School Physical Education and Activity

Interscholastic Sports

Form Approved

OMB No: 0920-0445

Expiration Date: xx/xx/xxxx

Physical Education and Activity
School Questionnaire

§

Public reporting burden for this collection of information is estimated to average 50 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

Job Title 1

Standards 2–4

Required Physical Education and Instuctional Content 5–39

Student Assessment 40–42

Use of Protective Gear 43

Physical Activity and Discipline 44–46

Students with Disabilities 47–52

Facilities 53–58

Staffing and Professional Development 59–63

Collaboration and Promotion 64–67

Physical Activity Clubs and Intramural Sports 68–79

Community Use of School Facilities 80–85

Physical Education Coordinator 86–97

MODULE 2

Interscholastic Sports 98–115

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. COMMENTS APPEARING IN THE MARGIN REPRESENT ASSISTANCE AVAILABLE TO THE RESPONDENT IF ADDITIONAL CLARIFICATION IS REQUIRED ON THE QUESTION OR THE SPECIFIC TERMINOLOGY USED. WHEN ASKED, THE INTERVIEWER WILL READ THESE STATEMENTS ALOUD TO THE RESPONDENT. 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.

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

Yes 1

No 2

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

Yes No

1. One or more physical education curricula? 1 2

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

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

IF THE SCHOOL DOES NOT FOLLOW ANY NATIONAL, STATE, OR DISTRICT PHYSICAL EDUCATION STANDARDS (Q2 IS “NO”), THEN SKIP TO THE INTRODUCTION TO Q5. OTHERWISE, CONTINUE TO Q4.

4. 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.

5. 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 Q35

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.

6. 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
   fitness test scores? 1 2

ANSWER 6E FOR ELEMENTARY AND MIDDLE SCHOOLS ONLY.
THEN, CONTINUE TO 6G.

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

ANSWER 6F FOR HIGH SCHOOL ONLY. THEN, CONTINUE TO 6G.

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

7. Participation in community sports activities? 1 2

8. Participation in community service activities? 1 2

ANSWER 6I, 6J, AND 6K FOR MIDDLE AND HIGH SCHOOL ONLY.
OTHERWISE, SKIP TO Q7.

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

10. Participation in school sports? 1 2

11. Participation in vocational training? 1 2

7. Does your school prohibit exemptions from physical education requirements for one grading period or longer?

Yes 1

No 2

8. Can students at your school be excused from one or more physical education class periods for additional instructional time, remedial work, or test preparation for other subjects?

Yes 1

No 2

9. 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 Q10 IF STUDENTS ARE TAUGHT INDIVIDUAL OR PAIRED ACTIVITIES IN REQUIRED PHYSICAL EDUCATION AT THIS SCHOOL (Q9B IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q11.

SHOW CARD 1

10. 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

(Q10 continued)

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

Climbing ropes or wall ladders 7

Climbing walls 8

Frisbee or frisbee golf 9

Golf 10

Gymnastics 11

Hiking, backpacking, or orienteering 12

Jumping rope 13

Martial arts 14

Non-stationary bicycling 15

Physical activity or fitness stations 16

Pilates 17

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

Rock climbing 19

Running or jogging 20

Skating, such as roller, in-line, or ice skating,
or skateboarding 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 Q11 IF STUDENTS ARE TAUGHT GROUP OR TEAM ACTIVITIES IN REQUIRED PHYSICAL EDUCATION AT THIS SCHOOL (Q9C IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q13.

SHOW CARD 2

11. 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 Q12 IF THIS SCHOOL IS AN ELEMENTARY SCHOOL THAT TEACHES GROUP OR TEAM ACTIVITIES IN REQUIRED PHYSICAL EDUCATION (Q9C IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q13.

SHOW CARD 3

12. 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 Q13 IF STUDENTS ARE TAUGHT DANCE ACTIVITIES IN REQUIRED PHYSICAL EDUCATION AT THIS SCHOOL (Q9E IS “YES”). OTHERWISE, SKIP TO THE INTRODUCTION TO Q14.

SHOW CARD 4

13. 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.

14. 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 Q20

It is required in specific grades 2 SKIP TO Q16

It is not required 3

15. 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 Q14

No 2 RETURN TO Q5 AND THEN SKIP TO THE INSTRUCTIONS BEFORE Q35

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

K 0

1^st 1

2^nd 2

3^rd 3

4^th 4

5^th 5

6^th 6

7^th 7

8^th 8

9^th 9

10^th 10

11^th 11

12^th 12

ANSWER Q17–Q19 FOR EACH GRADE ABOVE.

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

Weeks

18. 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

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

Minutes

IF Q14 IS 2 ONLY, SKIP TO THE INSTRUCTIONS BEFORE Q35.

20. 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 Q27

21. 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

22. Course 17

Course 18

Course 19

Course 20

ANSWER Q23–26 FOR EACH COURSE LISTED IN Q21 AND Q22.

23. In what grade do students usually take __________________?

K 0

1^st 1

2^nd 2

3^rd 3

4^th 4

5^th 5

6^th 6

7^th 7

8^th 8

9^th 9

10^th 10

11^th 11

12^th 12

No usual grade 13

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

Weeks

25. 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

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

Minutes

27. 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 THE INTRODUCTION TO Q35

28. 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

29. Course 17

Course 18

Course 19

Course 20

30. 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 Q31–Q34 FOR EACH COURSE LISTED IN Q28 AND Q29.

31. In what grade do students usually take __________________?

K 0

1^st 1

2^nd 2

3^rd 3

4^th 4

5^th 5

6^th 6

7^th 7

8^th 8

9^th 9

10^th 10

11^th 11

12^th 12

No usual grade 13

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

Weeks

33. 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

34. 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 Q36.

35. 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

36. 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

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

Yes 1

No 2

ANSWER Q38 FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q39.

SHOW CARD 5

My next question is about who teaches physical education.

38. 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 Q39 FOR MIDDLE AND HIGH SCHOOL ONLY. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q40.

SHOW CARD 6

My next question is about who teaches physical education.

39. 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 Q44. OTHERWISE, CONTINUE WITH Q40.

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

40. 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 Q43

41. 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

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

Yes 1

No 2

My next question is about protective gear.

43. 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.

44. Are staff at your school prohibited or actively discouraged from using physical activity, such as laps or push-ups, to punish students for bad behavior in physical education?

Yes 1

No 2

45. Are staff at your school prohibited or actively discouraged from excluding students from all or part of physical education as punishment for bad behavior in physical education?

Yes 1

No 2

46. Are staff at your school prohibited or actively discouraged from excluding students from all or part of physical education to punish them 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.

47. 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 Q53

IF THIS IS A PRIVATE OR CATHOLIC SCHOOL, SKIP TO Q49

48. 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

49. 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 Q53

50. 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 Q50A IS “YES” AND Q50B IS “NO” AND Q50C IS “NO,” SKIP TO Q52.

IF Q50A IS “NO” AND Q50B IS “NO” AND Q50C IS “NO,” SKIP TO Q53.

IF Q50A IS “NO” AND Q50B IS “YES” AND Q50C IS “NO,” ANSWER Q51 THEN SKIP TO Q53.

SHOW CARD 7

51. 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 Q50A IS “NO” AND Q50B IS “YES” AND Q50C IS “NO,” SKIP TO Q53.

SHOW CARD 8

52. 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.

53. 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.

54. 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.

55. 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 Q54A IS “NO” AND Q55B IS “NO,” SKIP TO THE INTRODUCTION TO Q57.

56. 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.

57. 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 Q58.

10. Playground equipment? 1 2

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

Yes 1

No 2

ANSWER Q59 AND Q60 IF THIS SCHOOL HAS ANY REQUIRED PHYSICAL EDUCATION (Q5 IS “YES”). OTHERWISE, SKIP TO Q61.

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

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

Yes 1

No 2 SKIP TO Q61

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

Students per teacher

61. 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

62. 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

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

Yes 1

No 2

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

64a. 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

64b. What about with health services staff from your school?

Yes 1

No 2

School does not have health services staff 3

64c. 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

64d. 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

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

Yes No

1. Alliance for a Healthier Generation? 1 2

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

3. A local health department? 1 2

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

5. A local college or university? 1 2

6. A local business? 1 2

7. Action for Healthy Kids? 1 2

8. A local parks or recreation department? 1 2

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

10. A local professional sports team? 1 2

11. A local hospital? 1 2

12. A local law enforcement agency? 1 2

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

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

15. A local health or fitness club? 1 2

64. During the past 12 months, has anyone from 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. Provided families of all students with information
   on physical activity? (Do not include information
   on physical education.) 1 2

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

5. Invited families of all students to attend physical
   education classes? 1 2

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

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

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

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

The next question asks whether certain groups have helped develop, communicate, or implement physical education or physical activity policies or activities. Examples of this might include sitting on a committee, presenting to the school board, organizing a fun run, or soliciting or providing donations for physical activity programs.

65. During the past two years, have any of the following groups helped develop, communicate, or implement physical activity policies or activities?

Yes No

1. Students 1 2

2. Students’ families 1 2

3. Community members 1 2

My next questions ask about opportunities that students at your school might have to participate in physical activity clubs and intramural sports programs. By “physical activity clubs” and “intramural sports programs,” 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.

66. Does your school offer opportunities for students to participate in physical activity clubs or intramural sports programs?

Yes 1

No 2 SKIP TO THE INSTRUCTIONS BEFORE Q80

67. Are students provided with information about physical activity clubs or intramural sports programs…

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

68. This card lists different physical activity clubs or intramural sports programs 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

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

12. Golf 1 2

13. Gymnastics 1 2

(Q70 continued)

Yes No

14. Hiking, backpacking, or orienteering 1 2

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

16. Jump rope 1 2

17. Lacrosse 1 2

18. Martial arts 1 2

19. Non-stationary bicycling 1 2

20. Pilates 1 2

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

22. Rock climbing 1 2

23. Running or jogging 1 2

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

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

26. Soccer 1 2

27. Swimming, diving, or water polo 1 2

28. Table tennis or Ping-Pong 1 2

29. Tennis 1 2

30. Volleyball 1 2

31. Walking 1 2

32. Weight training 1 2

33. Wrestling 1 2

34. Yoga 1 2

69. Are any of these physical activity clubs or intramural sports programs offered…

Yes No

1. Only to boys? 1 2

2. Only to girls? 1 2

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

Yes 1

No 2

Physical activity clubs/intramural sports
programs do not meet after school 3

71. Must students pay an activity fee to participate in any physical activity clubs or intramural sports programs?

Yes 1

No 2 SKIP TO Q75

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

Yes 1

No 2

73. Are staff paid to supervise, lead, or coach physical activity clubs or intramural sports programs?

Yes 1

No 2

74. Do community members volunteer to supervise, lead, or coach physical activity clubs or intramural sports programs?

Yes 1

No 2

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

Yes 1

No 2

76. Does your school follow any national, state, or district guidelines for physical activity clubs or intramural sports programs?

Yes 1

No 2

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

Yes 1

No 2

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

ANSWER Q80–Q85 IF THIS SCHOOL HAS ANY INDOOR OR OUTDOOR FACILITIES THAT COULD BE USED FOR PHYSICAL EDUCATION OR ACTIVITY (ANY Q54 OR Q57 IS “YES”). OTHERWISE, SKIP TO Q86.

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, physical activity clubs, or intramural sports programs.

78. 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 Q80 ARE “NO,” SKIP TO Q82. OTHERWISE, CONTINUE WITH Q81.

79. 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

80. 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 Q82 ARE “NO,” SKIP TO Q84. OTHERWISE, CONTINUE WITH Q83.

81. 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

82. 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 Q86

School does not have outdoor
physical activity/athletic facilities 3 SKIP TO Q86

83. 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

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

Yes 1

No 2 SKIP TO Q97

85. Are you this person?

Yes 1

No 2 SKIP TO Q97

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

86. 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

87. Do you coach an interscholastic sport?

Yes 1

No 2

88. Do you have an undergraduate degree?

Yes 1

No 2 SKIP TO Q96

89. 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

90. Did you have an undergraduate minor?

Yes 1

No 2 SKIP TO Q94

91. 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

92. Do you have a graduate degree?

Yes 1

No 2 SKIP TO Q96

93. In what area or areas was your graduate work?
    MARK ALL THAT APPLY

Physical education 1

Health education 2

Other education 3

Kinesiology, exercise physiology, or
exercise science 4

Other (Specify) 5

94. 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

95. 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.

96. 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 51) Athletic trainer

97. 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

15. Riflery 1 2

16. Soccer 1 2

17. Swimming or diving 1 2

18. Tennis 1 2

(Q99 continued)

Yes No

19. Track and field 1 2

20. Volleyball 1 2

21. Water polo 1 2

22. Weight lifting 1 2

23. Wrestling 1 2

IF THIS IS A SINGLE SEX SCHOOL, SKIP TO Q101.

98. Are any of these interscholastic sports offered…

Yes No

1. Only to boys? 1 2

2. Only to girls? 1 2

SHOW CARD 12

99. 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

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

Yes 1

No 2

101. Are coaches at your school prohibited or actively discouraged from using physical activity, such as laps or push-ups, to punish students for poor performance or bad behavior in interscholastic sports?

Yes 1

No 2

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

Yes 1

No 2

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

Yes 1

No 2 SKIP TO Q107

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

Yes 1

No 2

105. 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

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

Almost
Some- Always or
Never Rarely times Always

1. Require physical examination of
   student athletes by a healthcare provider
   before participation? 1 2 3 4

2. Require neurocognitive testing of
   student athletes 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

107. 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

108. 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. Complete a sports safety course? 1 2

6. Be certified in first aid? 1 2

7. Be certified in CPR? 1 2

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

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

109. 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

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

Yes 1

No 2

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

Yes No

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

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

IF Q113A IS “YES” THEN CONTINUE. OTHERWISE, SKIP TO Q115.

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

Yes 1

No 2

113. 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.

Physical Education and Activity School Questionnaire—Public Use Version 0