Appx J - Data Collection Checklist YRBS - supplemental docs

J. Data Collection Checklist for the Youth Risk Behavior Survey Supplemental Documents

J1. Letter to Teachers in Participating Schools

J2. Make-up List and Instructions

J1. Letter to Teachers in Participating Schools

2013 National Youth Risk Behavior Survey

Dear Teacher:

Thank you for agreeing to participate in the national Youth Risk Behavior Survey (YRBS), sponsored by the Centers for Disease Control and Prevention (CDC), Division of Adolescent and School Health. Results from the YRBS will help to determine the extent to which teenagers practice health risk behaviors and to develop education programs and other strategies to help reduce these behaviors. When published, your school will receive a copy of the national results from the CDC.

We appreciate your school hosting the 2013 national YRBS. Your class was randomly selected to participate and cannot be replaced. We have enclosed materials to better help you understand the YRBS, including the Summary of School Arrangements Form, a survey fact sheet, a Data Collection Checklist, and parental permission forms and reminders. A copy of the questionnaire is available with your school’s contact person, if you would like to view it. 

The enclosed Data Collection Checklist should be used to track and record the distribution and return of all parental permission forms. Names or ID’s for all students in your selected class should be listed on this checklist, not just those participating in the survey. Names will be kept confidential and destroyed after the completion of data collection. The names are needed to take roll, make sure students not in the selected class do not “slip in,” identify students eligible to complete the survey (i.e., returned parental permission form with a “yes” response), develop make-up lists of eligible students who are absent, and determine the gender and grade of all nonparticipants. This form needs to be filled out BEFORE the data collection.

You play a very important role in the survey. Your support and encouragement are necessary to ensure a high rate of participation among your students. A high participation rate is needed to produce valid national estimates of health risk behaviors.

Please follow the instructions below to help us prepare for survey administration in your class.

1. Please distribute a parental permission form to each student in the select class at least 10 days prior to the survey administration date. Please remind students in the selected class to return these forms as soon as possible. Encourage students to return the forms promptly.

2. Distribute the enclosed reminder and/or another parental permission form to students who do not return a form as of

3 days prior to the survey date. If requested, parental permission forms and reminders are provided in Spanish.

3. Track and record the return of permission forms on the Data Collection Checklist. Our data collector will meet with you immediately prior to the survey administration to review the checklist. NOTE: Returned parental permission forms remain at the school.

4. On the day of the survey, please plan an alternate activity for those students who do not have parental permission to take the survey or have not yet returned a parental permission form.

Survey procedures have been designed to protect your students’ privacy and allow for anonymous participation. During the survey administration, you will be asked to remain at the front of the classroom to increase student candor. The survey will be administered by specially trained field staff. It will take about 35 minutes.

The participation of your students in the YRBS will help the CDC, educators, and public health officials assess and improve efforts to reduce priority health risk behaviors among adolescents throughout the Nation. If you have any questions, please call me toll-free at 1-800-675-9727 between 8:30 a.m. and 5:30 p.m. eastern time. Thank you again for your cooperation.

Sincerely,

Kate Flint, Project Director

National Youth Risk Behavior Survey

J2. Make-up List and Instructions

MAKE-UP LIST
School Name: ________________________ State:_______ Grades(s): _____			Teacher Name(s):_______________________________ Class:__________________________Period:_______
Dear Teacher: Students who were selected to participate in the 2013 Youth Risk Behavior Survey, but did NOT complete the survey and need a make-up are listed below. The list includes absentees and students who lacked parental permission when the survey was originally administered. You are asked to administer a make-up with each of these students. An adequate supply of survey booklets, student envelopes, and pencils is enclosed. When administering the survey, please follow the enclosed make-up instruction guide closely. When you have completed the make-ups, please place each student’s sealed envelope containing his/her questionnaire, in the white, business reply, pre-paid envelope marked MAKE-UPS along with this form. Please enter your name, school name and address on the envelope prior to mailing. For any student(s) not completing a make-up survey, please note the reason (if known), and return any unused survey booklets and envelopes. Important: If a student has for all practical purposes ceased to attend school and you cannot conduct a make-up, mark a capital “D” next to his/her name. Please do NOT send back pencils. Thank you again for your help. If you have any questions, please call us toll-free at 800-675-9727. PLEASE PRINT NAMES CLEARLY.
Males Needing Make-ups	Code* (See list of codes below)	Females Needing Make-ups		Code* (See list of codes below)

NON-PARTICIPATION CODES*

A = Absent

ISS = In School Suspension

NFR = No Form Returned