SEA Safe and Supportive Environment Measures

Form Approved

OMB No: 0920-XXXX

Exp. Date: XX/XX/XXXX

“Promoting Adolescent Health through School-Based HIV/STD Prevention”

Att. 4a

SEA SSE Items

Public reporting burden of this collection of information is estimated to average 60 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: OMB-PRA (0920-New)

SEA Evaluation Measures

SEA SSE Evaluation Measures

Evaluation Measures

Questions for Collection of Evaluation Measures

SSE Performance Measure 1: % of priority districts that prevent bullying and sexual harassment, including electronic aggression

Currently, does [PRIORITY DISTRICT NAME] recommend or require schools do each of the following? (Mark yes or no for each item.)

Designate a staff member to whom students can confidentially report student bullying and sexual harassment, including electronic aggression.	Yes ⃝ No ⃝
Use electronic (e.g., e-mails, district web site), paper (e.g., flyers, postcards), or oral (e.g., phone calls, parent seminars) communication to publicize and disseminate policies, rules, or regulations on bullying and sexual harassment, including electronic aggression.	Yes ⃝ No ⃝
Provide information and resources to parents on preventing student bullying and sexual harassment, including electronic aggression.	Yes ⃝ No ⃝

SSE Performance Measure 2: % of priority districts that promote school connectedness strategies

Currently, does [PRIORITY DISTRICT NAME] recommend or require schools do each of the following? (Mark yes or no for each item.)

Provide a program in which family or community members serve as role models to students or mentor students, such as the Big Brothers Big Sisters program.	Yes ⃝ No ⃝
Provide service-learning opportunities for students.	Yes ⃝ No ⃝
Provide peer tutoring opportunities for students.	Yes ⃝ No ⃝
Have clubs and other activities that give students opportunities to learn about people different from them, such as students with disabilities, homeless youth, or people from different cultures.	Yes ⃝ No ⃝
Have a student-led club that aims to create a safe, welcoming, and accepting school environment for all youth, regardless of sexual orientation or gender identity. (These clubs sometimes are called gay/straight alliances.)	Yes ⃝ No ⃝
Provide school staff with materials on classroom management techniques (e.g., social skills training, environmental modification, conflict resolution and mediation, and behavior management.)	Yes ⃝ No ⃝

SSE Performance Measure 3: % of priority districts that promote parent engagement strategies

Currently, does [PRIORITY DISTRICT NAME] recommend or require schools do each of the following? (Mark yes or no for each item.)

Give students homework assignments or health education activities to do at home with their parents.	Yes ⃝ No ⃝
Use electronic (e.g., e-mails, school website), paper (e.g., flyers, postcards), or oral (e.g., phone calls, parent seminars) communication to inform parents about school health services and programs.	Yes ⃝ No ⃝
Have students’ families help develop or implement policies and programs related to school health.	Yes ⃝ No ⃝
Provide parents with information about how to communicate with their child about sex.	Yes ⃝ No ⃝
Provide parents with information about how to monitor their child (e.g., setting parental expectations, keeping track of their child, responding when their child breaks the rules).	Yes ⃝ No ⃝
Involve parents as school volunteers in the delivery of health education activities and services.	Yes ⃝ No ⃝
Link parents and families to health services and programs in the community.	Yes ⃝ No ⃝

SSE Process Measure 1:

Funded SEA has assessed its SSE-related policies, codes, and regulations

In the past six months, did you complete each of the following actions regarding the assessment of state-level SSE-related policies (including, laws, codes, or regulations)? (Mark yes or no for each item.)

Identified policies that guide SSE work.	Yes ⃝ No ⃝
Documented any gaps in SSE policies as compared with the School Level Impact Measures (ESHE SLIM 1-4).	Yes ⃝ No ⃝
Collaborated with SEA leadership and staff to prioritize actions for addressing any identified gaps in SSE policies.	Yes ⃝ No ⃝

SSE Process Measure 2:

% of priority districts that have assessed their SSE-related policies

In the past six months, did [PRIORITY DISTRICT NAME] complete each of the following actions regarding the assessment of SSE-related policies (including, laws, codes, or regulations)? (Mark yes or no for each item.)

Identified policies that guide SSE education work.	Yes ⃝ No ⃝
Determined whether SSE policies are aligned with state policies, codes, laws, and regulations.	Yes ⃝ No ⃝
Documented gaps in SSE policies as compared with the School Level Impact Measures (SSE SLIM 1-3).	Yes ⃝ No ⃝
Collaborated with district leadership and staff to prioritize actions for addressing identified gaps in SSE policies.	Yes ⃝ No ⃝

SSE Process Measure 3: Funded SEA has monitored the implementation of its SSE-related policies in priority districts

In the past six months, did you complete each of the following actions regarding the monitoring of priority district implementation of state-level SSE-related policies (including, laws, codes, or regulations)? (Mark yes or no for each item.)

Developed or maintained a list of priority districts’ current SSE policies.	Yes ⃝ No ⃝
Reviewed priority districts’ SSE policy guidance to ensure alignment with state law, state education agency policy, and district policy.	Yes ⃝ No ⃝
Tracked priority districts’ implementation of SSE policies	Yes ⃝ No ⃝

SSE Process Measure 4:

% of priority districts that monitored school implementation of SSE-related policies

In the past six months, did [PRIORITY DISTRICT NAME] complete each of the following actions regarding the monitoring of schools’ implementation of SSE-related policies (including, laws, codes, or regulations)? (Mark yes or no for each item.)

Maintained or developed a list of schools’ current SSE policy guidance.	Yes ⃝ No ⃝
Reviewed school-level SSE policy guidance to ensure alignment with state law, state education agency policy, and district policy.	Yes ⃝ No ⃝
Tracked school-level implementation of SSE policy guidance.	Yes ⃝ No ⃝
Prepared informational materials about SSE policies or policy options for stakeholders. Maintained a tracking system of schools that have used CDC’s School Health Index to evaluate SSE policy implementation.	Yes ⃝ No ⃝ Yes ⃝ No ⃝

SSE Process Measure 5:

% of priority districts that received assistance on SSE

In the past six months, how often did you interact with [PRIORITY DISTRICT NAME] to provide assistance (e.g., professional development events, technical assistance, guidance or resource materials, and referrals to other agencies or organizations) on SSE?

_____ Never

_____ 1 time

_____ 2 times

_____ 3 - 5 times

_____ 6 - 10 times

_____ 11 - 15 times

_____ 16 - 20 times

_____ 21 or more times

1. On what SSE topics did you provide assistance to [PRIORITY DISTRICT NAME]? (check all that apply)

• Select strategies to prevent bullying, sexual harassment, and electronic aggression

• Implement strategies to prevent bullying, sexual harassment, and electronic aggression

• Select parent engagement strategies

• Implement parent engagement strategies

• Select school connectedness strategies

• Implement school connectedness strategies

• Assess safe and supportive environment policies

• Monitor the implementation of safe and supportive environment policies

• Manage controversy around safe and supportive environments

• Build staff and student competencies and techniques to promote a safe and supportive environment for all students

SSE Process Measure 6:

Frequency with which funded SEA received assistance from NGO on SSE

In the past six months, how often did you interact with American Psychological Association to receive assistance (e.g., professional development events, technical assistance, guidance or resource materials, and referrals to other agencies or organizations) on SSE?

_____ Never

_____ 1 time

_____ 2 times

_____ 3 - 5 times

_____ 6 - 10 times

_____ 11 - 15 times

_____ 16 - 20 times

_____ 21 or more times

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