JJJ Student Program Fidelity 8th Grade Session 8

Form Approved

OMB No. 0920-XXXX

Exp. Date:

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Attachment JJJ:

Student Program Fidelity 8th Grade Session 8 (Standard)

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Student Curriculum – 8th Grade, Session 8 – Equal Power Through Communication

Attendance Log

Implementer Name: _________________________ Implementer ID: ___________________

School ID: ____________________________ Session ID: _________________

Classroom ID:______________________________ Program Year: ____________________

Please have each student sign initials next to their name to indicate attendance to the session

Student Names (Pre-Typed)	Student ID (pre-typed)	Student Initials for Present

S tudent Curriculum – 8th Grade, Session 8 – Equal Power Through Communication

Implementer Name: _____________________ Implementer ID: ___________________

School ID: ____________________________ Session ID: _________________

Classroom ID:_________________________

Program Year: ____________________ Time lesson began: ___________

Date: __________________________ Time lesson ended: ___________

Please indicate if you completed the following activities:

Activity	Yes	Yes w/ changes	No
Reviewed the 8 communication skills			
Asked students what each skill means			
Pointed out that sometimes these skills may not be useful on their own when there is unequal power in the relationship			
Facilitated role play - two students acted out the LaToya and Marcus script			
Asked students about the communication skills used in the LaToya and Marcus script			
Facilitated exercise where students practice the communication skills to address conflicts			
Discussed the Lucy & Chang scenario			
Asked students what Lucy can do if Chang is not going to cooperate			
Discussed the Tyler & Rachel scenario			
Asked students what Tyler can do if Rachel is not going to cooperate			
Pointed out that good communication can help keep power equal in relationships			
Pointed out that communication skills may not help in relationships that are already abusive			
Concluded session	q	q	q

Describe any changes you made to the session activities (please identify which activity you are describing by number).

Please indicate if you experienced any of these challenges that interfered with implementing today’s session.  Check all that apply.

Not enough time	
I did not have the needed materials	
I was uncomfortable discussing some of the topics	
Students were uncomfortable discussing some of the topics	
Some part of the session was difficult for students (e.g., role plays, reading aloud, worksheets)	
Classroom behavior management issues	
Other more pressing classroom demands	
Other – please specify____________________________________	

Please check the extent to which the students were engaged in today’s lesson on the following measures:

Most students…	Strongly Agree	Agree	Don’t Know	Disagree	Strongly Disagree
Asked relevant questions.					
Suggested solutions to scenario problems.					
Responded correctly to questions.					
Distracted other students.					
Participated extensively in discussions.					
Discouraged other students from participating.					

Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.

1. How well do you think the students understood the session material?

1  Not at all

2  A little

3  A lot

4  Completely

2. How well did the session material fit into the allotted time period?

1 Session was too packed/not enough time to complete all activities

2 Session was somewhat packed/able to complete most but not all

3 Session was just right

4 Not enough material/session ended before class period complete