Streamlined Clearance Process for Discretionary Grant

U.S. Department of Education Evidence of Effectiveness Form

OMB No. _________

Exp. XX/XX/XXXX

1. Level of Evidence

Select the level of evidence of effectiveness for which you are applying. See the Notice Inviting Applications or 34 CFR 77.1 for the relevant definitions.

[ ] Evidence of Promise [ ] Moderate Evidence of Effectiveness [ ] Strong Evidence of Effectiveness

2. Citation and Relevance

Fill in the chart below with the appropriate information about the studies that support your application.

A. Citation	B. Citation Outcome(s)	C. Relevance to Proposed Project

Instructions for Evidence Form

1. Level of Evidence. Check the box next to the level of evidence for which you are applying. For competitions that use multiple levels of evidence, select the strongest evidence level you are applying to meet. See the Notice Inviting Applications or 34 CFR 77.1 for the evidence definitions.

2. Citation and Relevance. Fill in the chart for each of the studies you are submitting to meet the evidence standards. If allowable under the program you are applying for, you may add additional rows to include more than four citations. (See below for an example citation.)

   1. Citation. Provide the full citation for each study you are using as evidence of effectiveness. If the study has been reviewed by the WWC, please include the rating it received. You may also include the URL link to the study.

   2. Citation Outcome(s). Describe: 1) the outcomes in the study presented and how those outcomes are statistically significant and 2) how the outcomes in the evidence relate to the outcomes proposed in your project.

   3. Relevance to Proposed Project. Briefly describe the intervention used in the study presented as evidence. How does the evidence relate to your proposed project? Will your proposed project measure the same outcomes? What link is there between the study presented and your proposed intervention and/or study? If applicable, explain how the population in your proposed project is similar to that used in the cited study.

EXAMPLE: For Demonstration Purposes Only

A. Citation	B. Citation Outcome(s)	C. Relevance to Proposed Project
Bettinger, E.P., & Baker, R. (2011). The effects of student coaching in college: An evaluation of a randomized experiment in student mentoring. Stanford, CA: Stanford University School of Education. Meets WWC Group Design Standards without Reservations.	This study found that students assigned to receive coaching and mentoring were significantly more likely than students in the comparison group to remain enrolled at their institutions. The proposed project will create an institutional mentoring and support structure that trains the professional staff and faculty coaches on how and when to effectively communicate with students who are at risk for withdrawing from or failing out of school.	The intervention in the study is a form of college mentoring called student coaching. Students were randomly assigned an individual coach who helped students throughout the first year of college. Coaches helped with a number of issues, including prioritizing studies and identifying barriers and ways to overcome them. Coaches were encouraged to contact their assignees by either phone, email, text messaging, or social networking sites. Our project will train professional staff and faculty coaches on the most effective way(s) to communicate with their mentees, suggest topics for mentors to talk to their mentees, and be aware of signals to prevent withdrawal or academic failure. The full study sample consisted of 13,555 students. The number of students examined for purposes of retention was 2,694. Sample characteristics for just these students are not presented; thus, the following characteristics are for the full sample of students in the study: control had a mean of 49% females, intervention group had a mean of 50% females and the average age for control students was 30.5, for intervention students it was 30.6. Alpha Beta Community College has 7,000 new students every year with a retention/completion rate of 55%. Our student body has 48% males and 52% females. ABCC student body has an average age of 28.5 years.

Paperwork Burden Statement: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is XXXX-XXXX. The time required to complete this information collection is estimated to vary from 1 to 4 hours per response, with an average of 1.5 hours per response, including the time to review instructions, search existing data sources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4537. If you have comments or concerns regarding the status of your individual submission of this form, write directly to the Office of Innovation and Improvement, U.S. Department of Education, 400 Maryland Avenue, S.W., Washington, D.C. 20202