District Physical Education and Activity

Physical Education Coordinator

Form Approved

OMB No: 0920-0445

Expiration Date: xx/xxx/xxxx

Physical Education and Activity
District Questionnaire

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Public reporting burden for this collection of information is estimated to average 40 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, Mailstop D-74, Atlanta, GA 30333; Attention PRA (0920-0445).

Physical Education and Activity
District Questionnaire

Questions

MODULE 1

Standards 1–4

MODULE 2

Elementary School Instruction 5–28

MODULE 3

Middle School Instruction 29–49

MODULE 4

High School Instruction 50–70

MODULE 5

Students with Disabilities 71

Use of Protective Gear 72

Physical Activity and Discipline 73–76

Staffing and Professional Development 77–79

Collaboration and Promotion 80–82

Evaluation 83–84

Interscholastic Sports 85–91

MODULE 6

Physical Education Coordinator 92–100

THIS QUESTIONNAIRE WILL BE ADMINISTERED USING WEB-BASED INTERVIEW TECHNOLOGY. AS THE RESPONDENT TYPES RESPONSES TO THE QUESTIONS INTO THEIR COMPUTER, THE INTERVIEW PROGRAM WILL 1) DISPLAY THE CORRECT TENSE OF VERBS, 2) PROVIDE ALTERNATE ANSWERS TO QUESTIONS (E.G., NOT APPLICABLE, “I DON’T KNOW”), 3) NAVIGATE COMPLEX SKIP PATTERNS, AND 4) PERFORM OTHER USEFUL FUNCTIONS. COMMENTS APPEARING IN THE MARGIN REPRESENT ADDITIONAL CLARIFICATION ON THE QUESTION OR THE SPECIFIC TERMINOLOGY USED. THIS TEXT WILL APPEAR ON-SCREEN UNDER THE MAIN QUESTION TEXT. THE PROGRAMMING SPECIFICATIONS FOR THE INTERVIEW ARE NOT INCLUDED IN THIS PRINTED VERSION OF THE QUESTIONNAIRE.

1. This questionnaire focuses on your district’s policies and practices regarding physical education.

2. For the purposes of this questionnaire, “policy” means any law, rule, regulation, administrative order, or similar kind of mandate issued by the local school board or other local agency with authority over schools in your district. SHPPS is most interested in what is required by the district, not what is recommended or contained in non-binding guidance documents, unless the question specifically asks about recommendations.

3. For the purposes of this questionnaire, “adopted a policy” means either that the district has its own policy or that the district follows a policy established at the state level, including any law, rule, regulation, administrative order, or similar kind of mandate.

4. If a district policy is worded in such a way that it requires schools to develop and adopt their own policies on a given topic, for the purposes of this questionnaire please consider it the same as a district-wide requirement.

5. Districts may sometimes grant policy exceptions or waivers, but please answer each question based on what is considered the general policy and standard practice in your district.

6. Please do not consider school practices or policies when answering the questions. This information is gathered during data collection from schools across the country.

7. Please do not include policies that are solely related to instruction on physical activity topics provided within health education curricula.

8. Unless the question specifically asks about regularly scheduled recess periods, do not include recess periods when answering questions about physical education.

9. For the purposes of this questionnaire, “elementary school” refers to a school that contains any of grades K–5. “Middle school” refers to a school that contains any of grades 6–8. Some jurisdictions may refer to these schools as “junior high schools.” “High school” refers to a school that contains any of grades 10–12. Some jurisdictions may refer to these schools as “senior high schools.”

The first questions ask about physical education standards adopted or used by your district. These standards might cover student expectations and performance outcomes for physical education.

1. Has your district adopted a policy stating that schools will follow any national, state, or district physical education standards?

Yes 1 SKIP TO Q3

No 2

2. Has your district adopted a policy encouraging schools to follow any national, state, or district physical education standards?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q5

3. Are these physical education standards based on the National Standards for Physical Education from the National Association for Sport and Physical Education (NASPE)?

Yes 1

No 2

4. Has your district adopted a policy requiring schools to assess student achievement of the physical education standards used by your district?

Yes 1

No 2

The next questions ask about elementary school instruction.

5. Does your district follow standards for elementary school physical education?

Yes 1

No 2 SKIP TO Q7

6. Do the standards followed by your district for elementary school 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

7. Has your district adopted a policy stating that elementary schools will teach physical education?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q13

8. Districts use many ways to describe how much physical education students are required to receive while in elementary school. For example, districts might describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for physical education at the elementary school level?

Yes 1

No 2

9. Has your district adopted a policy describing reasons that elementary school students may be exempted from physical education?

Yes 1

No 2 SKIP TO Q11

10. Has your district adopted a policy stating that elementary school students can be exempted from physical education requirements for one grading period or longer for…

Yes No

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

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

6. Participation in community sports activities? 1 2

7. Participation in community service activities? 1 2

11. Has your district adopted a policy prohibiting exemptions from physical education requirements for one grading period or longer for elementary school students?

Yes 1

No 2

12. Has your district adopted a policy stating that elementary school students can 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

The next questions ask about the curriculum used by elementary schools for physical education. For the purposes of these questions, “curriculum” means a detailed set of lessons, directions, strategies, and materials to facilitate student learning and teaching of content.

13. Does your district require or recommend that schools use one particular curriculum for elementary school physical education?

Require 1

Recommend 2

Neither 3 SKIP TO THE INTRODUCTION TO Q15

14. Who developed that curriculum?
    MARK ALL THAT APPLY

State education agency 1

Other state agency 2

School district 3

Commercial company 4

College or university 5

National or state-level health organization,
such as the American Heart Association
or the American Cancer Society 6

Other 7

The next questions ask about resources that your district might have provided for elementary school physical education.

15. During the past two years, has your district provided…

Yes No

1. A list of one or more recommended elementary school
   physical education curricula? 1 2

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

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

16. Has your district ever used a curriculum analysis tool such as the Physical Education Curriculum Analysis Tool (PECAT) to assess one or more physical education curricula for elementary schools?

Yes 1

No 2

The next questions ask about elementary school student assessment that your district requires or recommends.

17a. Does your district require or recommend that elementary schools give written tests of students’ knowledge related to physical education?

Require 1

Recommend 2

Neither 3

17b. Does your district require or recommend that elementary schools give skill performance tests related to physical education?

Require 1

Recommend 2

Neither 3

18. Does your district require or recommend that elementary schools assess students’ physical activity levels, such as through the use of physical activity logs or pedometers?

Require 1

Recommend 2

Neither 3

17. Does your district require or recommend that elementary schools test students’ fitness levels?

Require 1

Recommend 2

Neither 3 SKIP TO THE INTRODUCTION TO Q22

The next questions ask about specific fitness tests.

18. Does your district require or recommend that elementary schools use…

Require Recommend Neither

1. Fitnessgram? 1 2 3

2. The Physical Fitness Test, from the
   President’s Challenge? 1 2 3

3. Any other fitness test? (Specify) 1 2 3

19. Are elementary schools in your district required to submit students’ fitness test results to the state or district?

Yes 1

No 2

The next questions ask about staffing for elementary school physical education in your district.

20. Has your district adopted a policy specifying a maximum student-to-teacher ratio for physical education in elementary school?

Yes 1

No 2

21. Has your district adopted a policy stating that newly hired staff who teach physical education at the elementary school level will have undergraduate or graduate training in physical education or a related field?

Yes 1

No 2

22. Has your district adopted a policy stating that newly hired staff who teach physical education at the elementary school level will be certified, licensed, or endorsed by the state to teach physical education?

Yes 1

No 2

State does not offer certification, licensure, or
endorsement to teach physical education
at the elementary school level 3

The next questions ask about elementary school recess and physical activity breaks.

23. Does your district require or recommend that elementary schools provide students with regularly scheduled recess?

Require 1

Recommend 2

Neither 3 SKIP TO Q27

24. How many minutes per day of recess are required or recommended for elementary school students?

Less than 10 minutes per day 1

10 to 19 minutes per day 2

20 to 29 minutes per day 3

30 or more minutes per day 4

No specified time requirements or
recommendations 5

25. Does your district require or recommend that elementary schools provide regular physical activity breaks, outside of physical education class and recess, during the school day?

Require 1

Recommend 2

Neither 3

The next question asks about excluding students from recess as punishment for bad behavior.

26. Does your district prohibit or actively discourage elementary schools from excluding students from all or part of recess as punishment for bad behavior or failure to complete class work?

Yes 1

No 2

The next questions ask about middle school instruction.

27. Does your district follow standards for middle school physical education?

Yes 1

No 2 SKIP TO Q31

28. Do the standards followed by your district for middle school 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 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

29. Has your district adopted a policy stating that middle schools will teach physical education?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q37

30. Districts use many ways to describe how much physical education students are required to receive while in middle school. For example, districts might describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for physical education at the middle school level?

Yes 1

No 2

31. Has your district adopted a policy describing reasons that middle school students may be exempted from physical education?

Yes 1

No 2 SKIP TO Q35

32. Has your district adopted a policy stating that middle school students can be exempted from physical education requirements for one grading period or longer for…

Yes No

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

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

6. Participation in community sports activities? 1 2

7. Participation in community service activities? 1 2

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

9. Participation in school sports? 1 2

10. Participation in vocational training? 1 2

33. Has your district adopted a policy prohibiting exemptions from physical education requirements for one grading period or longer for middle school students?

Yes 1

No 2

34. Has your district adopted a policy stating that middle school students can 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

The next questions ask about the curriculum used by middle schools for physical education. For the purposes of these questions, “curriculum” means a detailed set of lessons, directions, strategies, and materials to facilitate student learning and teaching of content.

35. Does your district require or recommend that schools use one particular curriculum for middle school physical education?

Require 1

Recommend 2

Neither 3 SKIP TO THE INTRODUCTION TO Q39

36. Who developed that curriculum?
    MARK ALL THAT APPLY

State education agency 1

Other state agency 2

School district 3

Commercial company 4

College or university 5

National or state-level health organization,
such as the American Heart Association
or the American Cancer Society 6

Other 7

The next questions ask about resources that your district may have provided for middle school physical education.

37. During the past two years, has your district provided…

Yes No

1. A list of one or more recommended middle school
   physical education curricula? 1 2

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

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

38. Has your district ever used a curriculum analysis tool such as the Physical Education Curriculum Analysis Tool (PECAT) to assess one or more physical education curricula for middle schools?

Yes 1

No 2

The next questions ask about middle school student assessment that is required or recommended by your district.

41a. Does your district require or recommend that middle schools give written tests of students’ knowledge related to physical education?

Require 1

Recommend 2

Neither 3

41b. Does your district require or recommend that middle schools give skill performance tests related to physical education?

Require 1

Recommend 2

Neither 3

42. Does your district require or recommend that middle schools assess students’ physical activity levels, such as through the use of physical activity logs or pedometers?

Require 1

Recommend 2

Neither 3

39. Does your district require or recommend that middle schools test students’ fitness levels?

Require 1

Recommend 2

Neither 3 SKIP TO THE INTRODUCTION TO Q46

The next questions ask about specific fitness tests.

40. Does your district require or recommend that middle schools use…

Require Recommend Neither

1. Fitnessgram? 1 2 3

2. The Physical Fitness Test, from the
   President’s Challenge? 1 2 3

3. Any other fitness test? (Specify) 1 2 3

41. Are middle schools in your district required to submit students’ fitness test results to the state or district?

Yes 1

No 2

The next questions ask about staffing for middle school physical education in your district.

42. Has your district adopted a policy specifying a maximum student-to-teacher ratio for physical education in middle school?

Yes 1

No 2

43. Has your district adopted a policy stating that newly hired staff who teach physical education at the middle school level will have undergraduate or graduate training in physical education or a related field?

Yes 1

No 2

44. Has your district adopted a policy stating that newly hired staff who teach physical education at the middle school level will be certified, licensed, or endorsed by the state to teach physical education?

Yes 1

No 2

State does not offer certification, licensure, or
endorsement to teach physical education
at the middle school level 3

The next question asks about middle school physical activity breaks.

45. Does your district require or recommend that middle schools provide regular physical activity breaks, outside of physical education class, during the school day?

Require 1

Recommend 2

Neither 3

The next questions ask about high school instruction.

46. Does your district follow standards for high school physical education?

Yes 1

No 2 SKIP TO Q52

47. Do the standards followed by your district for high school 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

48. Has your district adopted a policy stating that high schools will teach physical education?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q58

49. Districts use many ways to describe how much physical education students are required to receive while in high school. For example, districts might describe these requirements in terms of minutes per week, hours per quarter, or hours per year. In your district, are there specified time requirements for physical education at the high school level?

Yes 1

No 2

50. Has your district adopted a policy describing reasons that high school students may be exempted from physical education?

Yes 1

No 2 SKIP TO Q56

51. Has your district adopted a policy stating that high school students can be exempted from physical education requirements for one grading period or longer for…

Yes No

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

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

6. Participation in community sports activities? 1 2

7. Participation in community service activities? 1 2

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

9. Participation in school sports? 1 2

10. Participation in vocational training? 1 2

52. Has your district adopted a policy prohibiting exemptions from physical education requirements for one grading period or longer for high school students?

Yes 1

No 2

53. Has your district adopted a policy stating that high school students can 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

The next questions ask about the curriculum used by high schools for physical education. For the purposes of these questions, “curriculum” means a detailed set of lessons, directions, strategies, and materials to facilitate student learning and teaching of content.

54. Does your district require or recommend that schools use one particular curriculum for high school physical education?

Require 1

Recommend 2

Neither 3 SKIP TO THE INTRODUCTION TO Q60

55. Who developed that curriculum?
    MARK ALL THAT APPLY

State education agency 1

Other state agency 2

School district 3

Commercial company 4

College or university 5

National or state-level health organization,
such as the American Heart Association
or the American Cancer Society 6

Other 7

The next questions ask about resources that your district may have provided for high school physical education.

56. During the past two years, has your district provided…

Yes No

1. A list of one or more recommended high school
   physical education curricula? 1 2

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

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

57. Has your district ever used a curriculum analysis tool such as the Physical Education Curriculum Analysis Tool (PECAT) to assess one or more physical education curricula for high schools?

Yes 1

No 2

The next questions ask about high school student assessment that is required or recommended by your district.

62a. Does your district require or recommend that high schools give written tests of students’ knowledge related to physical education?

Require 1

Recommend 2

Neither 3

62b. Does your district require or recommend that high schools give skill performance tests related to physical education?

Require 1

Recommend 2

Neither 3

63. Does your district require or recommend that high schools assess students’ physical activity levels, such as through the use of physical activity logs or pedometers?

Require 1

Recommend 2

Neither 3

58. Does your district require or recommend that high schools test students’ fitness levels?

Require 1

Recommend 2

Neither 3 SKIP TO THE INTRODUCTION TO Q67

The next questions ask about specific fitness tests.

59. Does your district require or recommend that high schools use…

Require Recommend Neither

1. Fitnessgram? 1 2 3

2. The Physical Fitness Test, from the
   President’s Challenge? 1 2 3

3. Any other fitness test? (Specify) 1 2 3

60. Are high schools in your district required to submit students’ fitness test results to the state or district?

Yes 1

No 2

The next questions ask about staffing for high school physical education in your district.

61. Has your district adopted a policy specifying a maximum student-to-teacher ratio for physical education in high school?

Yes 1

No 2

62. Has your district adopted a policy stating that newly hired staff who teach physical education at the high school level will have undergraduate or graduate training in physical education or a related field?

Yes 1

No 2

63. Has your district adopted a policy stating that newly hired staff who teach physical education at the high school level will be certified, licensed, or endorsed by the state to teach physical education?

Yes 1

No 2

State does not offer certification, licensure, or
endorsement to teach physical education
at the high school level 3

The next question asks about high school physical activity breaks.

64. Does your district require or recommend that high schools provide regular physical activity breaks, outside of physical education class, during the school day?

Require 1

Recommend 2

Neither 3

The next questions ask about physical education for students with long-term physical, medical, or cognitive disabilities, such as Down syndrome or conditions that require permanent use of a wheelchair.

65. Based on policies adopted by your district, are schools required to meet the physical education needs of students with long-term physical, medical, or cognitive disabilities by…

Yes No

1. Providing adapted physical education as appropriate? 1 2

2. Mainstreaming into regular physical education
   as appropriate? 1 2

3. Using modified equipment or facilities in regular
   physical education? 1 2

4. Using teaching assistants in regular physical education? 1 2

5. Including physical education in 504 plans or
   Individualized Education Programs (IEPs)? 1 2

6. Using modified instructional strategies? 1 2

7. Using modified assessment? 1 2

The next question is about your district’s policies on the use of protective gear.

66. Has your district adopted a policy requiring that students wear appropriate protective gear…

Yes No

1. During physical education? 1 2

2. When engaged in physical activity clubs or
   intramural sports? 1 2

3. When engaged in interscholastic sports? 1 2

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

67. Does your district prohibit or actively discourage schools from using physical activity, such as laps or push-ups, to punish students for bad behavior in physical education?

Yes 1

No 2

68. Does your district prohibit or actively discourage schools from using physical activity to punish students for poor performance or bad behavior in interscholastic sports?

Yes 1

No 2

69. Does your district prohibit or actively discourage schools 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

70. Does your district prohibit or actively discourage schools from excluding students from all or part of physical education to punish students for bad behavior in physical education?

Yes 1

No 2

The next questions ask about staffing and professional development in your district.

71. Has your district adopted a policy stating that those who teach physical education are required to earn continuing education credits on physical education topics or instructional strategies?

Yes 1

No 2

72. Has your district adopted a policy stating that each school will have someone to oversee or coordinate physical education at the school, for example a department chair?

Yes 1

No 2

The next questions are about professional development for those who teach physical education. This might include workshops, conferences, continuing education, graduate courses, or any other kind of in-service.

73. During the past two years, has your district provided funding for or offered professional development to those who teach physical education on…

Yes No

1. Methods to increase the amount of class time students
   are engaged in moderate-to-vigorous physical activity? 1 2

2. Methods to promote gender equity in physical education
   and sports? 1 2

3. Using technology such as computers or video cameras
   for physical education? 1 2

4. Using physical activity monitoring devices, such as
   pedometers or heart rate monitors for physical education? 1 2

5. Encouraging family involvement in physical activity? 1 2

6. Administering or using fitness tests? 1 2

7. Helping students develop individualized physical
   activity plans? 1 2

8. Injury prevention and first aid? 1 2

9. How to prevent, recognize, and respond to concussions
   among students? 1 2

10. Teaching physical education to students with long-term
    physical, medical, or cognitive disabilities? 1 2

(Q79 continued)

Yes No

11. Teaching individual or paired activities or sports? 1 2

12. Teaching team or group activities or sports? 1 2

13. Teaching movement skills and concepts? 1 2

14. Assessing or evaluating student performance in
    physical education? 1 2

15. Developing and using student portfolios for
    physical education? 1 2

16. Teaching methods to promote inclusion and active
    participation of overweight and obese children during
    physical education? 1 2

17. Chronic health conditions, for example asthma or
    diabetes, including recognizing and responding to
    severe symptoms or reducing triggers? 1 2

18. Methods for developing, implementing, and evaluating
    physical activity clubs or intramural sports programs? 1 2

19. Developing, implementing, and evaluating
    a comprehensive school physical activity program? 1 2

20. Establishing walking or biking to school programs? 1 2

21. Assessing student weight status using body mass index
    (BMI), skinfolds, or bioelectric impedance? 1 2

22. Aligning physical education standards to curriculum,
    instruction, or student assessment? 1 2

23. Teaching online or distance education courses? 1 2

24. Using the Physical Education Curriculum Analysis Tool
    (PECAT) to help assess physical education curricula? 1 2

25. Using data to plan or evaluate physical education
    policies or practices? 1 2

26. Helping classroom teachers integrate physical activity
    into their classrooms? 1 2

The next questions ask about collaboration with other district-level staff and outside organizations.

74. During the past 12 months, have district-level physical education staff worked on physical education activities with district-level…

No district-
level staff
Yes No in this area

1. Health education staff? 1 2 3

2. Health services staff? 1 2 3

3. Mental health or social services staff? 1 2 3

4. Nutrition or food service staff? 1 2 3

5. General curriculum coordinators or
   supervisors? 1 2 3

75. During the past 12 months, have district-level 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

76. During the past 12 months, has anyone from your district…

Yes No

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

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

3. Provided district or school personnel—for example,
   classroom teachers, administrators, or school board
   members—with information on school
   physical education? 1 2

4. Sought positive media attention for physical education? 1 2

5. Provided awards or recognition for outstanding
   implementation of physical activity programs, such as
   physical activity clubs or intramural sports programs? 1 2

The next questions ask about different aspects of school physical education that might have been evaluated during the past two years.

77. During the past two years, have the following aspects of physical education in your district been evaluated?

Yes No N/A

1. Physical education policies 1 2 3

2. Physical education curricula 1 2 3

3. Physical education professional
   development or in-service programs 1 2 3

4. Physical education teachers 1 2 3

78. Does your district require schools to report each of the following types of information?

Yes No

1. Number of minutes of physical education required
   in each grade 1 2

2. Number of minutes of elementary school recess 1 2

3. Number of minutes of classroom physical activity breaks 1 2

The next questions ask about interscholastic sports in your district.

79. Has your district adopted a policy stating that head coaches of interscholastic sports will…

Yes No

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

2. Have previous coaching experience in the sport(s)
   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 cardiopulmonary resuscitation (CPR)? 1 2

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

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

80. Has your district adopted a policy stating that assistant coaches or volunteer athletic aides will complete a training course?

Yes 1

No 2

Schools in this district do not have assistant
coaches/volunteer athletic aides 3

81. During the past two years, has your district provided any funding for or offered professional development to coaches of interscholastic sports?

Yes 1

No 2

82. Has your district adopted a policy requiring that student athletes suspected of having a concussion be removed immediately from practice or competition?

Yes 1

No 2

83. Has your district adopted a policy requiring clearance by a healthcare provider before allowing student athletes to further participate in practice or competition after a suspected concussion?

Yes 1

No 2

84. Has your district adopted a policy requiring schools to conduct neurocognitive testing of student athletes before participation in interscholastic sports?

Yes 1

No 2

85. During the past 12 months, has your district…

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

86. Currently, does someone in your district oversee or coordinate physical education?

Yes 1

No 2 That is the last question. Thank you very much for taking the time to complete this questionnaire.

87. Are you this person?

Yes 1

No 2 That is the last question. Thank you very much for taking the time to complete this questionnaire.

The last few questions ask about your educational background.

88. Do you have an undergraduate degree?

Yes 1

No 2 SKIP TO Q100

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 Q98

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 Q100

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. Are you certified, licensed, or endorsed by the state to teach physical education at the…

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

1. Elementary school level? 1 2 3

2. Middle school level? 1 2 3

3. High school level? 1 2 3

Thank you very much for taking the time to participate in this study.

If you would like more information about this study or would like clarification of any questions in this questionnaire, please call 800-287-1815.

Physical Education and Activity District Questionnaire—Public Use Version 0