Water Toolkit Att C

Attachment C: Assessment Instrument (Word Version)

Form approved

OMB No. 0920-0879

Expiration date: 04/30/2017

Welcome!

We are seeking feedback from state health department and education staff about their familiarity with and intended use of the Increasing Access to Drinking Water in Schools toolkit that was recently developed by the Centers for Disease Control and Prevention’s School Health Branch (CDC/SHB). This data collection is intended for State Health Department or Education Department staff only.

We are seeking your input given the role you play in coordinating statewide activities to support opportunities for healthy eating and physical activity in schools as part of State Public Health Actions/1305. Your feedback will inform our dissemination approach and will help us improve the resources we make available to help support students’ access to healthy school nutrition environments. Completing this online assessment is voluntary and takes approximately 12 minutes.

Please complete the questionnaire by [September date], 2014.

As you go through the questionnaire, please respond to the questions from your individual perspective and not that of your department as a whole, unless otherwise indicated. It is recommended that you finish the data collection in one session, but you have the option to save responses and resume later. Partially completed responses can be saved by closing your browser, and restarted by clicking on the link to the questionnaire for up to 3 weeks after you initially begin.

Your privacy is very important to us. The CDC will not publish or share any identifying information about individual respondents with CDC or any partner organizations etc. Data will only be presented in aggregate. There are no known risks or direct benefits to you from participating or choosing not to participate in this assessment, but your answers will help the CDC tailor content and communications channels to improve their relevance to state departments of public health and education looking to support accessible drinking water in schools.

If you have questions or feedback about this assessment, please contact Sarah Sliwa at [email protected].

To begin, please click next.

Public reporting burden of this collection of information is estimated to average 12 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, MS D-74, Atlanta, Georgia 30333: ATTN: PRA (0920-0879).

 

1. Do you work in a state, tribal, or territorial health department or the department of education/department of public instruction?

• No [END DATA COLLECTION—SENDS TO THANK YOU PAGE]

• Yes.

2. At which department do you work?

• Department of Health

• Department of Education/Department of Public Instruction

3. For your state’s work on State Public Health Actions/1305, which agency works directly with the local education agencies (LEAs)?

• Department of Health

• Department of Education/Department of Public Instruction

4. Which of the following best describes efforts around water access in the LEAs you work with as part of 1305?

• Through a contract or MOU between the Department of Public Health and Department of Education/Department of Public Instruction, the DOE/DPI does 100% of the school health related work plan activities.

• Through a contract or MOU between the Department of Public Health and Department

of Education/Department of Public Instruction, the two departments partner to complete the school health related work plan activities.

• The State Dept. of Health has a designated School Health contact who does 100% of the school health related work plan activities directly with our targeted LEAs.

• The State Dept. of Health has a designated School Health contact who primarily works indirectly with LEAs through partnerships and subcontracts.

5. As part of the Healthy Hunger-Free Kids Act (HHFKA), schools participating in the National School Lunch and School Breakfast programs are required to make plain drinking water available in the cafeteria at no cost during school meal times.

Beyond this requirement, some LEAs are taking actions to make plain drinking water more accessible to students throughout the school day (e.g., allowing water bottles in classrooms, updating water fountains).

• Our efforts are focused on meeting the HHFKA requirements around drinking water. (skip to Q7)

  

• We are working with some LEAs on efforts to increase access to drinking water throughout the school day.

• I am not sure how we are working with LEAs around promoting students’ access to drinking water. (skip to Q7)

6. For middle option only] How many LEAs are working on this strategy?

• 1-5

• 6-10

• 11-15

• 16-30

• 31-45

• 46-60

• 61-75

• 76-100

• >100

7. Please indicate whether you have seen, heard of, read and/or used the CDC Water Access in Schools Toolkit (“Water Toolkit”)

The CDC Water Access in Schools Toolkit outlines steps schools can take to meet federal requirements for drinking water during the meal periods, and to make drinking water available and accessible across the school campus.

Yes

No [SKIP TO QUESTION 20]

How did you hear about the “Water Toolkit”?	Select all that apply
CDC Project Officer
Colleague at the state health department in my state.
Colleague within another state or territorial health department.
Colleague within a local or tribal health department in my state or territory.
Colleague at my state’s department of education.
Colleague at another state department of education
Colleague within a local or tribal department of education
Colleague at a partner organization that contributes to school based activities for 1305
School Administrators (Principals, Superintendents)
School Staff (teachers, coaches)
Parent Organizations (PTA)
Social Media
CDC website
Website, Other
Email-blast, listserv, or e-newsletter
Webinar
Other:_________________________________

9. If you mentioned that you heard about the toolkit through a website, please specify which website/s.

• Did not see toolkit on a website

• Please specify which webinar/s:______________________________

10. If you mentioned that you heard about the toolkit through email-blast, list-serv, or e-newsletter, please specify which one/s.

• Did not hear about the toolkit through an email-blast/list-serv/e-newsletter

• Please specify which listserv etc.:______________________________

11. If you mentioned that you heard about the toolkit through a webinar, please specify which webinar/s.

• Did not hear about toolkit through a webinar

• Please specify which webinar/s:______________________________

In the past 6 months, with which of the following people have you sent/shared, recommended or mentioned the “Water Toolkit”:	Select all that apply
Colleague at the state health department where I work.
Colleague within another state or territorial health department.
Colleague within a local or tribal health department in my state.
Colleague at the state department of education.
Colleague at another state department of education
Colleague within a local department of education
Colleague in a partner organization that contributes to school based activities for 1305
School Administrators (Principals, Superintendents)
School Staff (teachers, coaches)
Parent Organizations (PTA)
A list-serv I subscribe to
I have not sent the product to anyone.
Other dissemination channels____________

Intended Use

The “Water Toolkit” outlines a step by step process that includes a needs assessment, the development and implementation of a School Water Access Plan, and suggestions for evaluation questions.

Please indicate your plans over the next 12 months to engage in the following steps related to the Water Toolkit? Select only 1 answer for each question	I have already done this	I plan to do this in the next 3 months (Sept, 2014-Dec 2014)	I plan to do this in the next 6 months (Sept, 2014 -May/June 2015)	I plan to do this in the next 12 months (September 2014-September 2015)	I do not plan to do this
Read the “Water Toolkit”
Disseminate the toolkit to colleagues and potential users
Coordinate/offer trainings to LEAs and/or partner organizations on the “Water Toolkit”
Work with LEAS/schools in LEAs to assemble teams interested in promoting access to water
Work with LEAS/schools in LEAs to review state, district, and school policies and practices around water access
Work with LEAS/schools in LEAs to review federal, state and local water testing requirements and recommendations
Work with LEAS/schools in LEAs to conduct a needs assessment to learn more about current school water environment
Work with LEAS/schools in LEAs to assess students’ and other stakeholders’ (e.g., school administrators, staff, health agency representatives, and families) perceptions about current drinking water and about providing drinking water in the school
Work with LEAS/schools in LEAs to identify key water champions
Work with LEAS/schools in LEAs to develop a school water access plan
Work with LEAS/schools in LEAs to implement a school water access plan
Work with LEAS/schools in LEAs to develop water promotion strategies
Work with LEAS/schools in LEAs to evaluate progress in access to drinking water
Other:_____________

The “Water Toolkit” outlines a step-by-step process for addressing water access in schools. It also includes appendixes/checklists/and planning questions to help identifying areas to prioritize.

To what extent do you agree with these statements?

14. “This framework helped advance our efforts to increase students’ access to water in schools.”

1. Haven’t read it yet [Skip to 16]

2. Disagree strongly

3. Disagree somewhat [Skip to 16]

4. Agree somewhat [Skip to 16]

5. Agree strongly [Skip to 16]

15. Follow up only if to 14 response= 2

“You indicated that the step-by-step process was not a very useful framework. How would you suggest we could improve this process?

16. ”The checklists and planning questions helped us to identify areas to prioritize.

1. Haven’t read it yet [Skip to 18]

2. Disagree strongly

3. Disagree somewhat [Skip to 18]

4. Agree somewhat [Skip to 18]

5. Agree strongly [Skip to 18]

17. Follow up if response to 16= 2

“You indicated that the appendixes/checklists/planning questions were not useful in prioritizing actions. How would you suggest we could improve this section?

18. What do you like the most about the “Water Toolkit”

• Overview of policies related to water

• Needs assessment checklist

• Planning questions

• Evaluation questions

• Stakeholder interview guide

• Strategies to overcome challenges

• Water testing diagram

• It’s too soon to tell

• Other ______________

19. If you have suggestions for making the “Water Toolkit” more useful for you, including any content or resources you’d like to see addressed, please enter them here.

20. With whom are you partnering/working with on efforts to increase students’ access to water in schools

20. What other tools or resources have you accessed to help you in your work to increase students’ access to water in schools?

• None

• Drink Up

• Rethink Your Drink

• Take Back the Tap

• Water Works: A Guide to Improving Water Access and Consumption in Schools to improve Health and Support Learning

• Keep It Flowing: A Practical Guide to School Drinking Water Planning, Maintenance & Repair

• Prevention Research Center/Harvard School of Public Health Water Access Audit Tool

• Other:____________________

20. What other resources, training/professional development, and/or technical assistance would help you in your work to increase students’ access to water in schools?

Thank you for taking time to complete this questionnaire!

Your responses will help CDC to improve the usefulness of its products to increase access to water in schools.

To learn more about the CDC Water Access in Schools Toolkit, please visit www.cdc.gov/healthyyouth/npao/pdf/Water_Access_in_Schools.pdf