULE 3
Middle School Instruction 32–54
MODULE 4
High School Instruction 55–77
MODULE 5
Students with Disabilities 78
Use of Protective Gear 79
Physical Activity and Discipline 80–87
Staffing and Professional Development 88–90
Collaboration 91–92
Promotion 93–94
Evaluation 95–96
Interscholastic Sports 97–103
Physical Education Coordinator 104–112
THIS QUESTIONNAIRE WILL BE ADMINISTERED USING WEB-BASED INTERVIEW TECHNOLOGY. AS THE RESPONDENT TYPES RESPONSES TO THE QUESTIONS INTO THEIR COMPUTER, THE INTERVIEW PROGRAM WILL 1) DISPLAY THE CORRECT TENSE OF VERBS, 2) PROVIDE ALTERNATE ANSWERS TO QUESTIONS (E.G., NOT APPLICABLE, “I DON’T KNOW”), 3) NAVIGATE COMPLEX SKIP PATTERNS, AND 4) PERFORM OTHER USEFUL FUNCTIONS. THE PROGRAMMING SPECIFICATIONS FOR THE INTERVIEW ARE NOT INCLUDED IN THIS PRINTED VERSION OF THE QUESTIONNAIRE.
This questionnaire focuses on your district’s policies and practices regarding physical education.
For the purposes of this questionnaire, “policy” means any law, rule, regulation, administrative order, or similar kind of mandate issued by the local school board or other local agency with authority over schools in your district. SHPPS is most interested in what is required by the district, not what is recommended or contained in non-binding guidance documents, unless the question specifically asks about recommendations.
If a district policy is worded in such a way that it requires schools to develop and adopt their own policies on a given topic, for the purpose of this questionnaire please consider it the same as a district-wide requirement.
Districts may sometimes grant policy exceptions or waivers, but please answer each question based on what is considered the general policy and standard practice in your district.
Please do not consider school practices or policies when answering the questions. This information is gathered during data collection from schools across the country.
Please do not include policies that are solely related to instruction on physical activity topics provided within health education curricula.
Unless the question specifically asks about regularly scheduled recess periods, do not include recess periods when answering questions about physical education.
For the purposes of this questionnaire, “elementary school” refers to a school that contains any of grades K–5. “Middle school” refers to a school that contains any of grades 6–8. Some jurisdictions may refer to these schools as “junior high schools.” “High school” refers to a school that contains any of grades 10–12. Some jurisdictions may refer to these schools as “senior high schools.”
The first questions ask about your district’s physical education standards. These standards might cover student expectations and performance outcomes for physical education.
Has your district adopted a policy stating that schools will follow any national, state, or district physical education standards?
Yes 1 SKIP TO Q3
No 2
Has your district adopted a policy encouraging schools to follow any national, state, or district physical education standards?
Yes 1
No 2 SKIP TO THE INTRODUCTION TO Q5
Are these physical education standards based on the National Standards for Physical Education from the National Association for Sport and Physical Education?
Yes 1
No 2
IF Q1 AND Q2 ARE “NO,” SKIP TO THE INTRODUCTION TO Q5.
Has your district adopted a policy requiring schools to assess student achievement of your district’s physical education standards?
Yes 1
No 2
The next questions ask about elementary school instruction.
Does your district have standards for elementary school physical education?
Yes 1
No 2 SKIP TO Q7
Do your district’s standards for elementary school physical education specifically address…
Yes No
Competence in motor skills and movement
patterns
needed to perform a variety of physical
activities? 1 2
Understanding of movement concepts,
principles,
strategies, and tactics as they apply to the
learning
and performance of physical activities? 1 2
Regular participation in physical activity? 1 2
Achievement and maintenance of a
health-enhancing
level of physical fitness? 1 2
Responsible personal and social behavior
that respects
self and others in physical activity
settings? 1 2
Value for physical activity for health,
enjoyment,
challenge, self-expression, and/or social
interaction? 1 2
Has your district adopted a policy stating that elementary schools will teach physical education?
Yes 1
No 2 SKIP TO THE INTRODUCTION TO Q13
Districts use many ways to describe how much physical education students are required to receive while in elementary school. For example, districts may describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for physical education at the elementary school level?
Yes 1
No 2
Has your district adopted a policy requiring that elementary school students will be engaged in moderate to vigorous physical activity for at least 50% of physical education class time?
Yes 1
No 2
Has your district adopted a policy describing reasons that elementary school students may be exempted from physical education?
Yes 1
No 2 SKIP TO Q12
Has your district adopted a policy stating that elementary school students can be exempted from physical education requirements for one grading period or longer for…
Yes No
Religious reasons? 1 2
Long-term physical or medical disability? 1 2
Cognitive disability? 1 2
Achievement of positive, passing, or high
physical
competency test
scores? 1 2
Achievement of positive, passing, or high
physical
fitness test scores? 1 2
Participation in school activities other
than sports,
such as band or chorus? 1 2
Participation in community sports activities? 1 2
Participation in community service activities? 1 2
Standardized test preparation for other subjects? 1 2
Has your district adopted a policy prohibiting exemptions from physical education requirements for elementary school students?
Yes 1
No 2
The next questions ask about the framework or course of study used by elementary schools for physical education. A framework or course of study provides information on how each standard can be addressed at all grade levels and provides guidance on content, instruction, and assessment.
Does your district require or recommend that schools use an approved framework, course of study, or scope and sequence for elementary school physical education?
Require 1
Recommend 2
Neither 3 SKIP TO THE INTRODUCTION TO Q15
How often is your framework or course of study reviewed or revised?
Every year 1
Every 2 to 3 years 2
Every 4 to 5 years 3
More than every 5 years 4
As needed 5
Other time frame 6
Never 7
The next questions ask about the curriculum used by elementary schools for physical education. For the purposes of these questions, “curriculum” means a detailed set of lessons, directions, strategies, and materials to facilitate student learning and teaching of content.
Does your district require or recommend that schools use one particular curriculum for elementary school physical education?
Require 1
Recommend 2
Neither 3 SKIP TO THE INTRODUCTION TO Q17
Who
developed that curriculum?
MARK ALL THAT APPLY
State education agency 1
Other state agency 2
School district 3
Commercial company 4
Academic institution 5
National or state-level health organization,
such as the
American Heart Association
or the American Cancer Society 6
Other 7
The next questions ask about resources that your district may have provided for elementary school physical education.
During the past two years, has your district provided…
Yes No
Physical education standards for elementary school? 1 2
A list of one or more recommended elementary
school
physical education curricula? 1 2
Lesson plans or learning activities for
elementary school
physical education? 1 2
Plans or tools for assessing or evaluating
students
in elementary school physical education? 1 2
Has your district ever used a self-assessment tool such as the Physical Education Curriculum Analysis Tool (PECAT) to assess a physical education curriculum for elementary schools?
Yes 1
No 2
The next questions ask about elementary school student assessment that your district requires or recommends.
19a. Does your district require or recommend that elementary schools give written tests of students’ knowledge related to physical education?
Require 1
Recommend 2
Neither 3
19b. Does your district require or recommend that elementary schools give skill performance tests related to physical education?
Require 1
Recommend 2
Neither 3
Does your district require or recommend that elementary schools assess students’ physical activity levels, such as through the use of physical activity logs or pedometers?
Require 1
Recommend 2
Neither 3
Does your district require or recommend that elementary schools test students’ fitness levels?
Require 1
Recommend 2
Neither 3 SKIP TO THE INTRODUCTION TO Q24
The next questions ask about specific fitness tests.
Does your district require or recommend that elementary schools use…
Require Recommend Neither
Fitnessgram? 1 2 3
The
Physical Fitness Test,
from the President’s
Challenge? 1 2 3
Any other fitness test? (Specify) 1 2 3
Does your district require elementary schools to submit students’ fitness test results to the district?
Yes 1
No 2
The next questions ask about staffing for elementary school physical education in your district.
Has your district adopted a policy specifying a maximum student-to-teacher ratio for physical education in elementary school?
Yes 1
No 2
Has your district adopted a policy stating that newly hired staff who teach physical education at the elementary school level will have undergraduate or graduate training in physical education or a related field?
Yes 1
No 2
Has your district adopted a policy stating that newly hired staff who teach physical education at the elementary school level will be certified, licensed, or endorsed by the state to teach physical education?
Yes 1
No 2
State does not offer certification, licensure,
or endorsement to
teach physical education
at the elementary school level 3
The next questions ask about elementary school recess and physical activity breaks.
Does your district require or recommend that elementary schools provide students with regularly scheduled recess?
Require 1
Recommend 2
Neither 3 SKIP TO Q29
How many minutes per day of recess are required or recommended for elementary school students?
Less than 10 minutes per day 1
10 to 19 minutes per day 2
20 to 29 minutes per day 3
30 or more minutes per day 4
No specified time requirements
or recommendations 5
Does your district require or recommend that elementary schools provide regular physical activity breaks, outside of physical education class and recess, during the school day?
Require 1
Recommend 2
Neither 3
The next questions ask about excluding students from recess as punishment for bad behavior.
Has your district adopted a policy that prohibits elementary schools from excluding students from all or part of recess as punishment for bad behavior or failure to complete class work?
Yes 1 SKIP TO THE INTRODUCTION TO Q32
No 2
Does your district actively discourage elementary schools from excluding students from all or part of recess as punishment for bad behavior or failure to complete class work?
Yes 1
No 2
The next questions ask about middle school instruction.
Does your district have standards for middle school physical education?
Yes 1
No 2 SKIP TO Q34
Do your district’s standards for middle school physical education specifically address…
Yes No
Competence in motor skills and
movement patterns
needed to perform a variety of physical
activities? 1 2
Understanding of movement concepts,
principles,
strategies, and tactics as they apply to
learning
and performance of physical activities? 1 2
Regular participation in physical activity? 1 2
Achievement and maintenance of a
health-enhancing
level of physical fitness? 1 2
Responsible personal and social behavior
that respects
self and others in physical activity
settings? 1 2
Value for physical activity for health,
enjoyment,
challenge, self-expression, and/or social
interaction? 1 2
Has your district adopted a policy stating that middle schools will teach physical education?
Yes 1
No 2 SKIP TO THE INTRODUCTION
TO Q40
Districts use many ways to describe how much physical education students are required to receive while in middle school. For example, districts may describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for physical education at the middle school level?
Yes 1
No 2
Has your district adopted a policy requiring that middle school students will be engaged in moderate to vigorous physical activity for at least 50% of physical education class time?
Yes 1
No 2
Has your district adopted a policy describing reasons that middle school students may be exempted from physical education?
Yes 1
No 2 SKIP TO Q39
Has your district adopted a policy stating that middle school students can be exempted from physical education requirements for one grading period or longer for…
Yes No
Religious reasons? 1 2
Long-term physical or medical disability? 1 2
Cognitive disability? 1 2
Achievement of positive, passing, or
high
physical competency test score? 1 2
Achievement of positive, passing, or
high
physical fitness test scores? 1 2
Participation in school activities other
than sports,
such as band or chorus? 1 2
Participation in community sports activities? 1 2
Participation in community service activities? 1 2
Standardized test preparation for other subjects? 1 2
Enrollment in other courses, such as math or science? 1 2
Participation in school sports? 1 2
Participation in vocational training? 1 2
Has your district adopted a policy prohibiting exemptions from physical education requirements for middle school students?
Yes 1
No 2
The next questions ask about the framework or course of study used by middle schools for physical education. A framework or course of study provides information on how each standard can be addressed at all grade levels and provides guidance on content, instructions, and assessment.
Does your district require or recommend that schools use an approved framework, course of study, or scope and sequence for middle school physical education?
Require 1
Recommend 2
Neither 3 SKIP TO THE INTRODUCTION TO Q42
How often is your framework or course of study reviewed or revised?
Every year 1
Every 2 to 3 years 2
Every 4 to 5 years 3
More than every 5 years 4
As needed 5
Other time frame 6
Never 7
The next questions ask about the curriculum used by middle schools for physical education. For the purposes of these questions, “curriculum” means a detailed set of lessons, directions, strategies, and materials to facilitate student learning and teaching of content.
Does your district require or recommend that schools use one particular curriculum for middle school physical education?
Require 1
Recommend 2
Neither 3 SKIP TO THE INTRODUCTION TO Q44
Who
developed that curriculum?
MARK ALL THAT APPLY
State education agency 1
Other state agency 2
School district 3
Commercial company 4
Academic institution 5
National or state-level health organization,
such as the
American Heart Association
or the American Cancer Society 6
Other 7
The next questions ask about resources that your district may have provided for middle school physical education.
During the past two years, has your district provided…
Yes No
Physical education standards for middle school? 1 2
A list of one or more recommended middle
school
physical education curricula? 1 2
Lesson plans or learning activities for
middle school
physical education? 1 2
Plans or tools for assessing or evaluating
students
in middle school physical education? 1 2
Has your district ever used a self-assessment tool such as the Physical Education Curriculum Analysis Tool (PECAT) to assess a physical education curriculum for middle schools?
Yes 1
No 2
The next questions ask about middle school student assessment that is required or recommended by your district.
46a. Does your district require or recommend that middle schools give written tests of students’ knowledge related to physical education?
Require 1
Recommend 2
Neither 3
46b. Does your district require or recommend that middle schools give skill performance tests related to physical education?
Require 1
Recommend 2
Neither 3
Does your district require or recommend that middle schools assess students’ physical activity levels, such as through the use of physical activity logs or pedometers?
Require 1
Recommend 2
Neither 3
Does your district require or recommend that middle schools test students’ fitness levels?
Require 1
Recommend 2
Neither 3 SKIP TO THE INTRODUCTION TO Q51
The next questions ask about specific fitness tests.
Does your district require or recommend that middle schools use…
Require Recommend Neither
Fitnessgram? 1 2 3
The
Physical Fitness Test,
from the President’s
Challenge? 1 2 3
Any other fitness test? (Specify) 1 2 3
Does your district require middle schools to submit students’ fitness test results to the district?
Yes 1
No 2
The next questions ask about staffing for middle school physical education in your district.
Has your district adopted a policy specifying a maximum student-to-teacher ratio for physical education in middle school?
Yes 1
No 2
Has your district adopted a policy stating that newly hired staff who teach physical education at the middle school level will have undergraduate or graduate training in physical education or a related field?
Yes 1
No 2
Has your district adopted a policy stating that newly hired staff who teach physical education at the middle school level will be certified, licensed, or endorsed by the state to teach physical education?
Yes 1
No 2
State does not offer certification, licensure,
or endorsement to
teach physical education
at the middle school level 3
The next question asks about middle school physical activity breaks.
Does your district require or recommend that middle schools provide regular physical activity breaks, outside of physical education class, during the school day?
Require 1
Recommend 2
Neither 3
The next questions ask about high school instruction.
Does your district have standards for high school physical education?
Yes 1
No 2 SKIP TO Q57
Do your district’s standards for high school physical education specifically address…
Yes No
Competence in motor skills and
movement patterns
needed to perform a variety of physical
activities? 1 2
Understanding of movement concepts,
principles,
strategies, and tactics as they apply to the
learning
and performance of physical activities? 1 2
Regular participation in physical activity? 1 2
Achievement and maintenance of a
health-enhancing
level of physical fitness? 1 2
Responsible personal and social behavior
that respects
self and others in physical activity
settings? 1 2
Value for physical activity for health,
enjoyment,
challenge, self expression, and/or social
interaction? 1 2
Has your district adopted a policy stating that high schools will teach physical education?
Yes 1
No 2 SKIP TO Q63
Districts use many ways to describe how much physical education students are required to receive while in high school. For example, districts may describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for physical education at the high school level?
Yes 1
No 2
Has your district adopted a policy requiring that high school students will be engaged in moderate to vigorous physical activity for at least 50% of physical education class time?
Yes 1
No 2
Has your district adopted a policy describing reasons that high school students may be exempted from physical education?
Yes 1
No 2 SKIP TO Q62
Has your district adopted a policy stating that high school students can be exempted from physical education requirements for one grading period or longer for…
Yes No
Religious reasons? 1 2
Long-term physical or medical disability? 1 2
Cognitive disability? 1 2
Achievement of positive, passing, or
high
physical competency test score? 1 2
Achievement of positive, passing, or
high
physical fitness test scores? 1 2
Participation in school activities other
than sports,
such as band or chorus? 1 2
Participation in community sports activities? 1 2
Participation in community service activities? 1 2
Standardized test preparation for other subjects? 1 2
Enrollment in other courses, such as math or science? 1 2
Participation in school sports? 1 2
Participation in vocational training? 1 2
Has your district adopted a policy prohibiting exemptions from physical education requirements for high school students?
Yes 1
No 2
The next questions ask about the framework or course of study used by high schools for physical education. A framework or course of study provides information on how each standard can be addressed at all grade levels and provides guidance on content, instructions, and assessment.
Does your district require or recommend that schools use an approved framework, course of study, or scope and sequence for high school physical education?
Require 1
Recommend 2
Neither 3 SKIP TO THE INTRODUCTION TO Q65
How often is your framework or course of study reviewed or revised?
Every year 1
Every 2 to 3 years 2
Every 4 to 5 years 3
More than every 5 years 4
As needed 5
Other time frame 6
Never 7
The next questions ask about the curriculum used by high schools for physical education. For the purposes of these questions, “curriculum” means a detailed set of lessons, directions, strategies, and materials to facilitate student learning and teaching of content.
Does your district require or recommend that schools use one particular curriculum for high school physical education?
Require 1
Recommend 2
Neither 3 SKIP TO Q67
Who
developed that curriculum?
MARK ALL THAT APPLY
State education agency 1
Other state agency 2
School district 3
Commercial company 4
Academic institution 5
National or state-level health organization,
such as the
American Heart Association
or the American Cancer Society 6
Other 7
The next questions ask about resources that your district may have provided for high school physical education.
During the past two years, has your district provided…
Yes No
Physical education standards for high school? 1 2
A list of one or more recommended high
school
physical education curricula? 1 2
Lesson plans or learning activities for high
school
physical education? 1 2
Plans or tools for assessing or evaluating
students
in high school physical education? 1 2
Has your district ever used a self-assessment tool such as the Physical Education Curriculum Analysis Tool (PECAT) to assess a physical education curriculum for high schools?
Yes 1
No 2
The next questions ask about high school student assessment that is required or recommended by your district.
69a. Does your district require or recommend that high schools give written tests of students’ knowledge related to physical education?
Require 1
Recommend 2
Neither 3
69b. Does your district require or recommend that high schools give skill performance tests related to physical education?
Require 1
Recommend 2
Neither 3
Does your district require or recommend that high schools assess students’ physical activity levels, such as through the use of physical activity logs or pedometers?
Require 1
Recommend 2
Neither 3
Does your district require or recommend that high schools test students’ fitness levels?
Require 1
Recommend 2
Neither 3 SKIP TO THE INTRODUCTION TO Q74
The next questions ask about specific fitness tests.
Does your district require or recommend that high schools use…
Require Recommend Neither
Fitnessgram? 1 2 3
The
Physical Fitness Test,
from the President’s
Challenge? 1 2 3
Any other fitness test? (Specify) 1 2 3
Does your district require high schools to submit students’ fitness test results to the district?
Yes 1
No 2
The next questions ask about staffing for high school physical education in your district.
Has your district adopted a policy specifying a maximum student-to-teacher ratio for physical education in high school?
Yes 1
No 2
Has your district adopted a policy stating that newly hired staff who teach physical education at the high school level will have undergraduate or graduate training in physical education or a related field?
Yes 1
No 2
Has your district adopted a policy stating that newly hired staff who teach physical education at the high school level will be certified, licensed, or endorsed by the state to teach physical education?
Yes 1
No 2
State does not offer certification, licensure,
or endorsement to
teach physical education
at the high school level 3
The next question asks about high school physical activity breaks.
Does your district require or recommend that high schools provide regular physical activity breaks, outside of physical education class, during the school day?
Require 1
Recommend 2
Neither 3
The next questions ask about physical education for students with long-term physical, medical, or cognitive disabilities, such as Down syndrome or conditions that require permanent use of a wheelchair.
Based on policies adopted by your district, are schools required to meet the physical education needs of students with long-term physical, medical, or cognitive disabilities by…
Yes No
Providing adapted physical education as appropriate? 1 2
Mainstreaming into regular physical
education
as appropriate? 1 2
Using modified equipment or facilities in
regular
physical education? 1 2
Using teaching assistants in regular physical education? 1 2
Including physical education in 504 plans
or
Individualized Education Programs, or IEPs? 1 2
Using modified assessment? 1 2
The next question is about your district’s policies on the use of protective gear.
Has your district adopted a policy requiring that students wear appropriate protective gear…
Yes No
During physical education? 1 2
When engaged in intramural activities
or
physical activity clubs? 1 2
When engaged in interscholastic sports? 1 2
The next questions ask about the use of physical activity as punishment for bad behavior and excluding students from physical education as punishment for bad behavior.
Has your district adopted a policy that prohibits schools from using physical activity, for example laps or push-ups, to punish students for bad behavior in physical education?
Yes 1 SKIP TO Q82
No 2
Does your district actively discourage schools from using physical activity to punish students for bad behavior in physical education?
Yes 1
No 2
Has your district adopted a policy that prohibits schools from using physical activity to punish students for poor performance or bad behavior in interscholastic sports?
Yes 1 SKIP TO Q84
No 2
Does your district actively discourage schools from using physical activity to punish students for poor performance or bad behavior in interscholastic sports?
Yes 1
No 2
Has your district adopted a policy that prohibits schools from excluding students from all or part of physical education as punishment for bad behavior or failure to complete classwork in another class?
Yes 1 SKIP TO Q86
No 2
Does your district actively discourage schools from excluding students from all or part of physical education to punish students for bad behavior or failure to complete classwork in another class?
Yes 1
No 2
Has your district adopted a policy prohibiting physical education teachers from excluding students from all or part of physical education as a punishment for bad behavior in physical education class?
Yes 1
No 2 SKIP TO THE INTRODUCTION TO Q88
Has your district adopted a policy that actively discourages physical education teachers from excluding students from all or part of physical education as punishment for bad behavior in physical education class?
Yes 1
No 2
The next questions ask about staffing and professional development in your district.
Has your district adopted a policy stating that those who teach physical education are required to earn continuing education credits on physical education topics or instructional strategies?
Yes 1
No 2
Has your district adopted a policy stating that each school will have someone to oversee or coordinate physical education at the school, for example a department chair?
Yes 1
No 2
The next questions are about professional development for those who teach physical education. This might include workshops, conferences, continuing education, graduate courses, or any other kind of in-service.
During the past two years, has your district provided funding for or offered professional development to those who teach physical education on…
Yes No
Methods to increase the amount of
class time students
are engaged in moderate to vigorous
physical activity? 1 2
Methods to promote gender equity in physical
education
and sports? 1 2
Using technology such as computers or video
cameras
for physical education? 1 2
Using physical activity monitoring
devices,
such as pedometers or heart rate monitors
for
physical education? 1 2
Encouraging family involvement in physical activity? 1 2
Administering or using fitness tests? 1 2
Helping students develop
individualized
physical activity plans? 1 2
Injury prevention and first aid? 1 2
How to prevent, recognize, and respond to
concussions
among students? 1 2
Q90 (continued)
Yes No
Teaching physical education to students with
long-term
physical,
medical, or cognitive disabilities? 1 2
Teaching individual or paired activities or sports? 1 2
Teaching team or group activities or sports? 1 2
Teaching movement skills and concepts? 1 2
Assessing or evaluating student
performance
in physical education? 1 2
Developing and using student portfolios
for
physical education? 1 2
Teaching methods to promote inclusion and
active
participation of overweight children
during
physical education? 1 2
Chronic health conditions, for example
asthma
or diabetes, including recognizing and responding
to
severe symptoms or reducing triggers? 1 2
Methods for developing, implementing, and
evaluating
intramural or physical activity clubs? 1 2
Developing, implementing, and evaluating
comprehensive
school physical activity programs? 1 2
Establishing walking or biking to school programs? 1 2
Assessing student weight status using body
mass index
(BMI), skinfolds, or bioelectric impedance? 1 2
Physical education standards? 1 2
Teaching online or distance education courses? 1 2
Transforming traditional face-to-face
courses into
an online format? 1 2
Using the Physical Education Curriculum
Analysis Tool
(PECAT) to help assess physical education
curricula? 1 2
Using data to plan or evaluate physical
education policies
or practices? 1 2
The next questions ask about collaboration with other district-level staff and outside organizations.
During the past 12 months, have district-level physical education staff worked on physical education activities with district-level…
District
does
not have staff
Yes No in this area
Health education staff? 1 2 3
Health services staff? 1 2 3
Mental health or social services staff? 1 2 3
Nutrition or food service staff? 1 2 3
General
curriculum coordinators
or supervisors? 1 2 3
During the past 12 months, have district physical education staff worked on physical education activities with staff or members from…
Yes No
A local health department? 1 2
A local hospital? 1 2
A local mental health or social services agency? 1 2
A health organization, such as the American
Heart
Association or the American Cancer Society? 1 2
A local college or university? 1 2
A local business? 1 2
A local parks or recreation department? 1 2
A local youth organization, such as
the
Boys and Girls Clubs? 1 2
Alliance for a Healthier Generation? 1 2
A local service club, such as the Rotary Club? 1 2
A local health or fitness club? 1 2
A local professional sports team? 1 2
A local department of transportation or public works? 1 2
A local law enforcement agency? 1 2
The next question asks about physical education promotion that might occur in your district.
During the past 12 months, has your district…
Yes No
Provided families of all students
with information
on school physical education? 1 2
Provided district or school personnel—for
example,
classroom teachers, administrators, or school
board
members—with information on school
physical
education? 1 2
Sought positive media attention for
physical
education? 1 2
The next question asks about physical activity promotion that might occur in your district.
During the past 12 months, has your district…
Yes No
Provided families of all students
with information
on physical activity? 1 2
Offered district-wide physical activity or
sports events,
such as fun runs, to families of all
students? 1 2
Provided awards or recognition for
outstanding physical
activity programs, such as intramural or
interscholastic
sports programs? 1 2
The next questions ask about different aspects of school physical education that might have been evaluated during the past two years.
During the past two years, have the following aspects of physical education in your district been evaluated?
Yes No N/A
Physical education policies 1 2 3
Physical education curricula 1 2 3
Physical
education professional
development or in-service programs 1 2 3
Physical education teachers 1 2 3
Does your district require schools to report each of the following types of information about implementation of the local wellness policy?
Yes No
Number of minutes of physical
education required
in each grade 1 2
Number of minutes of physical activity
provided outside of
physical education (e.g., classroom
physical activity breaks,
free time physical activity, or
recess) 1 2
Number of minutes of elementary school recess 1 2
Number of minutes of physical activity breaks 1 2
The integration of physical activity into
other academic
or classroom subjects 1 2
The next questions ask about interscholastic sports in your district.
Has your district adopted a policy stating that head coaches of interscholastic sports will…
Yes No
Have previous coaching experience in any sport? 1 2
Have previous coaching experience in the
sports
they will be coaching? 1 2
Have a teaching certificate? 1 2
Complete a coaches’ training course? 1 2
Be certified in first aid? 1 2
Be certified in cardiopulmonary resuscitation (CPR)? 1 2
Have training on how to prevent, recognize,
and respond
to concussions among students? 1 2
Be employed by the school or school district? 1 2
Has your district adopted a policy stating that assistant coaches or volunteer athletic aides will complete a training course?
Yes 1
No 2
Schools in this district do not have assistant
coaches/volunteer
athletic aides 3
During the past two years, has your district provided any funding for or offered professional development to coaches of interscholastic sports?
Yes 1
No 2
Has your district adopted a policy requiring that student athletes suspected of having a concussion be removed immediately from practice or competition?
Yes 1
No 2
Has your district adopted a policy requiring clearance by a healthcare provider before allowing student athletes to further participate in practice or competition after a suspected concussion?
Yes 1
No 2
Has your district adopted a policy requiring schools to conduct neurocognitive testing before participation in interscholastic sports?
Yes 1
No 2
During the past 12 months, has your district…
Yes No
Provided educational materials to
students or parents on
preventing, recognizing, and responding
to concussions? 1 2
Provided educational sessions to students or
parents on
preventing, recognizing, and responding to
concussions? 1 2
Currently, does someone in your district oversee or coordinate physical education?
Yes 1
No 2 That is the last question. Thank you very much for taking the time to complete this questionnaire.
Are you this person?
Yes 1
No 2 That is the last question. Thank you very much for taking the time to complete this questionnaire.
The last few questions ask about your educational background.
Do you have an undergraduate degree?
Yes 1
No 2 SKIP TO Q112
What did you major in?
MARK
ALL THAT APPLY
Physical education 1
Health education 2
Other education 3
Kinesiology, exercise physiology,
or exercise science 4
Other (Specify) 5
Did you have an undergraduate minor?
Yes 1
No 2 SKIP TO Q110
What
did you minor in?
MARK ALL THAT APPLY
Physical education 1
Health education 2
Other education 3
Kinesiology, exercise physiology,
or exercise science 4
Other (Specify) 5
Do have a graduate degree?
Yes 1
No 2 SKIP TO Q112
In what area or areas?
MARK
ALL THAT APPLY
Physical education 1
Health education 2
Other education 3
Kinesiology, exercise physiology,
or exercise science 4
Other (Specify) 5
Are you certified, licensed, or endorsed by the state to teach physical education at the…
State
does not
offer certification,
licensure,
or
endorsement
to teach physical
education
Yes No at
this level
Elementary school level? 1 2 3
Middle school level? 1 2 3
High school level? 1 2 3
Thank you very much for taking the time to participate in this study.
If you would like more information about this study or would like clarification of any questions in this questionnaire, please call 800-287-1815.
File Type | application/msword |
File Title | Form Approved |
Author | dallen |
Last Modified By | arp5 |
File Modified | 2011-03-09 |
File Created | 2011-03-03 |