LEA ESHE Measures

Promoting Adolescent Health through School-based HIV/STD Prevention

Att 5c LEA ESHE Items

Local Education Agency Exemplary Sexual Health Education Measures

OMB: 0920-1049

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Form Approved

OMB No: 0920-1049

Exp. Date: 02/28/2018







“Promoting Adolescent Health through School-Based HIV/STD Prevention”


Att. 5c


LEA ESHE Items






Public reporting burden of this collection of information is estimated to average 6 hours 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: OMB-PRA (0920-1049)








LEA Measures



LEA ESHE Measures

Measures

Questions for Collection of Measures

ESHE Performance Measure 1: Funded LEA has a written MS/HS curriculum framework that reflects ESHE programs

  1. Currently, does your district have a written curriculum framework for sexual health education?

Yes ⃝ No ⃝

  1. Does your district require a course including HIV, STD, or pregnancy prevention topics in each of the following grades or range of grades? (Mark yes or no for each.)

Grades


  1. 6

Yes ⃝ No ⃝

  1. 7

Yes ⃝ No ⃝

  1. 8

Yes ⃝ No ⃝

  1. 9

Yes ⃝ No ⃝

  1. 10

Yes ⃝ No ⃝

  1. 11

Yes ⃝ No ⃝

  1. 12

Yes ⃝ No ⃝

  1. Middle school (No specific grade)

Yes ⃝ No ⃝

  1. High school (No specific grade)

Yes ⃝ No ⃝


  1. Currently, does your district include each of the following topics in sexual health education for grades 6-8? (Mark yes or no for each topic.)

    1. How to create and sustain healthy and respectful relationships.

    Yes ⃝ No ⃝

    1. Communication and negotiation skills related to eliminating or reducing risk for HIV, other STD, and pregnancy.

    Yes ⃝ No ⃝

    1. Goal-setting and decision-making skills related to eliminating or reducing risk for HIV, other STD, and pregnancy.

    Yes ⃝ No ⃝

    1. The benefits of being sexually abstinent.

    Yes ⃝ No ⃝

    1. The importance of limiting the number of sexual partners.

    Yes ⃝ No ⃝

    1. The importance of using condoms consistently and correctly.

    Yes ⃝ No ⃝

    1. The importance of using a condom at the same time as another form of contraception to prevent both sexually transmitted diseases (STD) and pregnancy.

    Yes ⃝ No ⃝

    1. How to access valid and reliable health information, products, and services related to HIV, other STD, and pregnancy.

    Yes ⃝ No ⃝

    1. Preventive care such as screenings and immunizations that is necessary to maintain reproductive and sexual health.

    Yes ⃝ No ⃝

    1. Influences of family, peers, culture, media, technology, and other factors on sexual risk behaviors.

    Yes ⃝ No ⃝

    1. Influencing and supporting others to avoid or reduce sexual risk behaviors.

    Yes ⃝ No ⃝

  2. Currently, does your district include each of the following topics in sexual health education for grades 9-12? (Mark yes or no for each topic.)

  1. How to create and sustain healthy and respectful relationships.

Yes ⃝ No ⃝

  1. Communication and negotiation skills related to eliminating or reducing risk for HIV, other STD, and pregnancy.

Yes ⃝ No ⃝

  1. Goal-setting and decision-making skills related to eliminating or reducing risk for HIV, other STD, and pregnancy.

Yes ⃝ No ⃝

  1. The benefits of being sexually abstinent.

Yes ⃝ No ⃝

  1. The importance of limiting the number of sexual partners.

Yes ⃝ No ⃝

  1. The importance of using condoms consistently and correctly.

Yes ⃝ No ⃝

  1. The importance of using a condom at the same time as another form of contraception to prevent both sexually transmitted diseases (STD) and pregnancy.

Yes ⃝ No ⃝

  1. How to access valid and reliable health information, products, and services related to HIV, other STD, and pregnancy.

Yes ⃝ No ⃝

  1. Preventive care such as screenings and immunizations that is necessary to maintain reproductive and sexual health.

Yes ⃝ No ⃝

  1. Influences of family, peers, culture, media, technology, and other factors on sexual risk behaviors.

Yes ⃝ No ⃝

  1. Influencing and supporting others to avoid or reduce sexual risk behaviors.

Yes ⃝ No ⃝




  1. Currently, does your district recommend or require priority schools to assess the ability of students to do each of the following in grades 6-8? (Mark yes or no for each topic.)

  1. Comprehend concepts important to prevent HIV, other STD, and pregnancy.

Yes ⃝ No ⃝

  1. Analyze the influence of family, peers, culture, media, technology, and other factors on sexual risk behaviors.

Yes ⃝ No ⃝

  1. Access valid information, products, and services to prevent HIV, other STD, and pregnancy.

Yes ⃝ No ⃝

  1. Use interpersonal communication skills to avoid or reduce sexual risk behaviors.

Yes ⃝ No ⃝

  1. Use decision-making skills to prevent HIV, other STD, and pregnancy.

Yes ⃝ No ⃝

  1. Set personal goals that enhance health, take steps to achieve these goals, and monitor progress in achieving them.

Yes ⃝ No ⃝

  1. Influence and support others to avoid or reduce sexual risk behaviors.

Yes ⃝ No ⃝


  1. Currently, does your district recommend or require priority schools to assess the ability of students to do each of the following in grades 9-12? (Mark yes or no for each topic.)

    1. Comprehend concepts important to prevent HIV, other STD, and pregnancy.

    Yes ⃝ No ⃝

    1. Analyze the influence of family, peers, culture, media, technology, and other factors on sexual risk behaviors.

    Yes ⃝ No ⃝

    1. Access valid information, products, and services to prevent HIV, other STD, and pregnancy.

    Yes ⃝ No ⃝

    1. Use interpersonal communication skills to avoid or reduce sexual risk behaviors.

    Yes ⃝ No ⃝

    1. Use decision-making skills to prevent HIV, other STD, and pregnancy.

    Yes ⃝ No ⃝

    1. Set personal goals that enhance health, take steps to achieve these goals, and monitor progress in achieving them.

    Yes ⃝ No ⃝

    1. Influence and support others to avoid or reduce sexual risk behaviors.

    Yes ⃝ No ⃝

  2. Currently, does your district provide each of the following materials to those who teach sexual health education in grades 6-8? (Mark yes or no for each material.)

Materials


  1. Goals, objectives, and expected outcomes for sexual health education.

Yes ⃝ No ⃝

  1. A written health education curriculum that includes objectives and content addressing sexual health education.

Yes ⃝ No ⃝

  1. Strategies that are age-appropriate, relevant, and actively engage students in learning.

Yes ⃝ No ⃝

  1. A chart describing the annual scope and sequence of instruction for sexual health education.

Yes ⃝ No ⃝

  1. Methods to assess student knowledge and skills related to sexual health education.

Yes ⃝ No ⃝


  1. Currently, does your district provide each of the following materials to those who teach sexual health education in grades 9-12? (Mark yes or no for each material)

Materials


  1. Goals, objectives, and expected outcomes for sexual health education.

Yes ⃝ No ⃝

  1. A written health education curriculum that includes objectives and content addressing sexual health education.

Yes ⃝ No ⃝

  1. Strategies that are age-appropriate, relevant, and actively engage students in learning.

Yes ⃝ No ⃝

  1. A chart describing the annual scope and sequence of instruction for sexual health education.

Yes ⃝ No ⃝

  1. Methods to assess student knowledge and skills related to sexual health education.

Yes ⃝ No ⃝


ESHE Performance Measure 3: % of priority schools that have implemented sexual health curricula (including EBI if applicable)

  1. In the past 6 months, did [PRIORITY SCHOOL NAME] implement sexual health curricula in 6-8 grades?

Yes ⃝ No ⃝


  1. If yes, what sexual health curricula did [PRIORITY SCHOOL NAME] implement in 6-8 grades? (Mark all that apply and specify name or description of any “other” sexual health curricula.)

⃝ Aban Aya Youth Project

⃝ Adult Identity Mentoring (Project AIM)

⃝ All4You!

⃝ Be Proud! Be Responsible!

⃝ Becoming a Responsible Team (BART)

⃝ ¡Cuídate!

⃝ Draw the Line/Respect the Line

⃝ FOCUS

⃝ Focus on Youth + ImPACT

⃝ Heritage Keepers Abstinence Education

⃝ Horizons

⃝ It's Your Game: Keep it Real

⃝ Making a Difference!

⃝ Making Proud Choices!

⃝ Project AIM

⃝ Promoting Health Among Teens! Abstinence-Only Intervention (formerly known as 'Promoting Health Among Teens!')

⃝ Promoting Health Among Teens! Comprehensive Abstinence and Safer Sex Intervention (formerly known as 'Comprehensive Abstinence and Safer Sex Intervention!')

⃝ Raising Healthy Children (formerly known as the Seattle Social Development Project)

⃝ Reducing the Risk

⃝ RESPECT

⃝ Safe in the City

⃝ Safer Choices

⃝ Safer Sex

⃝ SIHLE

⃝ Sisters Saving Sisters

⃝ Street Smart

⃝ Teen Health Project

⃝ Teen Outreach Program

⃝ What Could You Do?

⃝ WILLOW

⃝ Other curriculum

Provide name or description of other curriculum:_______________________________________________


  1. In the past 6 months, did [PRIORITY SCHOOL NAME] implement sexual health curricula in 9-12 grades?

Yes ⃝ No ⃝


  1. If yes, what sexual health curricula did [PRIORITY SCHOOL NAME] implement in 9-12 grades? (Mark all that apply and specify name or description of any “other” sexual health curricula.)

⃝ Aban Aya Youth Project

⃝ Adult Identity Mentoring (Project AIM)

⃝ All4You!

⃝ Be Proud! Be Responsible!

⃝ Becoming a Responsible Team (BART)

⃝ ¡Cuídate!

⃝ Draw the Line/Respect the Line

⃝ FOCUS

⃝ Focus on Youth + ImPACT

⃝ Heritage Keepers Abstinence Education

⃝ Horizons

⃝ It's Your Game: Keep it Real

⃝ Making a Difference!

⃝ Making Proud Choices!

⃝ Project AIM

⃝ Promoting Health Among Teens! Abstinence-Only Intervention (formerly known as 'Promoting Health Among Teens!')

⃝ Promoting Health Among Teens! Comprehensive Abstinence and Safer Sex Intervention (formerly known as 'Comprehensive Abstinence and Safer Sex Intervention!')

⃝ Raising Healthy Children (formerly known as the Seattle Social Development Project)

⃝ Reducing the Risk

⃝ RESPECT

⃝ Safe in the City

⃝ Safer Choices

⃝ Safer Sex

⃝ SIHLE

⃝ Sisters Saving Sisters

⃝ Street Smart

⃝ Teen Health Project

⃝ Teen Outreach Program

⃝ What Could You Do?

⃝ WILLOW

⃝ Other curriculum

Provide name or description of other curriculum:_______________________________________________


ESHE Performance Measure 4: # of MS and HS students in priority schools who received a sexual health curriculum (including EBI if applicable)

  1. For each sexual health curriculum that [PRIORITY SCHOOL NAME] implemented in 6-8 grades, how many students did the curriculum reach?


Curriculum 1: ____________

Curriculum 2: ____________

Curriculum 3:_____________


  1. For each sexual health curriculum that [PRIORITY SCHOOL NAME] implemented in 9-12 grades, how many students did the curriculum reach?


Curriculum 1: ____________

Curriculum 2: ____________

Curriculum 3:_____________


ESHE Process Measure 1:

Funded LEA has assessed its sexual health and/or HIV education policies

In the past six months, did you complete each of the following actions regarding the assessment of sexual health and/or HIV education policies (including laws, codes, or regulations)? (Mark yes or no for each item.)

  1. Identified policies that guide sexual health and/or HIV education work.

Yes ⃝ No ⃝

  1. Determined whether sexual health and/or HIV education policies are aligned with state policies, codes, laws, and regulations.

Yes ⃝ No ⃝

  1. Documented gaps in sexual health and/or HIV education policies as compared with the Performance Measures.

Yes ⃝ No ⃝

  1. Collaborated with LEA leadership and staff to prioritize actions for addressing identified gaps in sexual health and/or HIV education policies.

Yes ⃝ No ⃝



ESHE Process Measure 2: Funded LEA has monitored the implementation of sexual health and/or HIV education policies in priority schools

In the past six months, did you complete each of the following actions regarding the monitoring of priority schools’ implementation of sexual health and/or HIV education policies (including laws, codes, or regulations)? (Mark yes or no for each item.)

  1. Developed or maintained a list of current school-level sexual health and/or HIV education policy guidance for priority schools.

Yes ⃝ No ⃝

  1. Reviewed priority schools’ sexual health and/or HIV education policy guidance to ensure alignment with state law, state education agency policy, and district policy.

Yes ⃝ No ⃝

  1. Tracked priority schools’ implementation of sexual health and/or HIV education related policies.

Yes ⃝ No ⃝

  1. Prepared informational materials about current sexual health and/or HIV education policies or policy options for stakeholders.

  2. Maintained a tracking system of priority schools that have used CDC’s School Health Index to evaluate sexual health and/or HIV education policy implementation.

Yes ⃝ No ⃝


Yes ⃝ No ⃝



ESHE Process Measure 3:

% of priority schools that received assistance on ESHE

  1. In the past six months, how often did you interact with [PRIORITY SCHOOL NAME] to provide assistance (e.g., professional development events, technical assistance, guidance or resource materials, and referrals to other agencies or organizations) on ESHE?

_____ Never

_____ 1 time

_____ 2 times

_____ 3 - 5 times

_____ 6 - 10 times

_____ 11 - 15 times

_____ 16 - 20 times

_____ 21 or more times


  1. On what ESHE topics did you provide assistance to [PRIORITY SCHOOL NAME]? (check all that apply)

  • Assess curricula with the Health Education Curriculum Analysis Tool (HECAT)

  • Select an appropriate curriculum (including evidence-based interventions, if appropriate)

  • Implement a specific curriculum with appropriate fidelity (including evidence-based interventions, if appropriate)

  • Make appropriate adaptations to curricula (including evidence-based interventions, if appropriate)

  • Implement a viable scope-and-sequence for sexual health education

  • Assess sexual health and/or HIV education policies

  • Monitor the implementation of sexual health and/or HIV education policies

  • Manage controversy around sexual health education

  • Build instructional competencies and techniques for sexual health education

  • Assess school policies with School Health Index

  • Establish and maintain a school health advisory council (SHAC


ESHE Process Measure 4:

Frequency with which funded LEA received assistance from NGO on ESHE

In the past six months, how often did you interact with Healthy Teen Network to receive assistance (e.g., professional development events, technical assistance, guidance or resource materials, and referrals to other agencies or organizations) on ESHE?

_____ Never

_____ 1 time

_____ 2 times

_____ 3 - 5 times

_____ 6 - 10 times

_____ 11 - 15 times

_____ 16 - 20 times

_____ 21 or more times



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