Form 7 Educator Outcome Survey

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OMB No. 0920-XXXX

Exp. Date:

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Attachment I:

Educator Outcome Survey

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

School ID number:

Survey Date:

Program Year:

Survey Iteration:

Evaluation of CDC’s Dating Matters™:

Strategies to Promote Healthy Teen Relationships Initiative

EDUCATOR SURVEY

Instructions

• Use a pencil or blue or black pen.

Fill bubbles completely. Like this: 

Do not mark answers with ’s or ’s.

1. Name of School: _________________________________

If you work at more than one school, please complete the survey based on the school with which

you are most familiar, and fill in this bubble 

2. How long have you been at this school?

 This is my first year

 This is my second year

 This is my third year

 I have been at this school four or more years

3. What is your role?

 Teacher  Custodian  Other staff

 Administrator  Lunch room worker

 Para-educator  Office staff

 Bus driver  Guidance counselor

4. Sex:

 Male

 Female

 Transgender

5. What is your race? You may mark one or more races, as appropriate:

 American Indian or Alaska Native

 Asian

 Black or African American

 Native Hawaiian or other Pacific Islander

 White

6. Are you Hispanic or Latino?

 Yes

 No

7. Have you ever implemented a dating violence prevention curriculum? {If YES, check all that apply }

 No	 Yes, for 6th, 7th or 8th grade students
	 Yes, for high school students
	 Yes, to help parents support their children

During this school year, are you currently teaching or have you completed teaching a Dating Matters (either ‘comprehensive’ or ‘standard/Safe Dates’) prevention curriculum?
{If YES, check all that apply}

 No	 Yes, comprehensive Dating Matters for 6th grade students
	 Yes, comprehensive Dating Matters for 7th grade students
	 Yes, comprehensive Dating Matters for 8th grade students
	 Yes, standard/Safe Dates for 8th grade students
	 Yes, to help parents support their children

9. Have you delivered any educational activities that addressed sexual harassment? {If YES, check all that apply}

 No	 Yes, for 6th, 7th or 8th grade students
	 Yes, for high school students
	 Yes, for adults

10. Are you aware of any educational activities in your school that addressed sexual harassment? {If YES, check all that apply}

 No	 Yes, for 6th, 7th or 8th grade students
	 Yes, for high school students
	 Yes, for adults

Safe Schools Survey

Please read each statement carefully, then indicate how strongly you agree or disagree with the statement. Answer questions based on the current school year.

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
1. Teachers respect students in this school.					
2. I feel safe before and after school while on school grounds.					
3. Parents are involved in activities at school.					
4. Students use drugs or alcohol outside of school.					
5. Teachers work hard to make every student successful.					
6. Students enjoy learning here.					
7. I feel that I belong at this school.					
8. Groups of students cause problems or conflicts at school.					
9. Students feel comfortable telling a teacher or an administrator about potential violence.					
10. I have seen a gun at school this year.					
11. I feel safe in the school hallways.					
12. Most students are proud of this school.					
13. Teachers have input in decision-making at this school.					
14. Some students are regularly hassled by other students.					
15. Teachers care about student learning at this school.					
16. Teachers and administrators supervise the halls during passing time.					
17. I have seen students smoking at school or on school grounds.					
18. Teachers praise students when they have done well.					
19. Arguments among students are common at school.					
20. Teachers enjoy teaching here.					
21. I have seen a knife at school (not including a cafeteria knife).					
22. Teachers listen carefully to what students have to say.					
23. Name-calling, insults, or teasing happen regularly at school.					
24. Students respect teachers in this school.					
25. Parents are made to feel welcome at this school.					
26. Students use alcohol or drugs at school.					
27. I am proud of this school.					
28. Students regularly cheat on tests or assignments.					
29. Students cut classes or are absent regularly.					
30. Overall, I feel that this school is a safe school.					
31. I have seen students with drugs or alcohol at school.					
32. Administrators listen to what teachers have to say.					
33. I feel safe in my classroom(s).					
34. Robbery or theft of school property over $10 in value is common.					
35. Students are generally treated fairly at this school.					
36. Sale of drugs occurs on school grounds.					
37. Students cooperate with teacher requests.					
38. Physical fighting or conflicts happen regularly at school.					
39. Most students are getting a good education at this school.					
40. Threats by one student against another are common at school.					

Attitudes toward TDV

How strongly do you agree or disagree with the following statements? Please choose one answer for each line.
In this school, students generally think that…	Strongly Agree	Agree Somewhat	Disagree Somewhat	Strongly Disagree
1. It is ok for a boy to hit his girlfriend if she did something to make him mad.				
2. It is ok for a boy to hit his girlfriend if she insulted him in front of friends.				
3. Girls sometimes deserve to be hit by the boys they date.				
4. A girl who makes her boyfriend jealous on purpose deserves to be hit.				
5. Boys sometimes deserve to be hit by the girls they date.				
6. Sometimes boys have to hit their girlfriends to get them back under control.				
7. It is ok for a boy to hit a girl if she hit him first.				
8. It is ok for a girl to hit a boy if he hit her first.				

Visibility of Sexual Harassment

	In your school, how often do you see students:		Never	Seldom	Sometimes	Often
a.		Make unwelcome sexual comments, jokes or gestures				
b.		Call another student gay or lesbian in a negative way				
c.		Touch another student in an unwelcome sexual way				
d.		Show other students sexy or sexual pictures that they don’t want to see				
e.		Physically intimidated another student in a sexual way				
f.		Forced another student to do something sexual				

Visibility of TDV

In your school, how often do you see students who you think might be dating or somehow “involved”:		Never	Seldom	Sometimes	Often
1.	Slap, push, pinch, pull hair or shove each other				
2.	Hit with a fist, kick, or beat each other up				
3.	Name call, humiliate, or belittle each other				
4.	Verbally threaten each other				
5.	Verbally harass their partner in a sexual way				
6.	Touch their partner sexually in a way that seemed unwanted				
7.	Send and/or receive text messages with sexual content				

Knowledge of Protocols to Follow if SH/TDV Behavior Witnessed

1. Have you been trained about school protocols for action(s) to take if you witness sexual harassment between students?

 Yes

 No

2. Have you been trained about school protocols for action(s) to take if you witness teen dating violence between students?

 Yes

 No

3. Are you knowledgeable about laws and your responsibilities if you witness sexual harassment or teen dating violence between students?

 Yes

 No

Problems (Adapted from Add Health)

Below is a list of problems that confront some adolescents today. Please tell us whether you think each is a big problem, a small problem, or no problem at all for the students in your school community.

		Big Problem	Small Problem	No Problem At All
1.	Smoking or tobacco use			
2.	Drug use			
3.	Alcohol use			
4.	Gang violence			
5.	Sexual harassment			
6.	Teen pregnancy			
7.	Vandalism/thieving			
8.	Eating disorders			
9.	Racial conflict			
10.	Dating violence			
11.	Stress or pressure			
12.	Bullying			

Educator Questions for Dating Matters Online Training

1. In the last 12 months, have you taken the Dating Matters online training for educators?

 Yes

 No

If yes, please indicate how strongly you agree or disagree with the following statements:

	Strongly Agree	Somewhat Agree	Somewhat Disagree	Strongly Disagree
2. Before taking this training, I believed teen dating violence could be prevented.				
3. Following this training, I believe that teen dating violence can be prevented.				
4. I see teen dating violence prevention programs and policies fitting within my school.				
5. Following this training, I plan to talk with my school administrator and/or other educators about how we can incorporate teen dating violence prevention into the curriculum and school policies.				
6. Before taking this training, I believed educators played an important role in teen dating violence prevention.				
7. Following this training, I believe educators can play an important role in teen dating violence prevention.				
8. After taking this training, I see the importance of adults modeling respectful relationships for youth.				
9. After taking the training, I plan to incorporate teen dating violence prevention into my classroom lessons.				
10. Before taking the training, I felt comfortable discussing teen dating violence with my students.				
11. After taking the training, I feel more confident in my ability to discuss teen dating violence with my students.				

{Educators who indicate that they have implemented DM or Standard of Care/Safe Dates this year are screened into the following questions.}

Please rate your level of agreement with the following statements regarding the sustainability of the Dating Matters initiative (this includes programs called “Dating Matters” or “Safe Dates”). (Please choose one answer for each line.)
	Strongly Agree	Agree Somewhat	Disagree Somewhat	Strongly Disagree
My school administration seems to be committed to the long-term goals of Dating Matters or Safe Dates.				
I am committed to the long-term goals of Dating Matters or Safe Dates.				
I am prepared to participate in the ongoing implementation of Dating Matters or Safe Dates.				

PERSPECTIVE ON EFFECTIVENESS OF INTERVENTIONS

Across all of the classroom sessions, rate your level of agreement with the following statements regarding engagement in the lessons. (Please choose one answer for each line.)
In this school, the students receiving the interventions…	Strongly Agree	Agree Somewhat	Disagree Somewhat	Strongly Disagree
1. mostly asked relevant questions during the session				
2. rarely paid attention during the sessions				
3. mostly responded correctly to questions during the sessions				
4. rarely suggested solutions during case examples during the sessions				
5. regularly were disruptive during the sessions				
6. regularly participated in the sessions				
7. were regularly supportive of each other during the sessions				
8. mostly did not take the sessions seriously				
9. mostly understood the key concepts from the sessions				
10 regularly expressed discomfort with the topics covered				

Would you say that the effectiveness of the classroom sessions varied by grade level and/or by gender? Please indicate the way in which the effectiveness of the curriculum sessions varied by grade level and/or by gender: Across all of the classroom sessions, rate your level of agreement with the following statements regarding the effectiveness of the lessons. (Please choose one answer for each line.)
I believe the intervention was very effective at …	Strongly Agree	Agree Somewhat	Disagree Somewhat	Strongly Disagree
1. reducing dating violence among students in the school				
2. reducing peer-to-peer violence among students in the school				
3. reducing sexual harassment among students in the school				
4. reducing risky sexual behavior among students in the school				
5. reducing substance use (alcohol use, cigarettes, drugs among students in the school				
6. reducing negative social interactions between students in the school				
7. increasing student reporting of violent behavior among students in the school				
8. increasing the willingness of students to seek help to address violent or harassing behavior among students in the school				

1. In general, which activities/lessons worked the best and in what ways? Why do you think?

2. Which activities/lessons were harder to get them involved in and why?

3. Do you think the CDC should revise the activities/lessons for the students? If yes, in what ways?

4. How do you think the lessons/interventions might be replicated for future and more widespread implementation?

5. Is there anything in general that you would like to add about the whole experience of being part of a research project? Feel free to comment either about the students, or your experiences/perceptions/observations?