NGO SHS Measures

Form Approved

OMB No: 0920-1049

Exp. Date: 02/28/2018

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

Att. 3a

NGO SHS Items

Public reporting burden of this collection of information is estimated to average 30 minutes 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)

NGO Evaluation Measures – SHS SEA

Evaluation Measures	Data Reporting System	Questions for Collection of Evaluation Measures
SHS Process Measure 1: % of funded SEAs that received assistance on SHS	PERS	In the past six months, how often did you interact with [FUNDED SEA NAME] to provide assistance (e.g., , professional development events, technical assistance, guidance or resource materials, and referrals to other agencies or organizations) on SHS? _____ Never _____ 1 time _____ 2 times _____ 3 - 5 times _____ 6 - 10 times _____ 11 - 15 times _____ 16 - 20 times _____ 21 or more times On what SHS topics did you provide assistance to [FUNDED SEA NAME]? (Check all that apply) Organizational Partnerships - Establish new or strengthen existing organizational partnerships, whether formal or informal, between districts or schools and youth-friendly sexual health service providers Referral Staff – Identify referral staff or build referral staff competencies to make referrals Referral Procedures – Develop, revise, or implement a written sexual health service referral procedure Referral Guide - Create or update a list of youth-friendly sexual health service providers (may also include listing providers that meet the needs of youth at disproportionate risk) Communications and Marketing - Implement strategies to ensure awareness among students and school staff of sexual health service providers and referral services Monitoring and Evaluation – Monitoring and evaluation of access to SHS. Management and Oversight - Collaborate with decision makers at the school or district levels to manage and oversee implementation of SHS referral systems Identify Student SHS needs – Provide guidance for school health services staff to appropriately identify student SHS needs Onsite Health Services - Expand or enhance onsite youth-friendly school sexual health services Reimbursement for Services - Obtain third-party reimbursement for the provision of school-based health services Engage Youth - Implement strategies to engage youth in the design, delivery and evaluation of sexual health services Policy Assessment - Assess sexual health services policies Policy Implementation Monitoring - Monitor the implementation of sexual health services policies SHS Controversy - Manage controversy around sexual health services Staff Competencies in SHS Delivery - Build staff competencies and techniques to improve the delivery of sexual health

NGO Evaluation Measures – SHS LEA

Evaluation Measures	Data Reporting System	Questions for Collection of Evaluation Measures
SHS Process Measure 1: % of funded LEAs that received assistance on SHS	PERS	In the past six months, how often did you interact with [FUNDED LEA NAME] to provide assistance (e.g., professional development events, technical assistance, guidance or resource materials, and referrals to other agencies or organizations) on SHS? _____ Never _____ 1 time _____ 2 times _____ 3 - 5 times _____ 6 - 10 times _____ 11 - 15 times _____ 16 - 20 times _____ 21 or more times On what SHS topics did you provide assistance to [FUNDED LEA NAME]? (Check all that apply) Organizational Partnerships - Establish new or strengthen existing organizational partnerships, whether formal or informal, between districts or schools and youth-friendly sexual health service providers Referral Staff – Identify referral staff or build referral staff competencies to make referrals Referral Procedures – Develop, revise, or implement a written sexual health service referral procedure Referral Guide - Create or update a list of youth-friendly sexual health service providers (may also include listing providers that meet the needs of youth at disproportionate risk) Communications and Marketing - Implement strategies to ensure awareness among students and school staff of sexual health service providers and referral services Monitoring and Evaluation – Monitoring and evaluation of access to SHS. Management and Oversight - Collaborate with decision makers at the school or district levels to manage and oversee implementation of SHS referral systems Identify Student SHS needs – Provide guidance for school health services staff to appropriately identify student SHS needs Onsite Health Services - Expand or enhance onsite youth-friendly school sexual health services Reimbursement for Services - Obtain third-party reimbursement for the provision of school-based health services Engage Youth - Implement strategies to engage youth in the design, delivery and evaluation of sexual health services Policy Assessment - Assess sexual health services policies Policy Implementation Monitoring - Monitor the implementation of sexual health services policies SHS Controversy - Manage controversy around sexual health services Staff Competencies in SHS Delivery - Build staff competencies and techniques to improve the delivery of sexual health