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pdfDating Matters Capacity Assessment: School Survey
Thank you for participating in the development of the Dating Matters Capacity Assessment School Survey. The survey
includes questions on your school’s experience with and attitudes toward prevention, resources to implement a
prevention program, leadership support, and likelihood of sustainability. The survey should take about 30 minutes.
RTI International, a notforprofit research organization, is conducting this study on behalf of the Centers for Disease
Control and Prevention.
Your responses will assist us in revising the assessment for use with grantees who receive funding from the Centers for
Disease Control and Prevention to implement teen dating violence prevention programs and policies.
Your participation is voluntary and you may refuse to answer any questions you do not feel comfortable with.
Thank you for your participation.
We will begin by asking you a few questions about your role within the school.
Before getting started, please enter the survey respondent code.
1. What is your primary role within the school?
Select one answer.
j Administrator (e.g., principal, assistant principal)
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j Teacher
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j Counselor, psychologist, social worker
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j Physical or occupational therapist, nurse
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j School district level administrator
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j Other
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If other, please specify
2. How long have you been in this role at this school?
Number of years
Number of months
Dating Matters Capacity Assessment: School Survey
3. In the past 12 months, how much of a problem has teen dating violence been at your
school?
Select one answer.
j Major problem
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n
j Moderate problem
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n
j Minor problem
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n
j Not a problem
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n
j Don't know
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n
4. In the past 12 months, how much of a problem has teen dating violence been at other
schools in the district?
Select one answer.
j Major problem
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m
n
j Moderate problem
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n
j Minor problem
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n
j Not a problem
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j Don't know
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5. In the past 12 months, has your school done any of the following?
Select one answer per row.
No
Adapted a prevention curriculum (on any topic) to better meet the needs of your community.
j
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n
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Implemented a teen dating violence prevention curriculum with students.
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Implemented a teen dating violence prevention curriculum with parents/caregivers or families.
j
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n
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n
Implemented a curriculum that included healthy relationship topics (but not specific to teen dating
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n
Provided training for a teen dating violence prevention curriculum.
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Provided training on the prevalence, causes, and consequences of teen dating violence.
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Facilitated youthled teen dating violence prevention programming.
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Identified gaps in school district policies on teen dating violence prevention.
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Supported the promotion of school district policies on teen dating violence prevention.
j
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n
violence).
Don't
Yes
know
Dating Matters Capacity Assessment: School Survey
6. In the past 12 months, has your school implemented any of the following
types of prevention and/or health promotional programming?
Select one answer per row.
Don't
Yes
No
Substance abuse prevention
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j
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j
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n
Gang prevention
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Teen pregnancy prevention or sexual health promotion
j
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Bullying prevention
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Sexual violence prevention
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School violence prevention
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Suicide prevention
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Positive behavioral interventions and supports (PBIS)
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n
Healthy living (e.g., exercise, nutrition)
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Other
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know
If other, please specify
7. Please indicate whether your school currently has the following resources
to implement the Dating Matters initiative.
Select one answer per row.
Don't
Yes
No
Staff who could assist an evaluator in collecting evaluation data such as surveys
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Training for evaluation assistant
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Staff who understand the importance of adhering to the curriculum implementation manual
j
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School staff to facilitate Dating Matters
j
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Access to a copier to prepare Dating Matters handouts
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Classroom space to teach Dating Matters
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Funds to hire substitute teachers when teachers receive the Dating Matters training
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Funds for purchasing Dating Matters supplies
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Funds to pay for Dating Matters training (excluding funds to hire substitute teachers)
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Access to ongoing technical assistance for implementing Dating Matters
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Class time for 10 classroom sessions
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Time allocated to show Dating Matters play
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know
Dating Matters Capacity Assessment: School Survey
8. Sometimes, programs like Dating Matters encounter challenges with gaining
full support of stakeholders. How much do you agree or disagree with each of
the following statements?
Select one answer per row.
Strongly
Disagree
Neither
Disagree Disagree
Agree
nor Agree
Strongly
Don’t
Agree
know
Dating Matters has support from school district leaders.
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j
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Dating Matters has support from the principal.
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Dating Matters has support from teachers.
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Dating Matters has support from parents.
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Dating Matters has support from students.
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9. How much do you agree or disagree with each of the following statements?
Select one answer per row.
I am confident that my school can...
Strongly
Disagree
Neither
Disagree Disagree
Agree
nor Agree
Strongly
Don’t
Agree
know
Explain the benefits of evaluation to parents and youth.
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Work with an evaluator to collect survey and other outcome data
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from Dating Matters participants.
Work with a local evaluator to collect implementation data from
Dating Matters participants and program staff.
10. In the past 12 months, have any of the following advocacy or promotional
efforts occurred?
Select one answer per row.
No
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Someone in our school advocated for policies on teen dating violence.
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There have been schoolwide or districtwide events promoting Dating Matters.
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The school has organized communitywide events promoting Dating Matters.
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Someone in our school advocated for resources, other than Dating Matters, for teen dating violence
prevention.
Don't
Yes
know
Dating Matters Capacity Assessment: School Survey
11a. Our Dating Matters school staff has received training to implement Dating Matters.
Select one answer.
j Yes
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j No
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j Don't know
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11b. How much do you agree or disagree with this statement? Select one answer.
Our Dating Matters school staff has been sufficiently trained to implement Dating
Matters.
j Strongly disagree
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n
j Disagree
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j Neither disagree or agree
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j Agree
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j Strongly agree
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j Don’t know
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11c. Our Dating Matters school staff has received ongoing technical assistance to
implement Dating Matters.
Select one answer.
j Yes
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j No
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j Don't know
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Dating Matters Capacity Assessment: School Survey
11d. How much do you agree or disagree with this statement? Select one answer.
The ongoing technical assistance our school staff has received to implement Dating
Matters is sufficient.
j Strongly disagree
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j Disagree
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j Neither disagree or agree
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j Agree
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j Strongly agree
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j Don’t know
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11e. Our Dating Matters school staff has received training or information on how to
adapt the Dating Matters initiative to our school.
Select one answer.
j Yes
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j No
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j Don't know
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11f. How much do you agree or disagree with this statement?
Select one answer.
Our Dating Matters school staff has received sufficient training or information on
adapting the Dating Matters initiative.
j Strongly disagree
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j Disagree
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j Neither disagree or agree
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j Agree
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j Strongly agree
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j Don’t know
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Dating Matters Capacity Assessment: School Survey
12. How much do you agree or disagree with each of the following statements?
Select one answer per row.
Neither
Strongly
Disagree
Strongly Don’t
Disagree
Agree
Disagree
nor
Agree know
Agree
Our school has the fiscal resources to implement the Dating Matters initiative.
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Our school has the time to implement Dating Matters.
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Our school has the time to participate in an evaluation of Dating Matters.
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Our school has the knowledge needed to implement Dating Matters.
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Dating Matters fits with our school’s educational philosophy.
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Our school understands the steps that are required to implement Dating
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School policies will make it difficult to adopt Dating Matters.
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Our school feels a strong commitment to implement Dating Matters.
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Our school believes that Dating Matters will benefit our students.
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Matters.
13. Please describe any barriers that may hinder implementation of the Dating Matters
initiative.
5
6
14. How much do you agree or disagree with each of the following statements?
Select one answer per row.
Neither
Strongly
Disagree
Strongly Don’t
Disagree
Agree
Disagree
nor
Agree know
Agree
Teachers at my school know better than researchers how to address teen dating
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Researchbased programs are not useful in “real world” prevention efforts.
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Frontline experience is more important than using interventions from a
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Teachers at my school would not use interventions from a manual.
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Teachers at my school generally believe that they should implement only
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violence prevention in our school.
manual.
those curricula lessons that they think are important
Teachers at my school believe it is acceptable to adapt curricula to make it
more relevant to their students.
Dating Matters Capacity Assessment: School Survey
15. How much do you agree or disagree with each of the following statements?
Select one answer per row.
In order for an evidencebased intervention to achieve results like those
demonstrated in its research studies...
Neither
Strongly
Disagree
Strongly Don’t
Disagree
Agree
Disagree
nor
Agree know
Agree
The implementer should cover all of the topic areas laid out in the intervention
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Yes
No
Collaborated with local health department on violence prevention projects.
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n
Collaborated with local health department on other healthrelated projects.
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Collaborated with other county or city agencies on violence prevention projects.
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Collaborated with communitybased organizations on violence prevention projects.
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manual.
The implementer should complete all of the specific activities laid out in the
intervention manual.
The implementer should deliver intervention content in the method specified
in the intervention manual (e.g., lecture vs. reading assignment).
The intervention should be delivered in the setting specified in the
intervention manual (e.g., home vs. school, small group vs. large group).
Intervention activities should be delivered according to the schedule specified
in the intervention manual.
16. In the past 12 months, has your school collaborated with other
organizations in any of the following ways?
Don't
know
Dating Matters Capacity Assessment: School Survey
17. Please rate how much these characteristics are true for your Dating Matter
initiative.
Select one answer per row.
Not at All A Little Somewhat
A Lot
Don’t
Know
Our school is planning for sustainability of Dating Matters.
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Our school is looking for other funding resources to support Dating Matters
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Our school is committed to the longterm goals of Dating Matters.
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Our school district leadership is committed to the longterm goals of Dating
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Dating Matters addresses key needs of our students.
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Dating Matters has strong local government support.
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when the grant ends.
Matters.
Dating Matters is part of a longterm collaborative effort with other
organizations to reduce youth violence.
| File Type | application/pdf |
| File Modified | 2011-07-12 |
| File Created | 2011-07-12 |