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Attachment Number	Document Description
1	Public Health Service Act Legislation
2	Teacher Interview Guide
3	Supplemental Handout for Teacher Interview Guide
4	Middle School Student Focus Group Guide
5	High School Student Focus Group Guide
6	Consultants on the Information Collection
7	Documentation of IRB Approval
8	Teacher Interview Consent Form
9	Middle School Parental Consent Form
10	High School Parental Consent Form
11	Middle School Student Verbal Assent Language
12	High School Student Verbal Assent Language

Section B: Collections of Information Employing Statistical Methods

B.1 Respondent Universe and Sampling Methods

Teacher Interviews

The respondent universe for the interviews consists of FWISD teachers who are teaching middle and high school health education classes during the 2015-2016 school year (n=81). For the teacher interviews, we will take a sample of 10-15 middle school health education teachers and 10-15 high school health education teachers. A purposive sampling technique will allow for identification of school staff who can represent a variety of experiences and backgrounds. The study team will work with the FWISD district-level staff to identify teachers to participate in the interviews. These teachers will be selected by the study team and FWISD district staff so that the sample selected includes a mix of teachers who vary in terms of characteristics such as credentialing method (i.e., traditional or non-traditional), length of time teaching, type of classroom (dedicated classroom versus a mobile cart that is moved to varied locations), etc. Additional inclusion criteria include: (1) being a teacher in FWISD; (2) having taught middle school or high school health during the 2015-2016 school year; and (3) having attended both the August and February PD training events held by FWISD during the 2015-2016 school year.

A total of 20-30 teachers are expected to be interviewed in this one-time data collection.

Student Focus Groups

The respondent universe for the student focus groups consists of FWISD middle and high school students who are enrolled in health education classes during the 2015-2016 school year (n= approximately 13,000). Four schools (two middle schools and two high schools) will be selected for participation based on (1) having large numbers of students for sufficient gathering of the sample, (2) recommendation from FWISD district staff, and (3) willingness of the school administration to allow students to be recruited and participate. Across these 4 schools, approximately 1300 students are estimated to be enrolled in spring semester health education schools. In each participating school, students who are enrolled in health education will receive a letter to take to parents that provides information on the study and a place for parents to provide active consent for students to participate (see Attachments 9 and 10). Consent forms will be distributed and collected for 7 days. After 7 days, a second round of consent forms (copies of the original form) will be redistributed to students who had not returned the consent form originally. From the pool of returned parental consent forms, the study team will randomly select 12 male students and 12 female students from each school (2 middle schools and 2 high schools) to participate in the focus groups. A total of 96 students will be scheduled to participate in the focus groups.

Information Collection	Respondent Type	Maximum number of Respondents
Teacher interviews	Middle school health education teachers	15
	High school health educaiton teachers	15
Student focus groups	Middle school male students	24
	Middle school female students	24
	High school male students	24
	High school female students	24

B.2 Procedures for the Collection of Information

Teacher Interviews

In spring 2016, (pending (OMB approval), the study team will conduct 20-30 in-person one-on-one interviews with FWISD teachers who are using the current sexual health education curriculum. Interviews will be conducted with 10-15 middle school and 10-15 high school teachers. Each interview will be conducted by a trained CDC contractor who is a member of the study team. The project has received IRB approval (see Attachment 7). The interviewer will use the semi-structured interview guide (see Attachment 2) accompanied by a supplemental sheet that provides key aspects of knowledge, skills and comfort for the respondent to reflect on to gather respondents’ thoughts and feedback about their perceptions of their knowledge, skills, comfort level, and confidence to deliver the sexual health lessons from the curriculum (see Attachment 3). Teacher interviews will last approximately 60 minutes in length and will be conducted in private space at the teacher’s school during a non-instructional time (e.g., before or after school, during lunch, during planning period). Interview start times and locations will vary depending on the teacher’s schedules and school administrator’s recommendations. All interviews will be audio-recorded (with participant permission) and transcribed verbatim to ensure an accurate record of what was discussed. Transcripts will be loaded into Atlas.ti qualitative data analysis software for analysis.

Student Focus Groups

Student focus groups (n=8) will be held in late spring 2016 (pending OMB approval). Each focus group will include up to 12 students. The focus groups will be stratified by gender and school level (2 focus groups will include female students in high school, 2 focus groups will include male students in high school, 2 focus groups will include female students in middle school, and 2 focus groups will include male students in middle school).

Each focus group will be moderated by one study team member (a CDC contractor) and will include one additional study team member (a CDC contractor) as the note-taker. The moderator will use a semi-structured focus group guide (see Attachment 4 for the middle school guide and Attachment 5 for the high school guide) that lists key questions and allows the moderator to probe for additional insight.

Focus groups will take place during non-instructional hours to ensure participation does not interfere with students’ learning. The location of the focus groups will vary by individual school but will be in accordance with school administration recommendations and will be in a secure and private space comfortable for students. Focus groups will last no more than 90 minutes. All focus groups will be audio-recorded (with participant permission) to ensure an accurate account of what was discussed. Since the focus groups will take place after school hours, student transportation must be pre-arranged by the student’s parent/guardian. Focus groups will be scheduled in advance to allow parents time to plan accordingly.

Power Analysis

The teacher interviews use a purposive sample drawn from staff who represent a variety of experiences and backgrounds across FWISD’s middle and high schools. The selection of respondents will be conducted to ensure the most appropriate individuals are identified and invited to participate. For the student focus groups, all students in 4 schools that are enrolled in health class during the spring 2016 academic semester are being invited to participate. It was not feasible to conduct focus groups in all schools (students would need transportation to other locations for the focus group), so for logistical purposes and to improve our ability to gain buy-in from school administrators, we limited the student data collection to a small number of schools. The schools will be selected because they enroll large numbers of students with diverse characteristics (race, ethnicity, income, etc). From the pool of students who return consents, groups of students (stratified by age and middle/high school level) will be selected for participation at random. Our goal in both of these information collections is to ensure input that is as broadly representative as possible and reduce potential for bias, but for this qualitative data collection, we do not expect results to be generalizable to all health education teachers or students.

B.3 Methods to Maximize Response Rates and Deal with No Response

Teacher Interviews

The semi-structured interview is brief (60 minutes), and was designed specifically for FWISD health education teachers. Interviews will be scheduled at a time that is convenient for participants. Interview slots before, during, and after school hours will be offered. The study team will make arrangements before the interview to conduct the interview in a quiet place that provides privacy. Interview candidates will be informed of measures that are in place to protect their identities; no information that could link a participant’s name to his/her interview will be released to anyone outside of the study team.

Student Focus Groups

All health education students in 4 schools will be given information about the study and invited to return parental consent forms. Among the students who return consent forms, students will be grouped into 4 stratifications: middle school male students, middle school female students, high school male students, and high school female students. Within each of these groups, 24 students will be invited to participate in the focus groups. Students will be contacted to schedule the focus group and gain confirmation of attendance. For each student who does not confirm availability, an alternate student from that same stratified group will be selected at random for the invitation. This process will begin weeks in advance of the focus group so that all invited slots can be filled with confirmed participants. However, the study team is aware that even confirmed participants may not show up on the day of the focus group. For this reason, 12 students are being invited to each group, with the expectation that groups could be run successfully (and meaningfully) with as few as 8 students per group.

B.4 Tests of Procedures or Methods to be Undertaken

The interview and focus group guides were developed with the extensive input of expert consultants both internal and external to CDC and the CDC’s contractor. Guides were constructed around key concepts found in the literature related to sexual health education, and were tailored for the context of FWISD with assistance from FWISD district-level staff. Pilot tests of interview and focus group guides were conducted to assess duration of administration, clarity of questions, and need for revision. The teacher interview guide was reviewed for content, clarity, and appropriateness by two FWISD district employees and the full study team (staff from CDC and its contractor) which include several former teachers; revisions were made to refine the guide based on the collective input. CDC’s contractor then pilot tested the guide with 3 individuals who have evaluation and/or school experience. The student focus group guides were reviewed for content, clarity, and appropriateness by two FWISD district employees and the full study team (staff from CDC and its contractor) which include several former teachers; revisions were made to refine the guides based on the collective input. CDC’s contractor then pilot tested the guides with 4 youth between the ages of 13-17 to ensure questions were clear and easily understood by the target ages for the focus groups. The feedback from the piloting process was used to further refine the instruments and prepare for interviewer training.

B.5 Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

Individuals consulted on statistical aspects and study design:

Catherine Lesesne, Ph.D.

ICF International

3 Corporate Square, Suite 370

Atlanta, GA 30329

[email protected]

404-321-3211 (phone)

404-321-3688 (fax)

Colleen Murray, DrPH

Manager, ICF International

3 Corporate Square, Suite 370

Atlanta, GA 30329

[email protected]

404-321-3211 (phone)

404-321-3688 (fax)

The individuals overseeing data collection and directing data analysis are:

Catherine Lesesne, Ph.D.

ICF International

3 Corporate Square, Suite 370

Atlanta, GA 30329

[email protected]

404-321-3211 (phone)

404-321-3688 (fax)

Colleen Murray, DrPH

Manager, ICF International

3 Corporate Square, Suite 370

Atlanta, GA 30329

[email protected]

404-321-3211 (phone)

404-321-3688 (fax)

Catherine Rasberry, PhD

CDC/OID/NCHHSTP, Health Scientist (Contracting Officer’s Representative providing oversight)

(404) 718-8170

[email protected]

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Author	Bleechington
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File Created	2021-01-24