Appendix E_Teacher of Health Education Survey

OMB Control # 0584-0524

Expiration Date: x/xx/20xx

OMB BURDEN STATEMENT: This information is being collected to assist the Food and Nutrition Service (FNS) in providing the public with information concerning its child nutrition programs. This voluntary information will be used to develop nutrition education resources and interventions for population groups served by FNS. Under the Privacy Act of 1974, any personally identifying information obtained will be kept private to the extent provided by law. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0524. The time to complete this information collection is estimated as part of the 10 minutes for the screener, including the time for reviewing instructions and completing the information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-0524). Do not return the completed form to this address.

Appendix E – Teacher of Health Education Survey

1. What grade(s) do you teach (please check at that apply)?

( ) Kindergarten ( ) 7^th Grade

( ) First Grade ( ) 8^th Grade

( ) 2nd Grade ( ) 9^th Grade

( ) 3^rd Grade ( ) 10^th Grade

( ) 4^th Grade ( ) 11^th Grade

( ) 5^th Grade ( ) 12^th Grade

( ) 6^th Grade

2. What subject(s) do you teach (please check at that apply)?

( ) English Language Arts ( ) Physical Education

( ) Math ( ) Health

( ) Science ( ) Professional Studies

( ) Nutrition ( ) Technology

( ) History ( ) Arts or Music

( ) Social Studies ( ) Library/Library Science

Education Technology: when we use the term education technology, we’re referring to any technology that helps support instruction, collaboration, preparation, communication, and/or student learning.

( ) Foreign Language Studies ( ) Other__________

3) Please name three ways in which you use education technology to help kids change their eating and physical activity behaviors. (If you don’t use technology, please explain why).

4) Please name three barriers to using education technology to teach health education:

5) In general, approximately how many hours in a week is technology used in your teaching in the following situations:
Students use electronic devices to complete classwork	_________
I use electronic devices to show or demonstrate information in class	_________
I use emails, websites, or social media to communicate with students	_________
I use emails, websites, or social media to communicate with parents/caregivers	_________

6) Which technologies and/or digital pedagogies do you use with your students? (check all that apply):
Touchscreen apps	
Smart Board/interactive white boards	
Showing videos to your class	
e-books	
Skype or other video conferencing	
Downloadable PDFs	
Photography and/or photo editing	
Video creation projects/assignments	
Online lessons	
Website visits	
Word processors/desktop publishing	
Internet searches	
Music	
YouTube	
Social Media (Facebook, Twitter etc.)	
Learning Management System	
Other: (please list) ________________	

7) Please indicate which of the following devices are used in your classroom (check all that apply):
Touchscreen Devices: IOS (e.g. iPads) Android (e.g. Galaxy, Nexus) Microsoft (e.g. Surface) Other _________________ I don’t know	    
Computers: Mac Desktop Mac Laptop PC Desktop PC Laptop Other _________________	    
Internet browser: Chrome Internet Explorer Safari Other _________________ I don’t know	    
Video Players: Streaming/Internet Players DVD Player VHS Player Other _________________ I don’t know	    

8) Please read the following statements and indicate your level of agreement.	Strongly Agree	Agree	Neither Agree nor disagree	Disagree	Strongly Disagree
The administration at this school supports the use of technology in the classroom and with students.					
There are adequate professional development opportunities for me to learn about using technology in my teaching.					
Using technology enables me to cover more material in my classes.					
Using technology to teach my students helps enhance student learning.					
Using technology to teach my students increases my productivity as a teacher.					
Using technology to teach my students enhances my effectiveness as a teacher.					
Learning to use technology is easy for me.					
I find it easy to use technology to do what I want to do.					
My interaction with technology does not require much effort.					
It is easy for me to become skillful at using technology.					
I find technology easy to use.					
I actively look for new ways to use technology to support my teaching.					