Attachment A – Assessment Instrument (Word Version)
Form approved
OMB No. 0920-0879
Expiration date: 03/31/2018
Thank you for taking time to complete this assessment! Your answers will help CDC tailor the resources they develop to improve their relevance to your work in school health.
We are seeking your input given the role you play in coordinating school-based strategies as part of State Public Health Actions/1305. This data collection is intended for State Health Department or Department of Education/Public Instructions staff only.
Completing this online assessment is voluntary and takes approximately 11 minutes. Please respond to the questions from your individual perspective and not that of your department as a whole. All data will be shared in aggregate and data will not be published.
Please complete the assessment by [ ---- ]
Where do you work?
Department of Health
Department of Education/Department of Public Instruction
I do not work at either of the options listed above [END DATA COLLECTION—SENDS TO THANK YOU PAGE]
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
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School Health Index [continue to Q4]
Health and Academic Achievement Overview (PDF Document) [If only selection, skip to Q14 in H&AA section]
Improving Academic Achievement through Healthy Eating and Physical Activity (PowerPoint Presentation) [If only selection, skip to Q14 in H&AA section]
I have not seen any of these resources [skip to Q22 in section for respondents who have not seen the tools]
(Respondents will be led to separate sections for each tool they indicate having seen)
The School Health Index (SHI) is a self-assessment and planning tool that schools can use to improve their health and safety policies and programs. Information about the SHI is found at http://www.cdc.gov/healthyyouth/shi/. In September 2014, CDC released a revised version of the SHI. The latest version updated physical activity and nutrition questions to align with new national standards and programs. Additionally, the revised version was adapted by the Alliance for a Healthier Generation for use in their Healthy Schools Program.
How did you hear about the School Health Index (SHI)?
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Select all that apply |
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Please tell us if, or how, you have used or plan to use the School Health Index (SHI).
Select only 1 answer for each statement |
I have already done this |
I plan to do this in the future |
I do not plan to do this |
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[If respondent marked ‘I do not plan to do this’ in all rows of Q5, as appropriate based on responses in Q3 skip to H&AA section Q14 or section for respondents who have not seen the tools Q22]
Thinking about the activities you mentioned above, which statement is most accurate:
I have primarily used the PDF document version of the SHI
I have primarily used the online, interactive version of the SHI that requires setting up an account password
I have used the interactive version and the PDF document equally
Which statement is most accurate for you?
I prefer the PDF document version of the SHI
I prefer the online, interactive version of the SHI
I do not have a preference between the versions of the SHI
(An open field comment box will populate where appropriate asking the respondent to explain their preference)
Thinking back on your experiences with the School Health Index (SHI), please share your opinions on the following statements.
Select only 1 answer for each statement |
Strongly Agree |
Agree |
Neutral |
Disagree |
Strongly Disagree |
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Thinking about the content of the School Health Index (SHI), please share your opinions on the following statements.
Select only 1 answer for each statement |
Strongly Agree |
Agree |
Neutral |
Disagree |
Strongly Disagree |
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Please place a check under the heading that most accurately conveys your opinion on the topics in the table. [force respondents to check one answer column per topic]
School Health Topics |
Schools I work with need minimal help in addressing this topic. |
Schools I work with need some help in addressing this topic. |
Schools I work with need significant help in addressing this topic. |
School Health and Safety Policies and Environment |
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Health Education |
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Physical Education and Other Physical Activity Programs |
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Nutrition Services |
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School Health Services |
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School Counseling, Psychological, and Social Services |
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Health Promotion for Staff |
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Family and Community Involvement |
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What I like best about the SHI is… [open field comment box]
What I liked least about the SHI is… [open field comment box]
Please provide additional feedback and suggestions on the SHI: [open field comment box]
[If respondent indicated in Q4 that he/she has seen the H&AA resources continue on to Q14. If the respondent has not seen them, skip to section for respondents who have not seen tools Q22]
The Health and Academic Achievement resources were released in July 2014 by CDC’s School Health Branch. The resources include evidence that can be used in presentations, key documents, or any other resource that communicates the evidence link between health (i.e., healthy eating and physical activity) and academic achievement. The resources include both a PDF brief and a set of PowerPoint slides.
Health and Academic Achievement PDF brief http://www.cdc.gov/healthyyouth/health_and_academics/pdf/health-academic-achievement.pdf
Health and Academic Achievement PowerPoint slide set http://www.cdc.gov/HealthyYouth/health_and_academics/
How did you hear about the Health and Academic Achievement Resources?
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Select all that apply |
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Please tell us if, or how, you have used or plan to use the Health and Academic Achievement Resources.
Select only 1 answer for each statement |
I have already done this |
I plan to do this in the future |
I do not plan to do this |
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[If respondent marked ‘I do not plan to do this’ in all rows of Q15, skip to Q22 for respondents who have not seen the tools]
Thinking about the activities you mentioned above, which statement is most accurate?
I have primarily used the Health and Academic Achievement Overview PDF document
I have primarily used the Improving Academic Achievement through Healthy Eating and Physical Activity PowerPoint® Presentation
I have used the PDF document and PowerPoint slides equally
Thinking back on your experiences with the Health and Academic Achievement resources, please rate the following statements
Select only 1 answer for each statement |
Strongly Agree |
Agree |
Neutral |
Disagree |
Strongly Disagree |
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Thinking about the content of the Health and Academic Achievement resources, please respond to the following statements:
Select only 1 answer for each statement |
Strongly Agree |
Agree |
Neutral |
Disagree |
Strongly Disagree |
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What I like best about the Health and Academic Achievement resources is… [open field comment box]
What I like least about the Health and Academic Achievement resources is… [open field comment box]
Please provide any additional feedback, comments or suggestions on the Health and Academic Achievement resources: [open field comment box]
[End assessment for respondents who have answered either the SHI or H&AA sections]
[This section would not display for users who indicate they have used or plan to use any of the tools]
When you need information on school health, where do you normally look for it? (Please list any organizations, websites, advisors, etc. you trust on this topic) [open field comment box]
Have you ever used any CDC resources or guidance to promote health in schools?
Yes
If yes: [open field comment box] appears
Please list the CDC resources, documents, or websites you remember using:
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Please generally rate how helpful you found the resources, documents, or websites to be.
Not at all Helpful Somewhat Helpful Extremely Helpful
1 2 3 4 5
No
Have you ever used any non-CDC resources or guidance to promote health in schools?
Yes
If yes: [open field comment box] appears
Please list the non-CDC resources, documents, or websites you remember using:
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Please generally rate how helpful you found the resources, documents, or websites to be.
Not at all Helpful Somewhat Helpful Extremely Helpful
1 2 3 4 5
No
Please indicate any topics on which you would like to have more information or resources.
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I’d like to have more information or resources on this topic. |
Neutral |
I don’t need more information or resources on this topic. |
Physical Education |
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Comprehensive School Physical Activity Programs |
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Recess |
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Competitive foods and beverages |
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School Meal Programs |
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Local Wellness Policy |
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School Health Services and Management of Chronic Conditions |
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Health Promotion for Staff |
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Family and Community Involvement |
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After-school programs |
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How would you prefer to receive information on school health? (check all that apply)
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Check all methods by which you like to receive information on school health |
Listserv and/or Email |
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Webinar |
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Detailed Workbooks |
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Brief Overview/Guidance Documents |
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Social Media Posts and Links |
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Power Point Slides |
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Conference Presentations |
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I do not need information on school health |
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Please tell us what would help you promote health in schools as part of your work: [open field comment box]
Exit page
Thank you for your time and feedback!
If you’d like to learn more about CDC School Health resources, please visit: http://www.cdc.gov/healthyyouth/schoolhealth/index.htm
Public reporting burden of this collection of information is estimated to average 11 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).
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | xxh8 |
File Modified | 0000-00-00 |
File Created | 2021-01-26 |