III Enrollment and Service Log Data Dictionary_rev copy

III Enrollment and Service Log Data Dictionary_rev copy.pdf

Regional Partnership Grants National Cross-Site Evaluation and Evaluation Technical Assistance

III Enrollment and Service Log Data Dictionary_rev copy

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INTRODUCTION
RPG grantees will share data for the RPG Cross-Site Evaluation through the RPG Data Portal.
This Portal is being developed by Mathematica Policy Research and its partner Walter R.
MacDonald &Associates (Mathematica/WRMA), and by Synergy Enterprises. Data submissions will
not begin until 2014 but this data dictionary is being written as the systems are being developed to
guide system designers and as a resource for grantees to use in preparing and submitting data.
The RPG Data Portal will consist of two components: (1) an Enrollment and Services Log,
where grantees will enter enrollment and case information along with information on their RPG
clients’ participation in the evidence-based programs and practices (EBPs) that make up their
programs; and (2) an Outcome and Impact Study System, where grantees will upload outcome data
from standardized instruments, the household roster, and administrative sources. This document is a
draft version of Part I of the RPG Data Dictionary; it contains specifications for the data elements
in the Enrollment and Services Log or “ESL.” Part II is not yet being drafted.
This draft document is subject to change. As noted in the following text, some data
elements and response options remain to be finalized. In addition, based on grantee feedback and
suggestions, some changes to the data elements may be needed. As well, some of the descriptions of
data elements and instructions for data entry are still sketchy and will need to be expanded, clarified,
and/or refined. If you find that item definitions or response categories are unclear in this version,
please realize that this is a work in progress.
Features of the ESL
Once the ESL component of the RPG Data Portal have been developed, we will demonstrate
its use. Meanwhile, here are the basic features of the system:
 The ESL consists of a brief series of data entry screens grantees will use to enter data.
 Users will automatically be directed to the relevant screen for all needed entries.
 Each grantee will designate a single grantee administrator who will establish permissions
for the specific people who will be entering enrollment or service data at the grantee or
partner agency(ies). This administrator is the only person who will be able to view all
entries; other staff members can view only their own entries. Grantees will not be able to
view each others’ entries.
 The system will not produce reports, however we expect to configure the system so that
the grantee administrator will be able to download their own data—and only their own
data.
 The system will include convenience features. For instance, staff can enter case member
names into the system. Entering names (or initials or nicknames if your IRB will not
allow you to use names) can facilitate data entry by RPG staff—for example, it will be
easier to quickly select names from a drop down list rather than relying only on ID
numbers. However, researchers at Mathematica will not have access to any names
entered into the system.

DRAFT

2

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 The enrollment and service log will be housed on a secure server maintained by
Mathematica’s subcontractor, Synergy Enterprises, and will adhere to all security
requirements for the project.
Content of the ESL Data Dictionary
For each item included in the ESL, the data dictionary provides the name of the data field, a
description of the field, and valid values. Additional comments may also be included, such as
information indicating that certain responses will take users to a related screen for additional
information.
For ease of use, the dictionary is divided into several sections. Sections A through E provide
data elements collected upon case enrollment and closure. Section F describes three data elements
that will be collected whenever an RPG case member is enrolled in any of the EBPs provided as part
of a grantee’s RPG program, and one item collected when they exit the EBP. Sections G through
L provide data elements collected only when RPG case members are enrolled in one of the ten focal
EBPs.1 This includes a reminder screen that will appear if no service or contact data have been
entered for two weeks on a case enrolled in a focal EBB (Section M).
For questions or to provide comments on the data elements or the draft data dictionary, please
contact your cross-site evaluation liaison (CSL). He or she will direct them to the cross-site
evaluation team member best qualified to address your questions or comments. You may also
contact the RPG Cross-Site Evaluation project director, Debra Strong, at any time at (609) 750-2001
or [email protected].

To reduce the burden on grantees to provide service data, the implementation study will collect service data on 10 focal
EBPs among the 50 EBPS grantees’ clients may recieve: (1) Celebrating Families!, (2) Child-Parent Psychotherapy, (3)
Cognitive Behavioral Therapy, (4) Hazelden Living Balance Programs, (5) Matrix Model Program, (6) Nurturing
Parenting Programs, (7) Parent and Child Interactive Therapy, (8) Seeking Safety, (9) Strengthening Families, and (10)
Trauma Focused Cognitive Behavior Therapy.
1

DRAFT

3

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Section A: Grantee Information
Sections A through E provide data elements collected upon case enrollment and closure.
Section A includes two fields, grantee ID and grantee name. These fields will be automatically
populated based on the user’s login credentials.

A.
#

Field

A.1
A.2

Grantee Information
Valid Values

GRANTEE ID

Description
Grantee identification
number provided by the
Children's Bureau to the
grantee

GRANTEE NAME

Name of grantee

Text

DRAFT

4

Text

Comment

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Section B: Case Enrollment
This section includes the fields that will need to be entered for case enrollment: the case ID, the
original case ID (only for cases that re-enroll after exiting RPG previously), the surname for the
case, and the RPG enrollment date. A user guide will provide instructions for how to handle cases
with multiple surnames. As noted during the webinar, CSLs will work with each grantee to define an
“RPG case” for the purposes of entering enrollment data into the ESL.

B.
#

Field

B.1

CASE ID

B.2

ORIGINAL ID

B.3

SURNAME

B.4

RPG ENROLL ATE

DRAFT

Case Enrollment

Description

Valid Values

Identification number
assigned to each case
Case's Original RPG CASE
ID
Last name of case or other
identifiable information
Date that case enrolled in
RPG program

5

Comment

Text- maximum (6)
Text- maximum (6)
Text
Date format –
MM/DD/YYYY

Staff can enter any type of
identifier that will make it
easy to recognize the case

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C. Demographics on Individuals in the Case
At case enrollment, the RPG staff member will enter demographic information for each
member of the RPG case. Some information will only be entered for adult case members.
Please note that for all fields that use a Checkbox, all choices will appear at once and the default
setting is unchecked. Values that are not applicable can be ignored.

C.
#

Field

Demographics

Description

Valid Values

C.1

IND ID

C.2

FIRST NAME

Each individual must be
assigned a unique ID. An
individual present in more
than one case should have
the same ID across cases.
Grantees must track
Individual IDs to ensure the
same person consistently
receives the same ID.
First name of individual or
other identifiable information

C.3

DOB

Date of Birth of individual

C.4

GENDER

Sex of individual

C.5
C.9

RACE

C.10

ETHNICITY

Race (mark all that apply)
Ethnicity identification of
individual

C.11

PRIMARY HOME LANG

C.12

PRIMARY HOME LANG
SPEC

C.13

PERSON TYPE

DRAFT

Text- maximum (6)
Text
Date formatMM/DD/YYYY
Male
Female
American Indian or
Alaskan Native
Asian
Black
Native Hawaiian or
Other Pacific Islander
White
Hispanic
non-Hispanic
English
Spanish
other (specify)

Language that is spoken at
home
If other than English or
Spanish, user can specify
what other language is
spoken.
Text
Indicate if person is an adult
or child- a flag will indicate if
the PERSON TYPE is the
family focal adult and/or the
recovery domain adult via a
check all that apply selection;
likewise for the child, a radio
button will indicate if the child Adult
is the focal child.
Child

6

Comment

Mark only one

Checkbox
Mark only one

Mark only one

Mark only one

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#

Field

Mathematica Policy Research

Description

Valid Values

C.14

HIGHEST EDUCATION

Highest/last level of
education attained

C.15

INCOME LEVEL

Annual monetary amount
received by individual

C.16
–
C.21

INCOME SOURCE WAGE
SALARY

Source(s) of individual's
income- wages/salary

C.22

EMPLOYMENT STATUS

Individual's Employment
Status

C.23

RELATIONSHIP STATUS

Individual's domestic
relationship upon enrollment

C.24

CURRENT RESIDENCE

Current type of residence for
individual

DRAFT

7

up to 8th Grad
some high schoo
"high school
diploma/GED
some voc/tech
education
voc/tech diploma
some college
associate's degree
bachelor's degree
some graduate or
professional school
master's degree
doctorate degree
professional degree
(MD, JD, DDS, etc.)
0-9,999
10,000-19,000
19,091-24,999
25,000-34,999
35,000-49,999
50,000 or higher
 Wages/salary
 Public assistance
 Retirement / Pension
 Disability
 Other
 None
 Full-time employment
Part-time employment
Self employed
Unemployed
not in labor force
 Single
 Married to child's other
biological parent
 Married to other
individual
 Co-habitating
 Divorced/separated
widowed
 case's primary
residence
 treatment facility
 correctional
facility/prison
 homeless/shelter
 foster parent's
residence
 other

Comment

Adult Only
Mark only one

Adult Only
Mark only one

Adult only
Checkbox

Adult only
Mark only one

Adult Only
Mark only one

Mark only one

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D. Flags for Specific Types of Case Members
RPG staff will indicate which case members are the focal child (selected by the grantee using an
established rule), the family functioning adult and the recovery adult. If the family functioning and
recovery adults have not been identified at the time of enrollment, RPG staff can enter this
information at a later date. RPG staff will also indicate each case member’s relationship to the focal
child.

D.
#

Flags for Specific Types of Case Members

Field

Description

D.1

FOCAL CHILD

Focal child is selected based
on defined parameters set
forth at grantee level

D.2

RELATIONSHIP TO
FOCAL CHILD

D.3

SPECIFY RELATIONSHIP
TO FOCAL CHILD

The relationship between
individual and focal child
Specification if
RELATIONSHIP TO FOCAL
CHILD  is  “Other”

D.4

FAMILY FUNCTIONING
ADULT

This Adult is the Family
Functioning Adult

D.5

DOMAIN RECOVERY
ADULT

This Adult is the Domain
Recovery Adult

DRAFT

Valid Values

8

Populate from FIRST
NAME entries for CASE
ID where PERSON TYPE
= "Child"
 Biological Parent
 Adoptive Parent
 Step-Parent by Marriage
 Foster Parent
 Grandparent
 Aunt / Uncle
 Biological / Adopted /
Foster / Step-Parent's
Partner
 Biological Sibling
 Adopted Sibling
 Step-Sibling by Marriage
 Cousin
 Self
 Other
Text
Populate from FIRST
NAME entries for CASE
ID where PERSON TYPE
= "Adult"
Populate from FIRST
NAME entries for CASE
ID where PERSON TYPE
= "Adult"

Comment

Only one child per case
can be coded as the focal
child

Mark only one

May be the same as the
recovery adult
May be the same as the
family functioning adult

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E. Case Closure
When an RPG case leaves the program, staff will indicate the date and reason for case closure.
It will be important that grantees establish rules and procedures to identify inactive cases that should
be closed even if not all program elements have been completed. Grantees should work with their
CSLs and the program management liaisons (PMLs) from the National Center for Substance Abuse
and Child Welfare (NCSACW) to determine these rules and procedures, and work with partners to
implement them.

E.
#

E.1

E.2
–
E.10
E.11

Field

Case Closure

Description

Valid Values

RPG CLOSE DATE

Date case was closed

CLOSURE REASON
SPECIFY RPG CASE
CLOSE

Reason for closing the case.
Select all that apply
Specification if REASON
RPG CASE CLOSE = "other"

DRAFT

9

Date formatMM/DD/YYYY
 Completed RPG
program
 Family moved out of
area
 Unable to locate
 Excessive missed
appointments /
unresponsive
 Family declined further
participation
 Transferred to another
service provider
 Miscarriage or fetal/child
death
 Parental death
 Other
Text

Comment

Select date from calendar

Checkbox

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F. Enrollment and Exit to Specific EBPs
Section F describes three data elements that will be collected whenever an RPG case member is
enrolled in any of the EBPs provided as part of a grantee’s RPG program, and one item collected
when they exit the EBP. For each EBP the grantee is implementing, RPG staff will enter the
enrollment and exit dates and the individual case members enrolled.

F. Enrollment and Exit into Specific EBPs
#

Field

F.1

EBP

F.2

EBP ENROLL DATE

F.3

EBP EXIT DATE

F.4

EBP CASE MEMBERS

DRAFT

Description

Valid Values

Name of Evidence Based
Program
Date case members enrolled
in EBP.
Date case members exited
EBP

The set of RPG Evidence
Based Programs
Date formatMM/DD/YYYY
Date formatMM/DD/YYYY

Case members participating
in EBP

List of case members with
IND ID populated for
CASE ID

10

Comment

The system will
automatically show a list
of case members; check
all that apply

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G. Service Contact Information
Sections G through L provide data elements collected only when RPG case members are
enrolled in one of the ten focal EBPs. This includes a reminder screen that will appear if no service
or contact data have been entered for two weeks on a case enrolled in a focal EBB (Section M).
In Section G, for each focal EBP, RPG staff will enter service contact information, including
the date of service, case members present, session location, session duration, others present during
the session, topics covered, session activities, and the staff person’s assessment of the extent to
which the session went as planned.

G. Service Contact Information
#

Field

Description

Valid Values

G.1

DATE OF SERVICE

Date service was rendered

G.2

EBP SERVICE

EBP delivered during
session

G.3

CASE MEMBERS
PRESENT

Case members attending the
session

G.4

SESSION LOCATION

Location of services provided

Date formatMM/DD/YYYY
 Celebrating Families!
 Child-Parent
Psychotherapy (CPP)
 Cognitive Behavior
Therapy (CBT)
 Hazelden Living Balance
Programs (LIB)
 Matrix Model program
 Nurturing Parenting
Programs (NPP)
 Parent and Child
Interactive Therapy
(PCIT)
 Seeking Safety
 Strengthening Families
 Trauma Focused
Cognitive Behavior
Therapy (TF-CBT)
Populate from FIRST
NAME entries for CASE
ID
 residential treatment
facility
 outpatient clinic
 family's home
 community site
 local government site
 school
 court
 parent's workplace
 correctional facility
 hospital

G.5

SESSION MINUTES

Session length in minutes

Integer > 0

DRAFT

11

Comment

Select only one
Check all that apply

Select only one

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#

G.6
–
G.14

Field

OTHERS PRESENT

DRAFT

Mathematica Policy Research

Description

Valid Values

Comment

Other individuals present in
session

 Foster parent / guardian
 Interpreter
 Grantee staff member
 Other relatives of case
member
 RPG partner staff
 Fidelity observer
 Health professional
(nurse, early
interventionist / Part C
staff)
 Supervisor
 Other professional staff

Checkbox; check all that
apply

12

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H. Topics Covered During Service Contact
Staff will indicate whether any of six possible topics were covered in the session. For any topic
covered, a screen showing possible subtopics will appear. The data elements for the subtopic
screens are shown in sections N through S, as indicated in the comments.
H.
#

Field

Topics Covered During Service Contact

Description

Valid Values

H.1

ADULT TOPICS SUB
ABUSE

Substantive areas covered
with adult in sessionSubstance Abuse

Checked or Unchecked

H.2

ADULT TOPICS PRNT
SKILLS

Substantive areas covered
with adult in sessionParenting Skills

Checked or Unchecked

H.3

ADULT TOPICS PERS
DEV

Substantive areas covered
with adult in sessionPersonal Development

Checked or Unchecked

H.4

CHILD TOPICS DEV AND
ED

Substantive areas covered
with child in sessionDevelopment and Education

Checked or Unchecked

CHILD TOPICS ED ADULT
SUB ABUSE

Substantive areas covered
with child in session Education on Adult
Substance Abuse

ED OTH RELAT

Was educational information
on substance use provided
to other family members
present?

H.5

H.6

DRAFT

13

Checked or Unchecked

"Yes"
"No"

Comment

If this topic is selected, the
user will be taken to
another screen showing
several potential
subtopics. See Section N.
If this topic is selected, the
user will be taken to
another screen showing
several potential
subtopics. See Section O.
If this topic is selected, the
user will be taken to
another screen showing
several potential
subtopics. See Section P.
If this topic is selected, the
user will be taken to
another screen showing
several potential
subtopics. See Section Q.
If this topic is selected, the
user will be taken to
another screen showing
several potential
subtopics. See Section R.
If this topic is selected, the
user will be taken to
another screen showing
several potential
subtopics. See Section S.

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I. Activities Conducted During Service Contact
For each session staff will be asked to check off any activities completed during the session,
such as group discussions or family meetings, from a drop-down list of activities.

I.

Activities Conducted During Service Contact

#

Field

Description

I.1 –
I.20

SESSION ACTIVITIES

List all activities conducted
during service contact

DRAFT

14

Valid Values
 Group Discussion
 Individual Discussion
 Family
Activity/Interaction
 Family Meeting
 Role Playing
 Re-enactments
 Exposure Activities
 Games/play
 Worksheets
 Watching videos
 Goal setting/planning
 Guided practice
 Coaching/feedback
 Provision of emotional
support
 Problem solving
 Crisis intervention
 Parenting skills
screening
 Child development
screening
 Health Assessment
 Mental health/substance
abuse screening

Comment

Checkbox

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J. Session Alignment with Session Plans
Staff will be asked to indicate whether the session went as planned—indicated by how well the
session plan aligned with what was actually accomplished during the session. If the session was not
“very well aligned” (that is, if it was only somewhat aligned or not well aligned), then the staff
member will be asked to check one or more reasons, such as whether there was a family crisis.

J.

Session Alignment with Session Plan

#

Field

J.1

SESSION ALIGNMENT

Description
Assessment of how session
plan aligned with
accomplishments

J.2 –
J.8

REASON NOT ALIGN FAM
C
SPECIFY REASON NOT
ALIGN

Reason visit was not wellaligned to intended
accomplishments
Specification if REASON
NOT ALIGN = "other"

J.9

DRAFT

15

Valid Values
1 = not well aligned
2 = somewhat aligned
3 = very well aligned
 Family Crisis
 Participants not engaged
in activity
 Participants interested in
topic other than one
planned
 Presence of other
individuals inhibited
session
activities/discussion
 Participant(s) were sick
 Physical space
constraints
 Other (please specify)
Text

Comment
Mark only one

Checkbox

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K. Referrals
When staff report making referrals during a service contact, they will be prompted to select
from a check-off list the type of referral made.

K.

Referrals

#

Field

K.1

SESSION REFERRALS

Description
Were referrals made for other
services besides the activities
completed during the session

K.2
–
K.26

REF TYPE PRENATAL
CARE

K.28

REF TYPE OTHER SPEC

DRAFT

Valid Values

Comment

Type of referral(s) select all
that apply

 Yes
 No
 Prenatal care
 Adult preventive care
 Reproductive health care
 Breastfeeding/feeding/nutrition
 Child developmental
screenings
 Dental services
 Hearing/vision services
 Childbirth education
 Pediatric primary care
 Early intervention
services/Part C services
 Mental health treatment
 Anger management/domestic
violence counseling
 Domestic violence shelters
 Family support centers
 Food (e.g. food banks)
 Housing
 School readiness
 Child care
 Job training or employment
services
 Adult education services
(including GED and ESL)
 Substance abuse treatment
 Legal
 Public assistance (Medicaid,
SNAP, WIC, SCHIP, TANF,
etc.)
 Other financial supports
 Other

Checkbox; check all
that apply

Type of referral(s) providedother (please specify)

Text

16

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L. Engagement Rating
At only two points during enrollment in a focal EBP—after the second service contact and
at exit from the EBP—staff will be prompted to provide a rating of the case member’s engagement
in the EBP.

L.

#

L.1

Engagement Rating (after second log entry and EBP exit)

Field

Description

CASE EBP ENGAGEMENT

Rate the specified case's
engagement to date in
evidence based program.

DRAFT

17

Valid Values
 4. Participants were
consistently highly involved in
services: The participants kept
most appointments and actively
participated in discussions and
activities. If homework was
assigned, the participants
completed it.
 3. Participants' involvement
varied: The participant(s)
sometimes kept appointments
and sometimes actively
participated in discussions and
activities. If homework was
assigned, the participants
sometimes completed it. At
other times, the participants'
involvement was low.
 2. Participants' involvement
was consistently low: The
participant(s) kept some
appointments but missed or
cancelled frequently. The
participant(s) rarely actively
participated in discussions and
activities. If homework was
assigned, the participant(s)
frequently did not complete it.
 1. Participants were minimally
or not involved at all: The
participant(s) kept few
appointments. The
participant(s) did not actively
participate in discussions and
activities. If homework was
assigned, the participant(s) did
not complete it.

Comment

Choose one

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M. Service Contact Check if No Contact Data Entered for Two Weeks
If no service contact data are entered during a two-week period for an RPG case enrolled in a
focal EBP, staff will be prompted when they log in to the system to confirm whether or not contact
has occurred. If no contact has occurred, staff will record the reason and whether an appointment
has been scheduled. If contact has occurred, staff will be prompted to enter the service data.

M. Service Contact Check if no Contact data Entered for Two Weeks

#
M.1

Field
CONTACT
CONFIRMATION

M.2

IN PERSON
CONFIRMATION

M.3
–
M.6

CONTACT TYPE PROV
REF SERV

M.7

SPECIFY CONTACT TYPE

M.8

REASON NO CASE
CONTACT

M.9

MISSED VISIT COUNT

M.10

ABILITY SCHED APP

DRAFT

Description
Contact with case since the
last recorded service log
In-person services provided
since last recorded service
log

Type of contact with case,
select all that apply
Specification if CONTACT
TYPE = "other"
Main reason no contact made
with case since last service
date
Scheduled visits that did not
occur since last service date
Caseworker able to schedule
an appointment.

18

Valid Values
 Yes
 No

Comment

 Yes
 No
 Provided referral services
 Tried to schedule appointment
 Checked in on family by
phone/email/other of contact
not in person
 Other

Check one

Text
 Exited from EBP
 scheduled visit did not occur
 no scheduled contact

Check one

Integer > 0
 Yes
 No

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N. Subtopics Covered During the Session: Substance Abuse
Sessions for the ten focal EBPs will typically address one of six possible topics, which are
shown in Table H: (1) substance abuse, (2) parenting skills, (3) adult personal development, (4) child
development and education, (5) education provided to the child on adult substance use, or (6)
education provided to other family members on substance use. For any topic that is checked, staff
will be asked to provide a little more detail by indicating which of several subtopics were addressed.
As an example of how the subtopics data entry will work, imagine a session during which the
service provider discussed adult substance use with the child or children in the case. The service
provider would check “education provided to the child on adult substance use” as a content area
discussed (this field is in Table H above). A pop-up screen will then appear showing all the potential
discussion subtopics (in this case the relevant subtopics are found in Section R below). The service
provider will check off the subtopics that were actually discussed during the session. For subtopics
what were not addressed no entry is needed.
N.

#

N.1
–
N.12

Field

PERS DEV TOPICs

DRAFT

Substance Abuse Treatment subtopics

Description
Respond to each of the
following topics:
 Acknowledging a substance
use problem
 Discussing readiness to
change
 Discussing past successful
behavioral changes
 Identifying and preventing
destructive behaviors
 Identifying triggers and
cravings
 Developing a relapse plan
 Fostering honesty and
responsibility
 Fostering self-help skills
 Providing information on
abuse and trauma
 Developing a understanding
of substance use and its
effects
 Addressing guilt, loss, and
grief
 Developing support
networks
 Enacted a plan for change
and recovery

19

Valid Values

Comment

 Primary topic for session
 One of several main topics
 Spent some time discussion
topic
 Touched on topic
 Did not discuss

Ask only if ADULT
TOPICS PERS
DEV is checked.
Default  is  “Did  not  
discuss”.

Type in RFP no., project no., short report title here

Mathematica Policy Research

O. Subtopics Covered During the Session: Parenting Skills

O. Parenting Skills Subtopics

#

O.1
–
O.11

Field

PERS DEV TOPICs

DRAFT

Description
Respond to each of the
following topics:
 Fostering  parent’s  ability  to  
effectively communicate with
child
 Teaching parent how to
develop  child’s  
communication skills
 Teaching parent about child
growth and development
 Teaching parent how to
establish care-giving routines
 Teaching parent to serve as
emotional base for child
 Fostering  parent’s  
understanding of and ability to
develop child autonomy
 Teaching parent strategies
to promote positive family
interactions
 Teaching parent to manage
child’s  behavior, foster
positive behavior, and set
developmentally appropriate
rules and consequences
 Educating parent about preteen and teen sex and STIs
 Educating parent about
child/adolescent substance
use
 Educating parent on
child/adolescent depression
and suicide

20

Valid Values

Comment

 Primary topic for session
 One of several main topics
 Spent some time discussion
topic
 Touched on topic
 Did not discuss

Ask only if ADULT
TOPICS PRNT
SKILLS is checked.
Default  is  “Did  not  
discuss”.

Type in RFP no., project no., short report title here

Mathematica Policy Research

P. Subtopics Covered During the Session: Adult Personal Development
#

P.1
–
P.10

Field

PERS DEV TOPICs

DRAFT

Description
Respond to each of the
following topics:
 Fostering communication
and social skills
 Fostering resiliency
 Fostering empathy and
kindness
 Learning to identify and
express feelings
 Fostering skills to manage
emotions
 Developing life management
skills
 Fostering ability and
commitment to making
healthy choices
 Fostering personal safety
and healthy, safe
relationships and boundaries
 Processing trauma and
developing a trauma narrative

21

Valid Values

Comment

 Primary topic for session
 One of several main topics
 Spent some time discussion
topic
 Touched on topic
 Did not discuss

Ask only if ADULT
TOPICS PERS
DEV is checked.
Default  is  “Did  not  
discuss”.

Type in RFP no., project no., short report title here

Mathematica Policy Research

Q. Subtopics Covered During the Session: Youth Therapy and Development

#

Q.1
–
Q.12

Field

DEV AND ED TOPICS

DRAFT

Description
Respond to each of the
following topics:
 Fostering communication
and social skills
 Fostering resiliency
 Fostering empathy and
kindness
 Learning to identify and
express feelings
 Fostering skills to manage
emotions
 Developing life management
skills
 Fostering ability and
commitment to making
healthy choices
 Fostering personal safety
and healthy, safe
relationships and boundaries
 Processing trauma and
developing a trauma narrative
 Developing positive
behaviors
 Developing a positive
support network

22

Valid Values

Comment

 Primary topic for session
 One of several main topics
 Spent some time discussion
topic
 Touched on topic
 Did not discuss

Ask only if CHILD
TOPICS DEV AND
ED is checked.
Default  is  “Did  not  
discuss”.

Type in RFP no., project no., short report title here

Mathematica Policy Research

R. Subtopics Covered During the Session: Education of Youth on Substance Use
and Recovery Subtopics

P.

#

R.1
–
R.5
R.6

Field

ADULT SUB USE TOPICs
ADULT SUB USE 6
SPECIFY

DRAFT

Education of Child on Adult Substance Abuse Subtopics

Description
Respond to each of the
following topics:
 Discussing impact of
substance abuse on
relationships
 Discussing relapse
prevention
 Educating on biology of
addiction
 Educating on the medical
effects of substance use
 Discussing risk factors for
youth developing substance
use disorder

Valid Values

Specification  if  R.6  is  other”

Text

23

 Primary topic for session
 One of several main topics
 Spent some time discussion
topic
 Touched on topic
 Did not discuss

Comment

Ask only if CHILD
TOPICS ED ADULT
SUB ABUSE is
checked. Default is
“Did  not  discuss”.
Select only one
Describe other topic

Type in RFP no., project no., short report title here

Mathematica Policy Research

S. Subtopics Covered During the Session: Education of Other Relatives on
Substance Use and Recovery Subtopics

Q. Education of other Family Members on Substance Use Subtopics

#

Field

S.1
–
S.4

EXT FAM SUB USE
TOPICs

S.5

EXT FAM USE 6 SPECIFY

DRAFT

Description
Respond to each of the
following topics:
 Discussing impact of
substance abuse on
relationships
 Discussing relapse
prevention
 Educating on biology of
addiction
 Educating on the medical
effects of substance use
Specification if S.6 is other
than  “Did  not  discuss”

24

Valid Values

Comment

 Primary topic for session
 One of several main topics
 Spent some time discussion
topic
 Touched on topic
 Did not discuss

Ask only if ED OTH
RELAT =  “Yes”.  
Default  is  “Did  not  
discuss”.

Text


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