SSE Performance Measure 1: Funded LEA prevents
bullying and sexual harassment, including electronic aggression
|
Currently, does your district 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: Funded LEA promotes
school connectedness strategies
|
Currently, does your district 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: Funded LEA
promotes parent engagement strategies
|
Currently, does your district 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 Performance Measure 4: %
of priority schools that prevent bullying and sexual
harassment, including electronic aggression
|
Currently, does [PRIORITY SCHOOL NAME] do 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 6: %
of priority schools that implement school connectedness
strategies
|
Currently, does [PRIORITY SCHOOL NAME] 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 8: %
of priority schools that implement parent engagement
strategies
|
Currently, does [PRIORITY SCHOOL NAME] do each 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 LEA has
assessed its SSE-related policies
|
In the past six months, did you 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 related
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 LEA leadership
and staff to prioritize actions for addressing identified
gaps in SSE policies.
|
Yes ⃝ No ⃝
|
|
SSE Process Measure 2: Funded LEA has monitored
the implementation of SSE-related policies in priority schools
|
In the past six months, did you complete each of the following
actions regarding the monitoring of priority schools’
implementation of policies (including, laws, codes, or
regulations)? (Mark yes or no for each item.)
Developed or maintained a list of current
school-level SSE policy guidance for priority schools.
|
Yes ⃝ No
⃝
|
Reviewed priority schools’
SSE policy guidance to ensure alignment with state law, state
education agency policy, and district policy.
|
Yes ⃝ No
⃝
|
Tracked priority schools’
implementation of SSE related policies.
|
Yes ⃝ No
⃝
|
Prepared
informational materials about current SSE policies or policy
options for stakeholders.
Maintained a tracking system of priority schools that
have used CDC’s School Health Index to evaluate SSE
policy implementation.
|
Yes ⃝ No ⃝
Yes ⃝ No ⃝
|
|
SSE Process Measure 3:
% of priority
schools that received assistance on SSE
|
In the past six months, how
often did you interact with [PRIORITY SCHOOL 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
On what SSE
topics did you provide assistance to [PRIORITY SCHOOL 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 4:
Frequency with
which funded LEA received assistance from NGO on SSE
|
In the past six months, how often did you interact with Gay
Straight Alliance Network 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
|