Eligibility Questionnaire

Appendix A3: PRISMS Toolkit Evaluation Eligibility Questionnaire

Please complete the questions below to help us determine your eligibility for participation in the evaluation of the Providing Reading Interventions for Students in Middle School (PRISMS) Toolkit.

Section 1: District information

Official district name

Name of person completing form

Email address of person completing form

Phone number of person completing form:

Section 2: School information (repeat this section for each school)

Name of school building eligible to participate. School must serve grade 6–8 students.

Total number of grade 6–8 teachers who teach at least one regular English language arts (ELA) class or reading intervention class.

The school is not currently participating and will not participate during the study year (fall 2025–spring 2026) in a program similar to PRISMS (see the project overview above).

• True

• False

In the event that the school is randomly selected to be part of the control group, the school is willing to wait to access the PRISMS program until the 2026/27 school year and participate in all data collection. Control schools will receive a $2,500 compensation for facilitating data collection in addition to stipends given to individuals for participating in data collection.

• True

• False

The school is willing to assign a data point of contact to provide student and teacher data, and engage in all data collection activities (teacher administrative and assessment data, student universal screener in literacy data, teacher survey, school leader checklist, Professional Learning Community (PLC) facilitator’s checklist, and leader and teacher interviews; see the project overview above).

• True

• False

Please provide any additional information you feel clarifies the questions above.

Section 3: Follow-up

What questions do you have about the project, and what would be required to participate?

Regional Educational Laboratory Southwest Toolkit Evaluation 1