Form Approved
OMB No: 0920-XXXX
Exp. Date: XX/XX/XXXX
“Promoting Adolescent Health through School-Based HIV/STD Prevention”
Att. 5c
LEA ESHE Items
Public reporting burden of this collection of information is estimated to average 6 hours 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)
LEA Measures
Measures
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Questions for Collection of Measures |
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ESHE Performance Measure 1: Funded LEA has a written MS/HS curriculum framework that reflects ESHE programs
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Yes ⃝ No ⃝
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ESHE Performance Measure 3: % of priority schools that have implemented sexual health curricula (including EBI if applicable) |
Yes ⃝ No ⃝
⃝ Adult Identity Mentoring (Project AIM) ⃝ All4You! ⃝ Becoming a Responsible Team (BART) ⃝ Draw the Line/Respect the Line ⃝ FOCUS ⃝ Heritage Keepers Abstinence Education ⃝ Horizons ⃝ It's Your Game: Keep it Real ⃝ Raising Healthy Children (formerly known as the Seattle Social Development Project) ⃝ RESPECT ⃝ SIHLE ⃝ WILLOW ⃝ Other curriculum Provide name or description of other curriculum:_______________________________________________
Yes ⃝ No ⃝
⃝ Aban Aya Youth Project ⃝ Adult Identity Mentoring (Project AIM) ⃝ All4You! ⃝ Be Proud! Be Responsible! ⃝ Becoming a Responsible Team (BART) ⃝ ¡Cuídate! ⃝ Draw the Line/Respect the Line ⃝ FOCUS ⃝ Focus on Youth + ImPACT ⃝ Heritage Keepers Abstinence Education ⃝ Horizons ⃝ It's Your Game: Keep it Real ⃝ Making a Difference! ⃝ Making Proud Choices! ⃝ Project AIM ⃝ Promoting Health Among Teens! Abstinence-Only Intervention (formerly known as 'Promoting Health Among Teens!') ⃝ Promoting Health Among Teens! Comprehensive Abstinence and Safer Sex Intervention (formerly known as 'Comprehensive Abstinence and Safer Sex Intervention!') ⃝ Raising Healthy Children (formerly known as the Seattle Social Development Project) ⃝ Reducing the Risk ⃝ RESPECT ⃝ Safe in the City ⃝ Safer Choices ⃝ Safer Sex ⃝ SIHLE ⃝ Sisters Saving Sisters ⃝ Street Smart ⃝ Teen Health Project ⃝ Teen Outreach Program ⃝ What Could You Do? ⃝ WILLOW ⃝ Other curriculum Provide name or description of other curriculum:_______________________________________________ |
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ESHE Performance Measure 4: # of MS and HS students in priority schools who received a sexual health curriculum (including EBI if applicable) |
Curriculum 1: ____________ Curriculum 2: ____________ Curriculum 3:_____________
Curriculum 1: ____________ Curriculum 2: ____________ Curriculum 3:_____________
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ESHE Process Measure 1: Funded LEA has assessed its sexual health and/or HIV education policies
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In the past six months, did you complete each of the following actions regarding the assessment of sexual health and/or HIV education policies (including laws, codes, or regulations)? (Mark yes or no for each item.)
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ESHE Process Measure 2: Funded LEA has monitored the implementation of sexual health and/or HIV education 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 sexual health and/or HIV education policies (including laws, codes, or regulations)? (Mark yes or no for each item.)
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ESHE Process Measure 3: % of priority schools that received assistance on ESHE |
_____ 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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ESHE Process Measure 4: Frequency with which funded LEA received assistance from NGO on ESHE |
In the past six months, how often did you interact with Healthy Teen Network to receive assistance (e.g., professional development events, technical assistance, guidance or resource materials, and referrals to other agencies or organizations) on ESHE? _____ 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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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | CDC User |
File Modified | 0000-00-00 |
File Created | 2021-01-26 |