Form AA Student Program Fidelity 7th Grade Session 1

Form Approved

OMB No. 0920-XXXX

Exp. Date:

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Attachment AA:

Student Program Fidelity 7th Grade Session 1

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

Student Curriculum – 7th Grade, Session 1 – Review

Attendance Log

Implementer Name: _________________________ Implementer ID: ___________________

School ID: ____________________________ Session ID: _________________

Classroom ID:_____________________________ Program Year: ____________________

Please have each student sign initials next to their name to indicate attendance to the session

Student Names (Typed)	Student ID (pre-typed)	Student Initials for Present

S tudent Curriculum – 7th Grade, Session 1 – Review

Implementer Name: _____________________ Implementer ID: ___________________

School ID: ____________________________ Session ID: _________________

Classroom ID:____________________________

Program Year: ____________________ Time lesson began: ___________

Date: __________________________ Time lesson ended: ___________

Please indicate if you completed the following activities:

Activity	Yes	Yes w/ changes	No
Introduced the Dating Matters curriculum			
Explained that the Dating Matters program will continue next year in 8th grade			
Acknowledged that students may or may not be dating and indicated that either is fine			
Distributed Student Handbooks			
Collectively established ground rules			
Made sure the following were included in the ground rules: Be respectful of other people and their feelings. Treat others in the way you would want to be treated—try to imagine yourself in their shoes. If you disagree about something, focus on the ideas that you disagree with, not the person himself/herself. Remember, it is okay to agree to disagree! Everything that is said in the room is confidential. This means you should not repeat what your classmates say outside of this room. If you share a personal story, avoid using the names of teachers, students, or other people.			
Allowed students to brainstorm different terms for “dating,” from casual to serious relationships			
Reinforced that the word “dating” refers to all types of relationships in the Dating Matters program			
Allowed students to brainstorm healthy relationship behaviors			
Allowed students to complete the worksheet in Activity 2			
Read the R.E.S.P.E.C.T. M.E. Rights aloud as a class			
Recapped Session 1			
Previewed the concept of unhealthy and unsafe relationship behaviors for Session 2			

Describe any changes you made to the session activities (please identify which activity you are

describing by number).

Please indicate if you experienced any of these challenges that interfered with implementing today’s session.  Check all that apply.

Not enough time	
I did not have the needed materials	
I was uncomfortable discussing some of the topics	
Students were uncomfortable discussing some of the topics	
Some part of the session was difficult for students (e.g., role plays, reading aloud, worksheets)	
Classroom behavior management issues	
Other more pressing classroom demands	
Other – please specify____________________________________	

Please check the extent to which the students were engaged in today’s lesson on the following measures:

Most students…	Strongly Agree	Agree	Don’t Know	Disagree	Strongly Disagree
Asked relevant questions.					
Suggested solutions to scenario problems.					
Responded correctly to questions.					
Distracted other students.					
Participated extensively in discussions.					
Discouraged other students from participating.					

Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.

1. How well do you think the students understood the session material?

1  Not at all

2  A little

3  A lot

4  Completely

2. How well did the session material fit into the allotted time period?

1 Session was too packed/not enough time to complete all activities

2 Session was somewhat packed/able to complete most but not all

3 Session was just right

4 Not enough material/session ended before class period completed