Form 26 School Physical Education and Activity

School Health Policies and Practices Study 2012

Appendix G-15 Physical Education_School

School Data Collection

OMB: 0920-0445

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OMB No: 0920-0445

Expiration Date: xx/xx/xxxx

Physical Education and Activity
School Questionnaire

6 January 2011

Frame1 §





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
School Questionnaire

Questions

MODULE 1

Standards 1–4

Required Physical Education 5–14

Instructional Content 15–38

Student Assessment 39–41

Use of Protective Gear 42

Physical Activity and Discipline 43–48

Students with Disabilities 49–54

Facilities 55–60

Staffing and Professional Development 61–66

Collaboration 67–68

Promotion 69–72

Intramural Activities and Physical Activity Clubs 73–84

Community Use of School Facilities 85–90

Physical Education Coordinator 91–102

MODULE 2

Interscholastic Sports 103–121



NOTE: THROUGHOUT THIS QUESTIONNAIRE, TEXT THAT APPEARS IN ALL CAPITAL LETTERS WILL NOT BE READ ALOUD TO RESPONDENTS.

THIS QUESTIONNAIRE WILL BE ADMINISTERED USING COMPUTER ASSISTED PERSONAL INTERVIEW TECHNOLOGY. THE INTERVIEWER WILL READ THE QUESTIONS ALOUD AND TYPE RESPONSES TO THE QUESTIONS INTO THE LAPTOP 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.

  1. What is your job title at the school? (In which role do you spend more time?)

1) Principal

2) Asst. Principal/Other School Administrator

3) School Secretary

4) Physical Ed Teacher

5) Athletic Director

6) Health Ed Teacher

7) Other Teacher

8) Food Service Manager

9) Commercial Food Service Provider

10) Other School Food Service Staff

11) School Counselor

12) Social Worker

13) Psychologist

14) Other Mental Health/
Social Services Provider

15) Nurse

16) Health Aide

17) Physician

18) Other Health Services Provider

19) SBHC Health Services Staff

20) SBHC Mental Health/
Social Services Staff

50) Other Staff

During this interview, I will ask about physical education at your school. By “physical education,” I mean class time that is spent teaching a physical education curriculum. Please do not include instruction on physical activity topics that are part of health education or any other subject. Also, do not consider regularly scheduled recess. You have been identified as the person who knows the most about how physical education is provided throughout all grades at the school. As you think about the questions that I ask, please consider all physical education provided to students at your school. Also, please think about the physical education requirements for students in general, even though there may be some exceptions.

The first questions ask about your school’s physical education standards. These standards might cover student expectations and performance outcomes for physical education.

  1. Does your school follow any national, state, or district physical education standards?

Yes 1

No 2

  1. Are those who teach physical education at your school provided with…

Yes No

  1. Standards for physical education? 1 2

  2. A framework or course of study for physical education? 1 2

  3. One or more physical education curricula? 1 2

  4. Instructional strategies for physical education? …………………1 2

  5. Lesson plans or learning activities for physical education? 1 2

  6. Plans or tools for assessing or evaluating students
    in physical education? 1 2

IF THOSE WHO TEACH PHYSICAL EDUCATION ARE PROVIDED WITH STANDARDS FOR PHYSICAL EDUCATION (Q3A IS “YES”), ANSWER Q4. OTHERWISE, SKIP TO THE INTRODUCTION TO Q5.

  1. Do your school’s standards for physical education specifically address…

Yes No

  1. Competence in motor skills and movement patterns
    needed to perform a variety of physical activities? 1 2

  2. Understanding of movement concepts, principles,
    strategies, and tactics as they apply to the learning
    and performance of physical activities? 1 2

  3. Regular participation in physical activity? 1 2

  4. Achievement and maintenance of a health-enhancing
    level of physical fitness? 1 2

  5. Responsible personal and social behavior that respects
    self and others in physical activity settings? 1 2

  6. Value for physical activity for health, enjoyment,
    challenge, self-expression, and/or social interaction? 1 2

Now I’d like to ask you about required physical education.

  1. Must students attending your school take any physical education as a requirement for graduation or promotion to the next grade level or school level?

Yes 1

No 2 SKIP TO THE INSTRUCTIONS BEFORE Q34

The next several questions are about physical education that students must take for graduation or promotion to the next grade level or school level. During the rest of the interview, I will refer to this physical education as required physical education.

I am going to read a list of reasons why students could be exempted for one grading period or longer from taking required physical education.

  1. Can students at your school be exempted for…

Yes No

  1. Religious reasons? 1 2

  2. Long-term physical or medical disability? 1 2

  3. Cognitive disability? 1 2

  4. Achievement of positive, passing, or high physical
    competency test scores? 1 2

  5. Achievement of positive, passing, or high physical
    fitness test scores? 1 2

  6. Participation in school activities other than sports,
    such as band or chorus? 1 2

  7. Participation in community sports activities? 1 2

  8. Participation in community service activities? 1 2

  9. Standardized test preparation for other subjects? 1 2

ANSWER J, K, AND L FOR MIDDLE AND HIGH SCHOOL ONLY. OTHERWISE, SKIP TO Q7.

  1. Enrollment in other courses, such as math or science? 1 2

  2. Participation in school sports? 1 2

  3. Participation in vocational training? 1 2

  1. Does your school prohibit exemptions from physical education requirements?

Yes 1

No 2

  1. In required physical education, are students at your school taught…

Yes No

ANSWER A FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO B.

  1. Movement concepts and skills? 1 2

  2. Individual or paired activities? 1 2

  3. Group or team activities? 1 2

  4. Aquatic activities? 1 2

  5. Dance activities? 1 2

ANSWER Q9 IF STUDENTS ARE TAUGHT INDIVIDUAL OR PAIRED ACTIVITIES IN REQUIRED PHYSICAL EDUCATION AT THIS SCHOOL (Q8B IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q10.

SHOW CARD 1

  1. Looking at this card, which is in alphabetical order, please tell me which individual or paired activities are taught in required physical education at your school. Please include the activity itself, lead-up skills, skills specific to the activity, or modified versions of the activity that are taught.
    MARK ALL THAT APPLY

Aerobics, such as step or low-impact 1

Archery 2

Badminton 3

Bowling 4

Canoeing or kayaking 5

Cardiovascular exercise machines, such as
rowers, ski machines, stair climbers,
stationary bikes, or treadmills 6

Climbing ropes or wall ladders 7

(Q9 continued)

Climbing walls 8

Physical activity or fitness stations 9

Frisbee or frisbee golf 10

Golf 11

Gymnastics 12

Hiking, backpacking, or orienteering 13

Jumping rope 14

Martial arts 15

Non-stationary bicycling 16

Pilates 17

Racquet sports, other than tennis, such as
racquetball, handball, squash, or paddleball 18

Rock climbing 19

Running or jogging 20

Skating, such as roller, in-line, or ice skating 21

Skiing, such as cross country, downhill,
or water skiing 22

Student-designed games 23

Table tennis or ping pong 24

Tennis 25

Track and field 26

Walking 27

Weight training 28

Wrestling 29

Yoga 30

None of the above 31

ANSWER Q10 IF STUDENTS ARE TAUGHT GROUP OR TEAM ACTIVITIES IN REQUIRED PHYSICAL EDUCATION AT THIS SCHOOL (Q8C IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q12.

SHOW CARD 2

  1. Looking at this card, please tell me which group or team activities are taught in required physical education at your school. Please include the activity itself, lead-up skills, skills specific to the activity, or modified versions of the activity that are taught.
    MARK ALL THAT APPLY

Baseball, softball, or whiffleball 1

Basketball 2

Dodgeball or bombardment 3

Football, such as touch or flag football 4

Hockey, such as field, floor, roller,
or ice hockey 5

Kickball 6

Lacrosse 7

Soccer 8

Student-designed games 9

Ultimate frisbee 10

Volleyball 11

None of the above 12

ANSWER Q11 IF THIS SCHOOL IS AN ELEMENTARY SCHOOL THAT TEACHES GROUP OR TEAM ACTIVITIES IN REQUIRED PHYSICAL EDUCATION (Q8C IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q12.

SHOW CARD 3

  1. Looking at this card, please tell me which group or team activities are taught in required physical education at your school.
    MARK ALL THAT APPLY

Duck-duck-goose 1

Elimination tag 2

King of the hill or capture the flag 3

Red rover 4

Relay races 5

None of the above 6

ANSWER Q12 IF STUDENTS ARE TAUGHT DANCE ACTIVITIES IN REQUIRED PHYSICAL EDUCATION AT THIS SCHOOL (Q8E IS “YES”). OTHERWISE, SKIP TO THE INTRODUCTION TO Q13.

SHOW CARD 4

  1. Looking at this card, please tell me which dance activities are taught in required physical education at your school. Please include the activity itself, lead-up skills, skills specific to the activity, or modified versions of the activity that are taught.
    MARK ALL THAT APPLY

Folk or multi-cultural dances 1

Performing art dances, such as ballet,
jazz, tap, or modern dances 2

Social dances, such as ballroom dances,
line dances, hip hop, or party dances 3

Square dances 4

None of the above 5

The next questions ask about physical education requirements at your school.

I’m going to read you three statements that describe requirements for physical education. Please listen to all three statements before giving your answer. You may choose more than one option.

  1. How would you describe the physical education requirements at your school?
    MARK ALL THAT APPLY

It is required, but not in a specific grade 1 SKIP TO THE INSTRUCTIONS BEFORE Q19

It is required in specific grades 2 SKIP TO Q15

It is not required 3

  1. Earlier you indicated that students at your school are required to take physical education for graduation or promotion to the next grade level or school level. Is physical education required at your school?

Yes 1 RETURN TO Q13

No 2 RETURN TO Q5 AND THEN SKIP TO THE INSTRUCTIONS BEFORE Q34

  1. At your school, in which grades do students receive required instruction in physical education?
    MARK ALL THAT APPLY

K 0

1st 1

2nd 2

3rd 3

4th 4

5th 5

6th 6

7th 7

8th 8

9th 9

10th 10

11th 11

12th 12

ANSWER Q16–Q18 FOR EACH GRADE ABOVE.

  1. How many weeks during the school year are _____ grade students scheduled to take physical education?

Weeks

  1. On average, how many days per week are _____ grade students scheduled to take physical education?

1 day 1

2 days 2

3 days 3

4 days 4

5 days 5

0 days one week, 1 day the next week 6

1 day one week, 2 days the next week 7

2 days one week, 3 days the next week 8

3 days one week, 4 days the next week 9

4 days one week, 5 days the next week 10

Other 11

  1. On average, how many minutes is each session of physical education scheduled to last?

Minutes

IF Q13 IS 2 ONLY, SKIP TO THE INSTRUCTIONS BEFORE Q34.

  1. Now, I’m asking about courses that include instruction in physical education that students are required to take while at your school. I am asking about required courses that students do not have to take during any particular grade. Any courses that are chosen by students or are optional for students we will list in the next set of questions. Are students at your school required to take specific courses that include instruction in physical education?

Yes 1

No 2 SKIP TO Q26

  1. Please tell me the names of these specific courses that include instruction in physical education that are required for students at your school.

Course 1 Course 9

Course 2 Course 10

Course 3 Course 11

Course 4 Course 12

Course 5 Course 13

Course 6 Course 14

Course 7 Course 15

Course 8 Course 16

  1. Course 17

Course 18

Course 19

Course 20

ANSWER Q22–25 FOR EACH COURSE LISTED IN Q20 AND Q21.

  1. In what grade do students usually take ?

K 0

1st 1

2nd 2

3rd 3

4th 4

5th 5

6th 6

7th 7

8th 8

9th 9

10th 10

11th 11

12th 12

No usual grade 13

  1. How many weeks is the course scheduled to last?

Weeks

  1. On average, how many days per week is the course scheduled to meet?

1 day 1

2 days 2

3 days 3

4 days 4

5 days 5

0 days one week, 1 day the next week 6

1 day one week, 2 days the next week 7

2 days one week, 3 days the next week 8

3 days one week, 4 days the next week 9

4 days one week, 5 days the next week 10

Other 11

  1. On average, how many minutes is each class period scheduled to last?

Minutes

  1. Some schools have a general physical education requirement for which students must select a certain number of courses from a larger set of courses to fulfill the requirement. These courses are sometimes called “required electives.” Next, I am going to ask you about courses that meet this type of general physical education requirement. However, please do not include any of the required physical education courses that I have already asked you about, including any physical education courses required in a certain grade or any other required courses. Are there any courses at your school that students must choose from to meet this type of general physical education requirement?

Yes 1

No 2 SKIP TO Q34

  1. Please tell me the names of these courses that meet a general physical education requirement at your school.

Course 1 Course 9

Course 2 Course 10

Course 3 Course 11

Course 4 Course 12

Course 5 Course 13

Course 6 Course 14

Course 7 Course 15

Course 8 Course 16

  1. Course 17

Course 18

Course 19

Course 20

  1. Of the courses you just listed, how many must students take to fulfill the general physical education requirement?

Number of courses for general physical education requirement

ANSWER Q30–Q33 FOR EACH COURSE LISTED IN Q27 AND Q28.

  1. In what grade do students usually take ?

K 0

1st 1

2nd 2

3rd 3

4th 4

5th 5

6th 6

7th 7

8th 8

9th 9

10th 10

11th 11

12th 12

No usual grade 13

  1. How many weeks is the course scheduled to last?

Weeks

  1. On average, how many days per week is the course scheduled to meet?

1 day 1

2 days 2

3 days 3

4 days 4

5 days 5

0 days one week, 1 day the next week 6

1 day one week, 2 days the next week 7

2 days one week, 3 days the next week 8

3 days one week, 4 days the next week 9

4 days one week, 5 days the next week 10

Other 11

  1. On average, how many minutes is each class period scheduled to last?

Minutes



Now, I’d like you to think about all physical education, not just required physical education.


IF THIS IS A SINGLE SEX SCHOOL, SKIP TO Q35.


  1. Are there any physical education classes or courses at your school that are taught…

Yes No

  1. Only to boys? 1 2

  2. Only to girls? 1 2

  1. Does your school offer any physical education courses that are taught…

Yes No

  1. Online only? 1 2

  2. Partially online and partially in-person? 1 2

  1. Does your school offer any physical education electives that are not required?

Yes 1

No 2

ANSWER Q37 FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q38.

SHOW CARD 5

My next question is about who teaches physical education.

  1. Looking at this card, please tell me who teaches physical education to students at your school.
    MARK ALL THAT APPLY

Physical education teacher(s) or specialist(s) 1

Regular classroom teacher(s) 2

Other(s) 3

ANSWER Q38 FOR MIDDLE AND HIGH SCHOOL ONLY. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q39.

SHOW CARD 6

My next question is about who teaches physical education.

  1. Looking at this card, please tell me who teaches physical education to students at your school.
    MARK ALL THAT APPLY

Physical education teacher(s) 1

Health education teacher(s) 2

Other teacher(s) 3

Other(s) 4

IF THIS SCHOOL DOES NOT HAVE ANY REQUIRED PHYSICAL EDUCATION (Q5 IS “NO”), SKIP TO THE INTRODUCTION TO Q43. OTHERWISE, CONTINUE WITH Q39.

These next questions ask about grading students in required physical education.

  1. What type of grade do students receive for required physical education at your school?
    MARK ALL THAT APPLY

Letter or numerical grade 1

Pass/Fail 2

Other 3

No grades given for physical education 4 SKIP TO THE INTRODUCTION TO Q42

  1. Are grades from required physical education counted the same as grades from other subject areas when determining grade point averages, honor roll status, or other indicators of academic standing?

Yes 1

No 2

School does not calculate grade point
averages or have any other indicators
of academic standing 3

  1. If students fail required physical education, are they required to repeat it?

Yes 1

No 2

My next question is about protective gear.

  1. Must students wear appropriate protective gear during required physical education?

Yes 1

No 2

Students do not engage in any physical
activities that require protective gear 3

My next questions are about the use of physical activity as punishment for bad behavior and excluding students from physical education as punishment for bad behavior.

  1. Are staff at your school allowed to use physical activity, such as laps or push-ups, to punish students for bad behavior in physical education?

Yes 1

No 2 SKIP TO Q45

  1. Are staff at your school actively discouraged from using physical activity to punish students for bad behavior in physical education?

Yes 1

No 2

  1. Are physical education teachers at your school allowed to exclude students from all or part of physical education as punishment for bad behavior in physical education class?

Yes 1

No 2 SKIP TO Q47

  1. Are physical education teachers at your school actively discouraged from excluding students from all or part of physical education as punishment for bad behavior in physical education class?

Yes 1

No 2

  1. Are staff at your school allowed to exclude students from all or part of physical education as punishment for bad behavior or failure to complete class work in another class?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q49

  1. Are staff at your school actively discouraged from excluding students from all or part of physical education to punish students for bad behavior or failure to complete class work in another class?

Yes 1

No 2

My 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.

  1. Currently, are there any students with long-term physical, medical, or cognitive disabilities enrolled at your school?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q55

  1. Is physical education ever included in Individualized Education Programs, or IEPs, or 504 plans for students with long-term physical, medical, or cognitive disabilities?

Yes 1

No 2

  1. Are there any students with long-term physical, medical, or cognitive disabilities who participate in required physical education at your school?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q55

  1. Do any of these students participate…

Yes No

  1. In adapted physical education only, that is separate
    from regular physical education? 1 2

  2. In regular physical education only? 1 2

  3. In both adapted and regular physical education? 1 2

IF Q52A IS “YES” AND Q52C IS “NO,” SKIP TO THE INSTRUCTIONS BEFORE Q54.

SHOW CARD 7

  1. Looking at this card, please tell me who assists the physical education teacher with teaching students with long-term physical, medical, or cognitive disabilities in regular physical education.
    MARK ALL THAT APPLY

Special education teacher(s) 1

Special education teacher’s aide(s) 2

Adapted physical education teacher(s)
or specialist(s) 3

Physical or occupational therapist(s) 4

Physical education teacher(s) or specialist(s) 5

Regular classroom teacher(s) 6

Other(s) 7

IF Q52B IS “YES”AND Q52C IS “NO,” SKIP TO THE INTRODUCTION TO Q55.

SHOW CARD 8

  1. Looking at this card, please tell me who teaches adapted physical education.
    MARK ALL THAT APPLY

Regular physical education teacher(s) 1

Adapted physical education teacher(s)
or specialist(s) 2

Special education teacher(s) 3

Special education teacher’s aide(s) 4

Physical or occupational therapist(s) 5

Regular classroom teacher(s) 6

Other(s) 7

In these next questions, I’ll ask about the facilities that your school might have for physical education.

  1. Does your school have locker rooms with showers for students?

Yes 1

No 2

SHOW CARD 9

This card lists facilities that your school might have access to for indoor physical education either on or off school property. As I read the list, please tell me which facilities your school has access to for indoor physical education.

  1. Does your school have access to…

Yes No

  1. A gymnasium? 1 2

  2. An indoor track? 1 2

  3. An indoor pool? 1 2

  4. A weight room? 1 2

  5. A cardiovascular fitness center? 1 2

  6. A wrestling room? 1 2

  7. A dance studio? 1 2

  8. A racquetball or squash court? 1 2

I am going to read you another list of facilities your school might use for physical activity during indoor physical education.

  1. Does your school use…

Yes No N/A

  1. Regular classrooms for indoor
    physical education? 1 2

  2. A cafeteria, auditorium, or other
    multi-purpose room for indoor
    physical education? 1 2

  3. Any trailers or mobile buildings
    for indoor physical education? 1 2 3

IF Q56A IS “NO” AND Q57B IS “NO,” SKIP TO THE INTRODUCTION TO Q59.

  1. How crowded is your _________________ during a typical physical education class? Would you say it is…

Less than 50% full? 1

50 to 75% full? 2

76 to 100% full? 3

Over capacity? 4

SHOW CARD 10

As I read this list, please tell me which facilities your school has access to for outdoor physical education either on or off school property.

  1. Does your school have access to…

Yes No

  1. A track for walking, jogging, or running? 1 2

  2. An outdoor pool? 1 2

  3. An outdoor volleyball court? 1 2

  4. An outdoor basketball court? 1 2

  5. An outdoor tennis court? 1 2

  6. A baseball or softball field? 1 2

  7. A soccer or football field? 1 2

  8. A general use field? 1 2

  9. Physical activity or fitness stations? 1 2

ANSWER J FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO Q60.

  1. Playground equipment? 1 2

  1. Does your school use a parking lot or black top area for outdoor physical education?

Yes 1

No 2

ANSWER Q61 AND Q62 IF THIS SCHOOL HAS ANY REQUIRED PHYSICAL EDUCATION (Q5 IS “YES”). OTHERWISE, SKIP TO Q63.

My next questions ask about staffing for physical education at your school.

  1. Is there a maximum student-to-teacher ratio allowed for required physical education at your school?

Yes 1

No 2 SKIP TO Q63

  1. What is the maximum student-to-teacher ratio allowed for physical education?

Students per teacher

  1. Are newly hired staff who teach physical education required to have undergraduate or graduate training in physical education or a related field?

Yes 1

No 2

  1. Are newly hired staff who teach physical education required to be certified, licensed, or endorsed by the state in physical education?

Yes 1

No 2

State does not offer certification, licensure,
or endorsement 3

  1. Are all staff who teach physical education required to earn continuing education credits on physical education topics or instructional strategies?

Yes 1

No ………..2 SKIP TO THE INTRODUCTION TO Q67



  1. How often are all staff who teach physical education required to earn continuing education credits on physical education topics or instructional strategies?

Every year 1

Every 2 to 3 years 2

Every 4 to 5 years 3

More than every 5 years 4

Other time frame 5

No specified time 6

Now I’m going to ask you about collaboration among physical education staff and other school and local agency staff.

67a. During the past 12 months, have the physical education staff worked on physical education activities with health education staff from your school?

Yes 1

No 2

School does not have health education staff 3

67b. What about with health services staff from your school?

Yes 1

No 2

School does not have health services staff 3

67c. What about with mental health or social services staff from your school?

Yes 1

No 2

School does not have mental health
or social services staff 3

67d. What about with nutrition or food service staff from your school?

Yes 1

No 2

School does not have nutrition
or food service staff 3

  1. During the past 12 months, have your school’s physical education staff worked on physical education activities with staff or members from

Yes No N/A

  1. A local health department? 1 2 3

  2. A local hospital? 1 2 3

  3. A local mental health or social
    services agency? 1 2 3

  4. A health organization, such as
    the American Heart Association or
    the American Cancer Society? 1 2 3

  5. A local college or university? 1 2 3

  6. A local business? 1 2

  7. A local parks or recreation department? 1 2 3

  8. A local youth organization, such as
    the Boys and Girls Clubs? 1 2 3

  9. Alliance for a Healthier Generation? 1 2

  10. A local service club, such as
    the Rotary Club? 1 2 3

  11. A local health or fitness club? 1 2 3

  12. A local professional sports team? 1 2 3

  13. A local department of transportation
    or public works? 1 2 3

  14. A local law enforcement agency? 1 2 3

  1. During the past 12 months has your school used fitness test scores for advocacy or policy change, such as to advocate for more physical education?

Yes 1

No 2

School does not conduct fitness tests 3



The next question asks about physical education promotion that might occur at your school.

  1. During the past 12 months, has your school…

Yes No

  1. Met with a parents’ organization, such as the PTA,
    to discuss school physical education? 1 2

  2. Provided families of all students with information
    on school physical education? 1 2

  3. Discussed student performance in physical education
    as part of parent-teacher conferences? 1 2

  4. Invited families of all students to attend physical

education classes? 1 2

  1. Collected suggestions from students about school
    physical education? 1 2

  2. Collected suggestions from students’ families
    about school physical education? 1 2

The next question asks about physical activity promotion that might occur at your school.

  1. During the past 12 months, has your school…

Yes No

  1. Provided families of all students with information
    on physical activity? 1 2

  2. Offered school-wide physical activity or sports events,
    such as fun runs, to families of all students? 1 2

  3. Invited families of all students to volunteer
    at physical activity programs, such as field day? 1 2

  1. During the past two years, have…

Yes No

  1. Students helped develop, communicate,
    or implement physical education or physical activity
    policies or activities? 1 2

  2. Students’ families helped develop, communicate,
    or implement physical education or physical activity
    policies or activities? 1 2

  3. Community members helped develop, communicate,
    or implement physical education or physical activity
    policies or activities? 1 2

My next questions ask about opportunities that students at your school might have to participate in intramural activities and physical activity clubs. By “intramural activities” and “physical activity clubs,” I mean any physical activity program that is voluntary for students, in which students are given an equal opportunity to participate regardless of physical ability, and in which students have the opportunity to be involved in the planning, organization, and administration of the program, under the supervision of a qualified adult.

  1. Does your school offer opportunities for students to participate in intramural activities or physical activity clubs?

Yes 1

No 2 SKIP TO THE INSTRUCTIONS BEFORE Q85

  1. Are students provided with information about intramural activities or physical activity clubs…

Yes No

  1. During school announcements? 1 2

  2. On a school Web site or in a school publication? 1 2

  3. On posters or other materials on display in the school? 1 2

SHOW CARD 11

  1. This card lists different intramural activities or physical activity clubs that might be offered to students at your school. As I read this list, please tell me if the activity is offered.

Yes No

  1. Aerobics, such as step or low-impact 1 2

  2. Archery 1 2

  3. Badminton 1 2

  4. Baseball, softball, or whiffleball 1 2

  5. Basketball 1 2

  6. Bowling 1 2

  7. Canoeing or kayaking 1 2

  8. Cardiovascular fitness 1 2

  9. Dance, such as ballroom, folk, or square dance 1 2

  10. Football, such as touch or flag football 1 2

(Q75 continued)

Yes No

  1. Frisbee, frisbee golf, or ultimate frisbee 1 2

  2. Golf 1 2

  3. Gymnastics 1 2

  4. Hiking, backpacking, or orienteering 1 2

  5. Hockey, such as field, floor, roller, or ice hockey 1 2

  6. Jump rope 1 2

  7. Lacrosse 1 2

  8. Martial arts 1 2

  9. Non-stationary bicycling 1 2

  10. Pilates 1 2

  11. Racquet sports, other than tennis, such as racquetball,
    handball, squash, or paddleball 1 2

  12. Rock climbing 1 2

  13. Running or jogging 1 2

  14. Skating, such as roller, in-line, or ice skating 1 2

  15. Skiing, such as cross country, downhill, or water skiing 1 2

  16. Soccer 1 2

  17. Swimming, diving, or water polo 1 2

  18. Table tennis or Ping-Pong 1 2

  19. Tennis 1 2

  20. Volleyball 1 2

  21. Walking 1 2

  22. Weight training 1 2

  23. Wrestling 1 2

  24. Yoga 1 2

  1. Are any of these intramural activities or physical activity clubs offered…

Yes No

  1. Only to boys? 1 2

  2. Only to girls? 1 2

  1. Does your school provide transportation home for students who participate in after-school intramural activities or physical activity clubs?

Yes 1

No 2

Intramurals/physical activity clubs
do not meet after school 3

  1. Must students pay an activity fee to participate in any intramural activities or physical activity clubs?

Yes 1

No 2 SKIP TO Q80

  1. Is the fee waived if the student cannot afford to pay?

Yes 1

No 2

  1. Are staff paid to supervise, lead, or coach intramural activities or physical activity clubs?

Yes 1

No 2

  1. Do community members volunteer to supervise, lead, or coach intramural activities or physical activity clubs?

Yes 1

No 2

  1. Do those who supervise, lead, or coach intramural activities or physical activity clubs receive any training from your school or district?

Yes 1

No 2

  1. Does your school follow any national, state, or district guidelines for intramural activities or physical activity clubs?

Yes 1

No 2

  1. Must students wear appropriate protective gear when engaged in intramural activities or physical activity clubs?

Yes 1

No 2

Students do not engage in any intramural
activities or physical activity clubs
that require protective gear 3

ANSWER Q85–Q90 IF THIS SCHOOL HAS ANY INDOOR OR OUTDOOR FACILITIES THAT COULD BE USED FOR PHYSICAL EDUCATION OR ACTIVITY (ANY Q56 OR Q59 IS “YES”). OTHERWISE, SKIP TO Q91.

The following questions are about the use of facilities on school property for programs sponsored by community organizations such as a YMCA, parks and recreation department, or Boys and Girls Clubs. Do not include school-sponsored interscholastic sports, intramural activities, or physical activity clubs.

  1. Outside of school hours or when school is not in session, do children or adolescents use any of your school’s physical activity or athletic facilities for…

Yes No

  1. Community-sponsored sports teams? 1 2

  2. Community-sponsored classes or lessons,
    such as tennis or gymnastics? 1 2

  3. Community-sponsored supervised “open-gym”
    or “free-play?” 1 2

IF ALL ANSWERS TO Q85 ARE “NO,” SKIP TO Q87. OTHERWISE, CONTINUE WITH Q86.

  1. Are any of these physical activity programs for children and adolescents offered…

Yes No

  1. Before school? 1 2

  2. After school? 1 2

  3. In the evenings? 1 2

  4. On the weekends? 1 2

  5. During school vacations? 1 2

  1. Outside of school hours or when school is not in session, do adults who are not school employees use any of your school’s physical activity or athletic facilities for…

Yes No

  1. Community-sponsored sports teams? 1 2

  2. Community-sponsored physical activity classes
    or lessons, such as tennis or aerobics? 1 2

  3. Community-sponsored “open-gym?” 1 2

IF ALL ANSWERS TO Q87 ARE “NO,” SKIP TO Q89. OTHERWISE, CONTINUE WITH Q88.

  1. Are any of these physical activity programs for adults offered…

Yes No

  1. Before school? 1 2

  2. After school? 1 2

  3. In the evenings? 1 2

  4. On the weekends? 1 2

  5. During school vacations? 1 2

  1. Can children or adults in the community use any of your school’s outdoor physical activity and athletic facilities without being in a supervised program?

Yes 1

No 2 SKIP TO Q91

School does not have outdoor
physical activity/athletic facilities 3 SKIP TO Q91

  1. Can children or adults in the community use your school’s outdoor physical activity and athletic facilities without being in a supervised program…

Yes No

  1. Before school? 1 2

  2. After school? 1 2

  3. In the evenings? 1 2

  4. On the weekends? 1 2

  5. During school vacations? 1 2

  1. Currently, does someone at your school oversee or coordinate physical education?

Yes 1

No 2 SKIP TO Q102

  1. Are you this person?

Yes 1

No 2 SKIP TO Q102

My last set of questions asks about your teaching experience and educational background.

  1. Counting this year as a full year and including years spent teaching physical education at any other elementary, middle, or high schools, how many years of experience do you have teaching physical education?

Years

  1. Do you coach an interscholastic sport?

Yes 1

No 2

  1. Do you have an undergraduate degree?

Yes 1

No 2 SKIP TO Q101

  1. 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

  1. Did you have an undergraduate minor?

Yes 1

No 2 SKIP TO Q99

  1. 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

  1. Do you have a graduate degree?

Yes 1

No 2 SKIP TO Q101

  1. 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

  1. Currently, are you certified, endorsed, or licensed by the state to teach physical education in…

State does not
offer certification,
licensure, or
endorsement
to teach physical
education
Yes No at this level

  1. Elementary school? 1 2 3

  2. Middle school? 1 2 3

  3. High school? 1 2 3

  1. My supervisor may wish to call you to ask about how I conducted this interview. Would you please tell me a telephone number where we might reach you starting with the area code?

( ) -

1) Daytime or

2) Evening/Weekend

Thank you very much for taking the time to complete this interview.

  1. What is your job title at the school? (In which role do you spend more time?)

    1) Principal

    2) Asst. Principal/Other School Administrator

    3) School Secretary

    4) Physical Ed Teacher

    5) Athletic Director

    6) Health Ed Teacher

    7) Other Teacher

    8) Food Service Manager

    9) Commercial Food Service Provider

    10) Other School Food Service Staff

    11) School Counselor

    12) Social Worker

    13) Psychologist

    14) Other Mental Health/
    Social Services Provider

    15) Nurse

    16) Health Aide

    17) Physician

    18) Other Health Services Provider

    19) SBHC Health Services Staff

    20) SBHC Mental Health/
    Social Services Staff

    50) Other Staff

  2. I am going to read a list of interscholastic sports that might be offered to students at your school. As I read the list, please tell me if the sport is offered.

Yes No

  1. Badminton 1 2

  2. Baseball 1 2

  3. Basketball 1 2

  4. Bowling 1 2

  5. Cheerleading or competitive spirits 1 2

  6. Cross-country 1 2

  7. Downhill or cross country skiing 1 2

  8. Fast pitch or slow pitch softball 1 2

  9. Field hockey 1 2

  10. Football 1 2

  11. Golf 1 2

  12. Gymnastics 1 2

  13. Ice hockey 1 2

  14. Lacrosse 1 2

(Q104 continued)

  1. Riflery 1 2

  2. Soccer 1 2

  3. Swimming or diving 1 2

  4. Tennis 1 2

  5. Track and field 1 2

  6. Volleyball 1 2

  7. Water polo 1 2

  8. Weight lifting 1 2

  9. Wrestling 1 2

IF THIS IS A SINGLE SEX SCHOOL, SKIP TO Q106.

  1. Are any of these interscholastic sports offered…

Yes No

  1. Only to boys? 1 2

  2. Only to girls? 1 2

SHOW CARD 12

  1. Which of the following statements best describes your school’s tryout procedures for interscholastic sports?

Students must try out to be able to participate
on all interscholastic sports teams 1

Students must try out to be able to participate
on some interscholastic sports teams 2

Students are not required to try out to be able
to participate on any interscholastic
sports teams 3

  1. Does your school distribute a handbook containing policies, regulations, rules, and enforcement measures for students who participate in interscholastic sports?

Yes 1

No 2

  1. Are coaches at your school allow to use physical activity, such as laps or push-ups, to punish students for poor performance or bad behavior in interscholastic sports?

Yes 1

No 2 SKIP TO Q110

  1. Are coaches at your school actively discouraged from using physical activity to punish students for poor performance or bad behavior in interscholastic sports?

Yes 1

No 2

  1. Does your school provide transportation home for students who participate in interscholastic sports?

Yes 1

No 2

  1. Must students pay an activity fee to participate in any interscholastic sports?

Yes 1

No 2 SKIP TO Q113

  1. Is the fee waived if the student cannot afford to pay?

Yes 1

No 2

  1. Must students wear appropriate protective gear when engaged in interscholastic sports?

Yes 1

No 2

Students do not engage in any interscholastic
sports that require protective gear 3

  1. How often does the interscholastic sports program at your school…

Almost
Some- Always or
Never Rarely times Always

  1. Require physical examination by a health
    care provider before participation? 1 2 3 4

  2. Require neurocognitive testing
    before participation? 1 2 3 4

  3. Require student athletes and their parents
    to review and sign a concussion
    information sheet before participation? 1 2 3 4

  4. Avoid excesses in training regime
    that may result in injuries, such as
    heat stroke, exhaustion, dehydration,
    sprains, or strains? 1 2 3 4

  5. Reward students for good sportsmanship,
    teamwork, and adherence to safety rules? 1 2 3 4

  6. Strictly enforce prohibitions against
    alcohol or drug use? 1 2 3 4

  7. Actively discourage student use of
    steroids, hormones, or other substances
    to enhance athletic performance? 1 2 3 4

  8. Strictly enforce prohibitions against
    violence and aggression by students,
    spectators, coaches, and other persons
    during sporting events? 1 2 3 4

  9. Strictly enforce prohibitions against
    dangerous athletic behaviors, such as
    spearing in football, high sticking in
    hockey, or bat throwing in baseball? 1 2 3 4

  10. Report all sports-related injuries
    to the appropriate authority? 1 2 3 4

  1. Does the interscholastic sports program…

Yes No

  1. Establish criteria, including clearance by a healthcare
    provider, before allowing further participation in practice
    or reentry into game play after a suspected concussion? 1 2

  2. Establish criteria for safe playing conditions,
    for example avoiding extreme temperatures
    or dangerous field conditions? 1 2

  1. Is a head coach at your school required to…

Yes No

  1. Have previous coaching experience in any sport? 1 2

  2. Have previous coaching experience in the sports
    they will be coaching? 1 2

  3. Have a teaching certificate? 1 2

  4. Complete a coaches’ training course? 1 2

  5. Be certified in first aid? 1 2

  6. Be certified in CPR? 1 2

  7. Have training on how to prevent, recognize, and respond
    to concussions among student athletes? 1 2

  8. Be employed by your school or school district? 1 2

  1. Are assistant coaches or volunteer athletic aides required to complete a training course?

Yes 1

No 2

School does not have assistant
coaches/volunteer athletic aides 3

  1. Do any certified athletic trainers provide services for the interscholastic sports teams?

Yes 1

No 2

  1. During the past 12 months, has your school…

Yes No

  1. Provided educational materials to students or parents
    on preventing, recognizing, and responding to concussions? 1 2

  2. Provided educational sessions to students or parents
    on preventing, recognizing, and responding to concussions? 1 2

IF RESPONDENT ANSWERS YES TO Q119A, THEN ASK:

  1. Were “Heads Up” materials from the Centers for Disease Control and Prevention included in these materials?

Yes 1

No 2

  1. My supervisor may wish to call you to ask about how I conducted this interview. Would you please tell me a telephone number where we might reach you starting with the area code?

( ) -

1) Daytime or

2) Evening/Weekend

Thank you very much for taking the time to complete this interview with me.



Physical Education School Questionnaire—National Review Version

File Typeapplication/msword
File TitleForm Approved
Authordallen
Last Modified Byarp5
File Modified2011-03-09
File Created2011-03-03

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