ENV_School - public use version Form Approved OMB No: 0920-0445 Expiration Date: 11/30/2008 School Policy and Environment School Questionnaire School Policy and Environment School Questionnaire Questions General School Environment 1 - 12 Violence Prevention 13 - 42 Tobacco Use Prevention 43 - 76 Alcohol Use Prevention 77 - 87 Illegal Drug Use Prevention 88 - 108 Injury Prevention and Safety 109 - 117 Physical School Environment 118 - 134 Crisis Preparedness, Response, and Recovery 135 - 145 School Climate 146 - 155 Physical Activity 156 – 165 Food and Beverages Sold Outside of the School Meal Program 166 – 194 School Health Councils 195 - 201 Public reporting burden for this collection of information is estimated to average 60 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, Mailstop D-74, Atlanta, GA 30333; Attention PRA (0920-0445). Note: Throughout this questionnaire, text that appears in all capital LETTERS WILL NOT BE READ ALOUD TO RESPONDENTS. THIS QUESTIONNAIRE WILL BE ADMINISTERED USING COMPUTER ASSISTED PERSONAL INTERVIEW TECHNOLOGY. THE INTERVIEWER WILL READ THE QUESTIONS ALOUD AND TYPE RESPONSES TO THE QUESTIONS INTO THE LAPTOP COMPUTER. THE INTERVIEW PROGRAM WILL 1) DISPLAY THE CORRECT TENSE OF VERBS, 2) PROVIDE ALTERNATE ANSWERS TO QUESTIONS (E.G., NOT APPLICABLE, “I DON’T KNOW”), 3) NAVIGATE COMPLEX SKIP PATTERNS, AND 4) PERFORM OTHER USEFUL FUNCTIONS. THE PROGRAMMING SPECIFICATIONS FOR THE INTERVIEW ARE NOT INCLUDED IN THIS PRINTED VERSION OF THE QUESTIONNAIRE. 1. What is your job title at the school? (In which role do you spend more time?) 1) Principal 11) School Counselor 2) Asst. Principal/Other School 12) Social Worker Administrator 13) Psychologist 3) School Secretary 14) Other Mental Health/Social Services 4) Physical Ed Teacher Provider 5) Athletic Director 15) Nurse 6) Health Ed Teacher 16) Health Aide 7) Other Teacher 17) Physician 8) Food Service Manager 18) Other Health Services Provider 9) Commercial Food Service Provider 19) SBHC Health Services Staff 10) Other School Food Service Staff 20) SBHC Mental Health/Social Services Staff 50) Other Staff During this interview, I will ask about policies and practices that affect the health, safety and security of the school environment at this school, such as measures taken to reduce violence, and to reduce alcohol or other drug use at school. When I ask about “policies,” I mean any mandate issued by the state, the local school board, or any other agency that affects your school environment. Please consider any policies officially adopted by your school or district, including policies developed by your school or (district/diocese), as well as policies built on model federal or state policies. In addition, I will ask about practices that you might follow to promote the health and well-being of students. Please keep in mind that I will be asking only about policies and practices, not about standard classroom instruction on these topics. If I ask about things that do not apply to this school or that your school does not do, please bear with me. 2. How many students are currently enrolled in... Kindergarten? ________ Students 1ST Grade? ________ Students 2ND Grade? ________ Students 3RD Grade? ________ Students 4TH Grade? ________ Students 5TH Grade? ________ Students 6TH Grade? ________ Students 7TH Grade? ________ Students 8TH Grade? ________ Students 9TH Grade? ________ Students 10TH Grade? ________ Students 11TH Grade? ________ Students 12TH Grade? ________ Students My next questions focus on safety and security measures. 3. Must visitors to this school report to the main office or reception area upon arrival? Yes 1 No 2 4. Is this school a “closed campus,” meaning that students are not allowed to leave school during the school day, including during lunchtime? Yes 1 No 2 5. During the school day, are staff or adult volunteers assigned to monitor... Yes No a. School halls during classes? 1 2 b. School halls between classes? 1 2 c. Bathrooms? 1 2 d. School grounds? 1 2 ANSWER E FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q6. e. Playgrounds, while they are in use? 1 2 ANSWER Q6 FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO Q7. 6. Does this school routinely conduct locker searches? Yes 1 No 2 7. Are students at this school required to wear school uniforms? Yes 1-->SKIP TO Q9A No 2 8. Is there a dress code at your school? Yes 1 No 2 9a. Are students at your school required to wear identification badges? Yes 1 No 2 9b. What about visitors to your school? Yes 1 No 2 9c. What about school faculty and staff? Yes 1 No 2 10. During the school day, does your school use... Yes No a. Security or surveillance cameras, either inside or outside the building? 1 2 b. Metal detectors, including wands? 1 2 c. Communication devices such as cell-phones, 2-way radios, walkie-talkies, or intercoms? 1 2 11. I’m going to ask about different types of security staff that this school might use. During the regular school day, does your school use... Yes No a. Police or school resource officers? 1 2 b. Security guards? 1 2 IF THIS SCHOOL USES SECURITY STAFF (Q11A OR B IS “YES”) CONTINUE WITH Q12. OTHERWISE, SKIP TO THE INTRODUCTION TO Q13. 12. Are any of the security staff at your school armed? Yes 1 No 2 Now I would like to ask about your school’s policies regarding violence. 13. Has this school adopted a policy prohibiting physical fighting by students on school property? Yes 1 No 2 14. Has this school adopted a policy prohibiting physical fighting by students at off-campus, school-sponsored events? Yes 1 No 2 IF Q13 AND Q14 ARE “NO,” SKIP TO Q16. 15. Does your school’s policy include guidelines on what actions the school should take when students are caught fighting? Yes 1 No 2 16. During the 2004-05 school year, about how many times were students caught fighting? _____ Times IF Q16 IS LESS THAN 4, SKIP TO Q20. SHOW CARD 1 17. Which of the things listed on this card helped determine what actions the school took when students were caught fighting? MARK ALL THAT APPLY Zero-tolerance 1 Effect or severity of the violation 2 Grade level of student 3 Victim versus perpetrator status 4 Repeat offender status 5 None 6 SHOW CARD 2 18. When students were caught fighting, how often were they... Almost Some- Always or Never Rarely times Always N/A a. Referred to a school counselor? 1 2 3 4 5 b. Referred to a school administrator? 1 2 3 4 c. Referred to peer mediation? 1 2 3 4 5 d. Encouraged, but not required, to participate in an assistance program? 1 2 3 4 5 e. Required to participate in an assistance program? 1 2 3 4 5 f. Referred to legal authorities? 1 2 3 4 g. Placed in detention? 1 2 3 4 5 h. Given in-school suspension? 1 2 3 4 5 i. Not allowed to participate in extracurricular activities or interscholastic sports? 1 2 3 4 j. Suspended from school? 1 2 3 4 k. Expelled from school? 1 2 3 4 l. Reassigned to an alternative school? 1 2 3 4 5 19. When students were caught fighting, how often were students’ families notified? Never 1 Rarely 2 Sometimes 3 Almost always or always 4 20. Has this school adopted a policy prohibiting weapon use by students on school property? Yes 1 No 2 21. Has this school adopted a policy prohibiting weapon use at offcampus, schoolsponsored events? Yes 1 No 2 IF Q20 AND Q21 ARE “NO,” SKIP TO Q23. 22. Does your school’s policy include guidelines on what actions the school should take when students are caught using a weapon? Yes 1 No 2 23. Has this school adopted a policy prohibiting weapon possession by students on school property? Yes 1 No 2 24. Has this school adopted a policy prohibiting weapon possession at offcampus, schoolsponsored events? Yes 1 No 2 IF Q23 AND Q24 ARE “NO,” SKIP TO Q26. 25. Does your school’s policy include guidelines on what actions the school should take when students are caught possessing a weapon? Yes 1 No 2 26. During the 2004-05 school year, about how many times were students caught... Times a. Using a weapon? ________ b. Possessing a weapon? ________ IF Q26B IS LESS THAN 4, SKIP TO THE INSTRUCTIONS BEFORE Q30. SHOW CARD 3 27. Which of the things listed on this card helped determine what actions the school took when students were caught possessing a weapon? MARK ALL THAT APPLY Zero-tolerance 1 Effect or severity of the violation 2 Grade level of student 3 Repeat offender status 4 Type of weapon 5 None 6 SHOW CARD 4 28. When students were caught possessing a weapon, how often were they... Almost Some- Always or Never Rarely times Always N/A a. Referred to a school counselor? 1 2 3 4 5 b. Referred to a school administrator? 1 2 3 4 c. Encouraged, but not required, to participate in an assistance program? 1 2 3 4 5 d. Required to participate in an assistance program? 1 2 3 4 5 e. Referred to legal authorities? 1 2 3 4 f. Placed in detention? 1 2 3 4 5 g. Given in-school suspension? 1 2 3 4 5 h. Not allowed to participate in extracurricular activities or interscholastic sports? 1 2 3 4 i. Suspended from school? 1 2 3 4 j. Expelled from school? 1 2 3 4 k. Reassigned to an alternative school? 1 2 3 4 5 29. When students were caught possessing a weapon, how often were students’ families notified? Never 1 Rarely 2 Sometimes 3 Almost always or always 4 IF Q26A IS LESS THAN 4, SKIP TO Q33. SHOW CARD 3 30. Which of the things listed on this card helped determine what actions the school took when students were caught using a weapon? MARK ALL THAT APPLY Zero-tolerance 1 Effect or severity of the violation 2 Grade level of student 3 Repeat offender status 4 Type of weapon 5 None 6 SHOW CARD 4 31. When students were caught using a weapon, how often were they... Almost Some- Always or Never Rarely times Always N/A a. Referred to a school counselor? 1 2 3 4 5 b. Referred to a school administrator? 1 2 3 4 c. Encouraged, but not required, to participate in an assistance program? 1 2 3 4 5 d. Required to participate in an assistance program? 1 2 3 4 5 e. Referred to legal authorities? 1 2 3 4 f. Placed in detention? 1 2 3 4 5 g. Given in-school suspension? 1 2 3 4 5 h. Not allowed to participate in extracurricular activities or interscholastic sports? 1 2 3 4 i. Suspended from school? 1 2 3 4 j. Expelled from school? 1 2 3 4 k. Reassigned to an alternative school? 1 2 3 4 5 32. When students were caught using a weapon, how often were students’ families notified? Never 1 Rarely 2 Sometimes 3 Almost always or always 4 33. Has this school adopted a policy prohibiting gang activity, such as recruiting or wearing gang colors, symbols, or other gang attire? Yes 1 No 2 Now, I’d like to ask about procedures that your school might use to involve students, families, and other community members in your violence prevention efforts. 34. During the past two years, have... Yes No a. Students helped develop, communicate, or implement violence prevention policies or activities? 1 2 b. Students’ families helped develop, communicate, or implement violence prevention policies or activities? 1 2 c. Community members helped develop, communicate, or implement violence prevention policies or activities? 1 2 35. Does your school have procedures to inform all students... Yes No a. About violence-related rules? 1 2 b. About what happens if they break the rules? 1 2 36. Does your school have procedures to inform the families of all students... Yes No a. About violence-related rules? 1 2 b. About what happens if students break the rules? 1 2 37. Does your school post signs marking a weapons-free school zone, that is, a specified distance from school grounds where weapons are not allowed? Yes 1 No 2 The next questions ask about bullying. By “bullying,” I mean the repeated infliction or attempted infliction of injury, discomfort, or humiliation of a student by one or more other students. 38. Has this school adopted a policy prohibiting bullying on school property? Yes 1 No 2 39. Has this school adopted a policy prohibiting bullying at off-campus, school-sponsored events? Yes 1 No 2 40. Does your school have or participate in... Yes No a. A peer mediation program? 1 2 b. A safe-passages to school program? 1 2 c. A program to prevent gang violence? 1 2 d. A program to prevent bullying? 1 2 41. Does this school have a plan for the actions to be taken when a student at risk for suicide is identified? Yes 1 No 2-->SKIP TO THE INTRODUCTION TO Q43 42. Does this plan require that... Yes No a. The student’s family will be informed? 1 2 b. The student will be referred to a mental health provider? 1 2 c. A visit with a mental health provider will be documented before the student returns to school? 1 2 The next questions ask about your school’s policies regarding tobacco use. 43. Has this school adopted a policy prohibiting cigarette smoking by students? Yes 1 No 2-->SKIP TO Q46 44. Does your school’s policy specifically prohibit cigarette smoking by students... Yes No a. In school buildings? 1 2 b. Outside on school grounds, including parking lots and playing fields? 1 2 c. On school buses or other vehicles used to transport students? 1 2 d. At off-campus, school-sponsored events? 1 2 45. Does your school’s policy include guidelines on what actions the school should take when students are caught smoking cigarettes? Yes 1 No 2 46. During the 2004-05 school year, about how many times were students caught smoking cigarettes? _______Times IF Q46 IS LESS THAN 4, SKIP TO Q50. SHOW CARD 5 47. Which of the things listed on this card helped determine what actions the school took when students were caught smoking cigarettes? MARK ALL THAT APPLY Zero-tolerance 1 Effect or severity of the violation 2 Grade level of student 3 Repeat offender status 4 None 5 SHOW CARD 6 48. When students were caught smoking cigarettes, how often were they... Almost Some- Always or Never Rarely times Always N/A a. Referred to a school counselor? 1 2 3 4 5 b. Referred to a school administrator? 1 2 3 4 c. Encouraged, but not required, to participate in an assistance, education, or cessation program? 1 2 3 4 5 d. Required to participate in an assistance, education, or cessation program? 1 2 3 4 5 e. Referred to legal authorities? 1 2 3 4 f. Placed in detention? 1 2 3 4 5 g. Given in-school suspension? 1 2 3 4 5 h. Not allowed to participate in extracurricular activities or interscholastic sports? 1 2 3 4 i. Suspended from school? 1 2 3 4 j. Expelled from school? 1 2 3 4 k. Reassigned to an alternative school? 1 2 3 4 5 49. When students were caught smoking cigarettes, how often were students’ families notified? Never 1 Rarely 2 Sometimes 3 Almost always or always 4 50. Has this school adopted a policy prohibiting cigar or pipe smoking by students? Yes 1 No 2 51. Has this school adopted a policy prohibiting smokeless tobacco use by students? Yes 1 No 2-->SKIP TO Q54 52. Does your school’s policy specifically prohibit smokeless tobacco use by students... Yes No a. In school buildings? 1 2 b. Outside on school grounds, including parking lots and playing fields? 1 2 c. On school buses or other vehicles used to transport students? 1 2 d. At off-campus, school-sponsored events? 1 2 53. Does your school’s policy include guidelines on what actions the school should take when students are caught using smokeless tobacco? Yes 1 No 2 54. During the 2004-05 school year, about how many times were students caught using smokeless tobacco? _______Times IF Q54 IS LESS THAN 4, SKIP TO Q58. SHOW CARD 5 55. Which of the things listed on this card helped determine what actions the school took when students were caught using smokeless tobacco? MARK ALL THAT APPLY Zero-tolerance 1 Effect or severity of the violation 2 Grade level of student 3 Repeat offender status 4 None 5 SHOW CARD 6 56. When students were caught using smokeless tobacco, how often were they... Almost Some- Always or Never Rarely times Always N/A a. Referred to a school counselor? 1 2 3 4 5 b. Referred to a school administrator? 1 2 3 4 c. Encouraged, but not required, to participate in an assistance, education, or cessation program? 1 2 3 4 5 d. Required to participate in an assistance, education, or cessation program? 1 2 3 4 5 e. Referred to legal authorities? 1 2 3 4 f. Placed in detention? 1 2 3 4 5 g. Given in-school suspension? 1 2 3 4 5 h. Not allowed to participate in extracurricular activities or interscholastic sports? 1 2 3 4 i. Suspended from school? 1 2 3 4 j. Expelled from school? 1 2 3 4 k. Reassigned to an alternative school? 1 2 3 4 5 57. When students were caught using smokeless tobacco, how often were students’ families notified? Never 1 Rarely 2 Sometimes 3 Almost always or always 4 58. Is tobacco advertising prohibited... Yes No a. In the school building? 1 2 b. On school grounds, including on the outside of the school building, on playing fields, or other areas of the campus? 1 2 c. On school buses or other vehicles used to transport students? 1 2 d. In school publications? 1 2 e. Through sponsorship of school events? 1 2 59. Are students at your school prohibited from wearing tobacco brand-name apparel or carrying merchandise with tobacco company names, logos, or cartoon characters on it? Yes 1 No 2 Now, I’d like to ask about procedures that your school might use to involve students, families, and other community members in your tobacco use prevention efforts. 60. During the past two years, have... Yes No a. Students helped develop, communicate, or implement tobacco use prevention policies or activities? 1 2 b. Students’ families helped develop, communicate, or implement tobacco use prevention policies or activities? 1 2 c. Community members helped develop, communicate, or implement tobacco use prevention policies or activities? 1 2 61. Does your school have procedures to inform all students... Yes No a. About rules related to tobacco use by students? 1 2 b. About what happens if they break the rules? 1 2 62. Does your school have procedures to inform the families of all students... Yes No a. About rules related to tobacco use by students? 1 2 b. About what happens if students break the rules? 1 2 63. Does your school post signs marking a tobacco-free school zone, that is, a specified distance from school grounds where tobacco use is not allowed? Yes 1 No 2 ANSWER Q64 FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO THE INTRODUCTION TO Q65. 64. Does your school have or participate in a youth empowerment or advocacy program related to tobacco use prevention? Yes 1 No 2 These next questions are about tobacco use by faculty and staff. 65. Has this school adopted a policy prohibiting cigarette smoking by faculty and staff during any school-related activity? Yes 1 No 2-->SKIP TO Q67 66. Does your school’s policy specifically prohibit cigarette smoking by faculty and staff... Yes No a. In school buildings? 1 2 b. Outside on school grounds, including parking lots and playing fields? 1 2 c. On school buses or other vehicles used to transport students? 1 2 d. At off-campus, school-sponsored events? 1 2 67. Has this school adopted a policy prohibiting cigar or pipe smoking by faculty and staff during any school-related activity? Yes 1 No 2 68. Has this school adopted a policy prohibiting smokeless tobacco use by faculty and staff during any school-related activity? Yes 1 No 2-->SKIP TO THE INSTRUCTIONS BEFORE Q70 69. Does your school’s policy specifically prohibit smokeless tobacco use by faculty and staff... Yes No a. In school buildings? 1 2 b. Outside on school grounds, including parking lots and playing fields? 1 2 c. On school buses or other vehicles used to transport students? 1 2 d. At off-campus, school-sponsored events? 1 2 IF Q65, Q67, AND Q68 ARE ALL “NO,” SKIP TO THE INTRODUCTION TO Q71. OTHERWISE, CONTINUE. 70. Does your school have procedures to inform faculty and staff… Yes No a. About rules related to tobacco use by faculty and staff? 1 2 b. About what happens if they break the rules? 1 2 These next questions are about tobacco use by school visitors. By visitors, I mean anyone other than students or faculty and staff, including family members, community members, and repair workers. These people might visit school during or outside of school hours. 71. Has this school adopted a policy prohibiting cigarette smoking by school visitors? Yes 1 No 2-->SKIP TO Q73 72. Does your school’s policy specifically prohibit cigarette smoking by school visitors... Yes No a. In school buildings? 1 2 b. Outside on school grounds, including parking lots and playing fields? 1 2 c. On school buses or other vehicles used to transport students? 1 2 d. At off-campus, school-sponsored events? 1 2 73. Has this school adopted a policy prohibiting cigar or pipe smoking by school visitors? Yes 1 No 2 74. Has this school adopted a policy prohibiting smokeless tobacco use by school visitors? Yes 1 No 2-->SKIP TO THE INSTRUCTIONS BEFORE Q76 75. Does your school’s policy specifically prohibit smokeless tobacco use by school visitors... Yes No a. In school buildings? 1 2 b. Outside on school grounds, including parking lots and playing fields? 1 2 c. On school buses or other vehicles used to transport students? 1 2 d. At off-campus, school-sponsored events? 1 2 IF THIS SCHOOL HAS ADOPTED ANY POLICIES PROHIBITING TOBACCO USE BY SCHOOL VISITORS (Q71, Q73 OR Q74 IS “YES”), ANSWER Q76. OTHERWISE, SKIP TO THE INTRODUCTION TO Q77. 76. Does your school have procedures to inform school visitors... Yes No a. About rules related to tobacco use by visitors? 1 2 b. About what happens if they break the rules? 1 2 Now I would like to ask about your school’s policies regarding alcohol use. 77. Has this school adopted a policy prohibiting alcohol use by students on school property? Yes 1 No 2 78. Has this school adopted a policy prohibiting alcohol use by students at off-campus, school-sponsored events? Yes 1 No 2 IF Q77 AND Q78 ARE “NO,” SKIP TO Q80. 79. Does your school’s policy include guidelines on what actions the school should take when students are caught drinking alcohol? Yes 1 No 2 80. During the 2004-05 school year, about how many times were students caught drinking alcohol? _______Times IF Q80 IS LESS THAN 4, SKIP TO THE INTRODUCTION TO Q84. SHOW CARD 5 81. Which of the things listed on this card helped determine what actions the school took when students were caught drinking alcohol? MARK ALL THAT APPLY Zero-tolerance 1 Effect or severity of the violation 2 Grade level of student 3 Repeat offender status 4 None 5 SHOW CARD 4 82. When students were caught drinking alcohol, how often were they... Almost Some- Always or Never Rarely times Always N/A a. Referred to a school counselor? 1 2 3 4 5 b. Referred to a school administrator? 1 2 3 4 c. Encouraged, but not required, to participate in an assistance, education, or cessation program? 1 2 3 4 5 d. Required to participate in an assistance, education, or cessation program? 1 2 3 4 5 e. Referred to legal authorities? 1 2 3 4 f. Placed in detention? 1 2 3 4 5 g. Given in-school suspension? 1 2 3 4 5 h. Not allowed to participate in extracurricular activities or interscholastic sports? 1 2 3 4 i. Suspended from school? 1 2 3 4 j. Expelled from school? 1 2 3 4 k. Reassigned to an alternative school? 1 2 3 4 5 83. When students were caught drinking alcohol, how often were students’ families notified? Never 1 Rarely 2 Sometimes 3 Almost always or always 4 Now, I’d like to ask about procedures that your school might use to involve students, families, and other community members in your alcohol use prevention efforts. 84. During the past two years, have... Yes No a. Students helped develop, communicate, or implement alcohol use prevention policies or activities? 1 2 b. Students’ families helped develop, communicate, or implement alcohol use prevention policies or activities? 1 2 c. Community members helped develop, communicate, or implement alcohol use prevention policies or activities? 1 2 85. Does your school have procedures to inform all students... Yes No a. About rules related to alcohol use by students? 1 2 b. About what happens if they break the rules? 1 2 86. Does your school have procedures to inform the families of all students... Yes No a. About rules related to alcohol use by students? 1 2 b. About what happens if students break the rules? 1 2 87. Does your school have or participate in a community-based alcohol use prevention program, such as SADD? Yes 1 No 2 The next questions ask about your school’s policies on illegal drug use. 88. Has this school adopted a policy prohibiting illegal drug possession or use by students on school property? Yes 1 No 2 89. Has this school adopted a policy prohibiting illegal drug possession or use by students at off-campus, school-sponsored events? Yes 1 No 2 IF Q88 AND Q89 ARE “NO,” SKIP TO Q91. 90. Does your school’s policy include guidelines on what actions the school should take when students are caught possessing or using illegal drugs? Yes 1 No 2 91. During the 2004-05 school year, about how many times were students caught possessing or using illegal drugs? ______Times IF Q91 IS LESS THAN 4, SKIP TO THE INTRODUCTION TO Q95. SHOW CARD 7 92. Which of the things listed on this card helped determine what actions the school took when students were caught possessing or using illegal drugs? MARK ALL THAT APPLY Zero-tolerance 1 Effect or severity of the violation 2 Grade level of student 3 Repeat offender status 4 Type of drug 5 None 6 SHOW CARD 4 93. When students were caught possessing or using illegal drugs, how often were they... Almost Some- Always or Never Rarely times Always N/A a. Referred to a school counselor? 1 2 3 4 5 b. Referred to a school administrator? 1 2 3 4 c. Encouraged, but not required, to participate in an assistance, education, or cessation program? 1 2 3 4 5 d. Required to participate in an assistance, education, or cessation program? 1 2 3 4 5 e. Referred to legal authorities? 1 2 3 4 f. Placed in detention? 1 2 3 4 5 g. Given in-school suspension? 1 2 3 4 5 h. Not allowed to participate in extracurricular activities or interscholastic sports? 1 2 3 4 i. Suspended from school? 1 2 3 4 j. Expelled from school? 1 2 3 4 k. Reassigned to an alternative school? 1 2 3 4 5 94. When students were caught possessing or using illegal drugs, how often were students’ families notified? Never 1 Rarely 2 Sometimes 3 Almost always or always 4 Now, I’d like to ask about procedures that your school might use to involve or inform students, families, and other community members in your illegal drug use prevention efforts. 95. During the past two years, have... Yes No a. Students helped develop, communicate, or implement illegal drug use prevention policies or activities? 1 2 b. Students’ families helped develop, communicate, or implement illegal drug use prevention policies or activities? 1 2 c. Community members helped develop, communicate, or implement illegal drug use prevention policies or activities? 1 2 96. Does your school have procedures to inform all students... Yes No a. About rules related to illegal drug use by students? 1 2 b. About what happens if they break the rules? 1 2 97. Does your school have procedures to inform the families of all students... Yes No a. About rules related to illegal drug use by students? 1 2 b. About what happens if students break the rules? 1 2 98. Does your school post signs marking a drug-free school zone, that is, a specified distance from school grounds where illegal drugs are not allowed? Yes 1 No 2 99. Does your school have or participate in a community-based illegal drug use prevention program? Yes 1 No 2 ANSWER Q100 FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO THE INTRODUCTION TO Q109. The next questions ask about student drug testing. 100. Does your school conduct any drug testing on students? Yes 1 No 2-->SKIP TO THE INTRODUCTION TO Q109 IF THIS IS A PUBLIC SCHOOL, SKIP TO Q102. 101. The next questions ask about how students are chosen for drug testing at your school. Yes No a. Is student drug testing conducted randomly, with the entire student population subject to testing? 1 2 IF A IS “YES,” SKIP TO C. b. Is student drug testing conducted randomly among members of specific groups of students, such as athletes, students who participate in other extracurricular activities, or student drivers? 1 2 c. Is student drug testing conducted when it is suspected that a student is using drugs at school, that is, for cause? 1 2 d. Is student drug testing voluntary for all students? 1 2 IF D IS “YES,” SKIP TO F. e. Is student drug testing voluntary for specific groups of students, such as athletes, students who participate in other extracurricular activities, or student drivers? 1 2 f. Are students chosen for drug testing using criteria other than the ones we just discussed? 1 2 PRIVATE SCHOOL RESPONDENTS SKIP TO Q103. 102. The next questions ask about how students are chosen for drug testing at your school. Yes No a. Is student drug testing conducted randomly among members of specific groups of students, such as athletes, students who participate in other extracurricular activities, or student drivers? 1 2 b. Is student drug testing conducted when it is suspected that a student is using drugs at school, that is, for cause? 1 2 c. Is student drug testing voluntary for all students? 1 2 IF C IS “YES,” SKIP TO E. d. Is student drug testing voluntary for specific groups of students, such as athletes, students who participate in other extracurricular activities, or student drivers? 1 2 e. Are students chosen for drug testing using criteria other than the ones we just discussed? 1 2 103. Does your school test for… Yes No a. Alcohol? 1 2 b. Nicotine? 1 2 c. Cocaine? 1 2 d. Marijuana? 1 2 e. Opiates, for example heroin or morphine? 1 2 f. Amphetamines, for example methamphetamine or ecstasy? 1 2 g. Phencyclidine, that is, PCP? 1 2 h. Steroids? 1 2 SHOW CARD 8 104. Which of the methods on this card does your school use to conduct drug testing? MARK ALL THAT APPLY Breathalyzer (breath alcohol test) 1 Urine 2 Hair 3 Saliva 4 Sweat 5 Other 6 105. During the 2004-05 school year, about how many times did students test positive for drugs? ______Times IF Q105 IS LESS THAN 4, SKIP TO THE INTRODUCTION TO Q109. SHOW CARD 9 106. Which of the things listed on this card helped determine what actions the school took when students tested positive for drugs? MARK ALL THAT APPLY Zero-tolerance 1 Grade level of student 2 Repeat offender status 3 Type of drug 4 None 5 SHOW CARD 4 107. When students tested positive for drugs, how often were they… Almost Some- Always or Never Rarely times Always N/A a. Referred to a school counselor? 1 2 3 4 5 b. Referred to a school administrator? 1 2 3 4 c. Encouraged, but not required, to participate in an assistance, education, or cessation program? 1 2 3 4 5 d. Required to participate in an assistance, education, or cessation program? 1 2 3 4 5 e. Referred to legal authorities? 1 2 3 4 f. Placed in detention? 1 2 3 4 5 g. Given in-school suspension? 1 2 3 4 5 h. Not allowed to participate in extracurricular activities or interscholastic sports? 1 2 3 4 i. Suspended from school? 1 2 3 4 j. Expelled from school? 1 2 3 4 k. Reassigned to an alternative school? 1 2 3 4 5 108. When students tested positive for drugs, how often were students’ families notified? Never 1 Rarely 2 Sometimes 3 Almost always or always 4 Now, please think about injury prevention and safety procedures related to sports or playground activities, school lab or workshop activities, the use of school vehicles, and fire safety. 109. During the past 12 months, have the following been inspected and provided with the appropriate maintenance? Yes No N/A ANSWER A FOR ELEMENTARY AND MIDDLE/JUNIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO B. a. Playground facilities and equipment, such as playing surfaces, benches, monkey bars, and swings 1 2 3 b. Indoor athletic facilities and equipment, such as playing surfaces, benches, tumbling mats, and weight lifting equipment 1 2 c. Outdoor athletic facilities and equipment, such as playing fields and bleachers 1 2 3 d. Special classroom areas, such as chemistry labs, workshops, and art rooms 1 2 3 e. Other areas of the school, such as halls, stairs, and regular classrooms 1 2 f. Smoke alarms 1 2 g. Fire extinguishers 1 2 h. Sprinkler systems 1 2 i. Lighting inside school buildings 1 2 j. Lighting outside school buildings 1 2 110. Must students wear appropriate protective gear when engaged in... Yes No N/A a. Classes such as wood shop or metal shop? 1 2 3 b. Lab activities for photography, chemistry, biology, or other science classes? 1 2 3 ANSWER Q111 FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO Q112. 111. Does your school use the safety checklist and equipment guidelines published in the Handbook for Public Playground Safety by the U.S. Consumer Product Safety Commission? Yes 1 No 2 112. During the past two years, have... Yes No a. Students helped develop, communicate, or implement injury prevention and safety policies or activities? 1 2 b. Students’ families helped develop, communicate, or implement injury prevention and safety policies or activities? 1 2 c. Community members helped develop, communicate, or implement injury prevention and safety policies or activities? 1 2 113. Does your school have procedures to inform all students about rules related to school safety and injury prevention? Yes 1 No 2 114. Does your school have procedures to inform the families of all students about rules related to school safety and injury prevention? Yes 1 No 2 115. Has your school ever been sued because of an injury that occurred on school property or at an off-campus, school-sponsored event? Please include any claim filed with a court, regardless of the outcome. Yes 1 No 2 The next questions ask about sun safety. 116. During the past 12 months, how often were… Almost Some- Always or Never Rarely times Always a. Outdoor activities scheduled to avoid times when the sun was at peak intensity? 1 2 3 4 b. Students encouraged to use sunscreen before going outside? 1 2 3 4 117. Does your school provide shade structures such as trees or canopies in outdoor spaces? Yes 1 No 2 The next section asks about the physical school environment, such as building maintenance, indoor air quality, pest control, and chemicals. 118. Does your school conduct periodic inspections… Yes No N/A a. For pests? 1 2 b. For condensation in and around the school facilities? 1 2 c. Of the building foundation, walls, and roof for cracks or leaks? 1 2 d. For mold? 1 2 e. Of the plumbing system? 1 2 f. Of the heating, ventilation, and air conditioning system (HVAC)? 1 2 g. That test drinking water outlets for lead? 1 2 h. Of on-site large-capacity drinking water tanks? 1 2 3 119. Does your school have a plan for how to address mold problems? Yes 1 No 2 120. During the past 12 months, did your school respond to moisture-related issues, such as floods, leaks, or condensation within 48 hours or less? Yes 1 No 2 No moisture-related issues during the past 12 months 3 121. Does your school have an indoor air quality management program? Yes 1 No 2-->SKIP TO Q123 122. Is your program based on EPA’s Indoor Air Quality Tools for Schools? Yes 1 No 2 123. During the past 12 months, how often… Almost Some- Always or Never Rarely times Always N/A a. Were ASHRAE standards for ventilation maintained? 1 2 3 4 b. Was relative indoor humidity kept below 60 percent? 1 2 3 4 c. Were openings in walls, floors, doors, and windows sealed with caulk or weather stripping? 1 2 3 4 5 d. Were vegetation, shrubs, and wood mulch kept at least 1 foot away from buildings to control pests? 1 2 3 4 5 e. Was eating allowed only in designated areas to control pests? 1 2 3 4 f. Was waste stored in plastic, glass, or metal containers with tight lids so that it was inaccessible to pests? 1 2 3 4 ANSWER G FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO H. g. Were lockers cleaned to remove any food remains? 1 2 3 4 5 h. Were desks cleaned to remove any food remains? 1 2 3 4 i. Were trash containers cleaned with a disinfectant? 1 2 3 4 j. Were cracks in pavement and sidewalks repaired? 1 2 3 4 5 k. Were infested or diseased plants removed? 1 2 3 4 5 l. Were spot treatments and baiting used rather than widespread applications of pesticides? 1 2 3 4 5 m. Were staff and students informed prior to the application of pesticide? 1 2 3 4 5 n. Were indoor and outdoor areas that had been treated with pesticides clearly marked? 1 2 3 4 5 124. Does your school operate its own water system, that is, the school obtains drinking water from its own well, spring, or small reservoir? Yes 1-->SKIP TO Q127 No 2 125. During the past 12 months, was your school’s drinking water tested for… Yes No a. Bacteria? 1 2 b. Coliforms? 1 2 c. Other contaminants? 1 2 IF Q125A, Q125B, OR Q125C IS “YES,” ANSWER Q126. OTHERWISE, SKIP TO Q127. 126. Were the results of this/these test(s) provided to… Yes No a. School faculty and staff? 1 2 b. Students’ families? 1 2 c. Students? 1 2 127. During the past 12 months, were your school’s drinking water outlets flushed? Yes 1 No 2 The next question asks about low-emitting products, which are products designed to give off low levels of fumes or vapors. These products might include floor covering, furniture, paint, cleaners, markers, textiles, or adhesives. 128. Has your school adopted a policy to purchase low-emitting products for use in and around the school and school grounds, including in art classes, industrial art classes, and science laboratories? Yes 1 No 2 The next questions ask about hazardous materials. Hazardous materials are materials that may be harmful to people or the environment. Some examples are paint, chemicals used for science experiments, cleaning products, and medical waste. 129. Does your school have a plan for… Yes No a. How to use hazardous materials? 1 2 b. How to label hazardous materials? 1 2 c. How to store hazardous materials? 1 2 d. How to dispose of hazardous materials? 1 2 e. How to reduce the use of hazardous materials? 1 2 130. Does your school keep an inventory of hazardous materials in the school? Yes 1 No 2 131. Are custodial or maintenance staff at this school required to receive training on… Yes No a. Use of hazardous materials? 1 2 b. Labeling of hazardous materials? 1 2 c. Storage of hazardous materials? 1 2 d. Disposal of hazardous materials? 1 2 e. How to address mold problems? 1 2 f. Indoor air quality? 1 2 g. Flushing drinking water outlets? 1 2 Now I would like to ask about staffing related to the physical school environment. 132. Currently, does someone at your school oversee custodial, maintenance, and environmental issues, such as hazardous materials and pest management, in and around the school? Yes 1 No 2-->SKIP TO THE INTRODUCTION TO Q135 133. Are you the person who oversees custodial, maintenance, and environmental issues at this school? Yes 1 No 2 The next question asks about formal training that might be required for a newly hired person in this position. By formal training, I mean college classes, including community college; workshops; seminars; conferences; or any other kind of in-service or pre-service. 134. At this school, is a newly hired person in this position required to have any formal training in issues related to the physical environment of buildings and health hazards likely to be encountered in schools? Yes 1 No 2 The next questions ask about crisis preparedness, response, and recovery in the event of a natural disaster or other emergency situation. SHOW CARD 10 135. Which of the following best describes your school’s plan to address crisis preparedness, response, and recovery in the event of a natural disaster or other emergency or crisis situation? This school does not have such a plan 1-->SKIP TO Q141 This school uses a plan provided by the district 2 This school uses a district-level plan that has been adapted to meet our school’s needs 3 This school has its own plan 4 IF Q135 IS 2, SKIP TO Q139. 136. Did your school use any materials from the U.S. Department of Education to develop the plan? Yes 1 No 2 137. In developing the crisis preparedness, response, and recovery plan, did your school work with staff or members from… Yes No N/A a. A local fire department? 1 2 b. A local law enforcement agency? 1 2 c. Local emergency medical services? 1 2 d. The local public transportation department? 1 2 3 e. A local health department? 1 2 3 f. A local mental health or social services agency? 1 2 3 g. A local hospital? 1 2 3 h. A local homeland security office? 1 2 3 i. A local emergency management agency? 1 2 3 j. The FBI? 1 2 138. Did your school work with students, families, or other community members to develop the crisis preparedness, response, and recovery plan? Yes 1 No 2 139. Does the crisis preparedness, response, and recovery plan used by your school include… Yes No a. Evacuation plans? 1 2 b. Procedures to stop people from leaving or entering school buildings, that is, lock down plans? 1 2 c. Procedures to control the exterior of the building and school grounds? 1 2 d. Plans to seek immediate shelter and remain in that area during a chemical, biological, or radiological emergency rather than evacuating, or shelter-in-place plans? 1 2 e. Requirements to conduct regular emergency drills, other than fire drills? 1 2 f. Family reunification procedures? 1 2 g. Provisions for students and staff with special needs? 1 2 h. Plans to resume normal activities after buildings or facilities have been damaged? 1 2 i. Provision of mental health services for students, faculty, and staff after a crisis has occurred, for example to treat post-traumatic stress disorder? 1 2 j. Mechanisms for communicating with school personnel? 1 2 k. Establishment of an incident command system? 1 2 l. Procedures for responding to media inquiries? 1 2 m. Mechanisms for communicating the plan to students’ families? 1 2 n. Requirements to periodically review and revise emergency response plans? 1 2 140. During the past two years, has your school provided training on the crisis preparedness, response, and recovery plan to... Yes No a. School faculty and staff? 1 2 b. Students? 1 2 c. Students’ families? 1 2 141. During the past two years, has your school offered education on crisis preparedness, response, and recovery to students’ families? Yes 1 No 2 IF Q135 IS 1 OR 2, SKIP TO Q143. 142. During the past 12 months, has your school’s crisis preparedness, response, and recovery plan been evaluated or assessed? Yes 1 No 2 143. Some communities have a group of local agencies that coordinates crisis preparedness, response, and recovery efforts. Such a group might be called a local emergency planning committee, an emergency management team, or something else. Is your school a member of such a group? Yes 1 No 2 No such group 3 144. Is your school designated to serve as a staging area or a community shelter during local emergencies? Yes 1 No 2 145. Does your school have a NOAA-approved weather radio? Yes 1 No 2 The next questions ask about your school’s efforts to promote a positive climate. By positive school climate, I mean a sense of community and welcome within the school, exemplified through caring student-teacher relationships, high teacher morale, student involvement and leadership in activities and programs, and family involvement. My first question asks about school-wide practices or programs that explicitly promote a positive climate. These include programs such as Positive Behavior Interventions and Supports, PeaceBuilders, Positive Action Program, and locally developed programs. 146. Has your school adopted any school-wide practices or programs that explicitly promote a positive climate? Yes 1 No 2 The next question is about staff development, which might include workshops, conferences, continuing education, graduate courses, or any other kind of in-service. 147. During the past two years, have faculty and staff received any staff development on topics explicitly related to school climate? Yes 1 No 2 148. Has this school adopted a prosocial code of conduct that addresses such concepts as cooperation, conflict resolution, and helping others? Yes 1 No 2 SHOW CARD 11 This card lists some ways faculty might promote family involvement in school. 149. During the past 12 months, how many of your school’s faculty... None Some Most All N/A a. Provided students’ families with a way to communicate directly with teachers, such as voicemail or an email address? Would you say none, some, most, or all? 1 2 3 4 b. Provided families with the opportunity to review curricula? 1 2 3 4 c. Provided families with copies of assignments? 1 2 3 4 d. Contacted families to communicate about problems with their child? 1 2 3 4 5 e. Contacted families to communicate praise about their child? 1 2 3 4 f. Encouraged families to volunteer at the school, for example by asking parents for assistance with fundraising efforts or to serve as a chaperone for school trips? 1 2 3 4 g. Discussed with families ways to reinforce learning at home? 1 2 3 4 h. Requested that families regularly review and sign homework assignments? 1 2 3 4 5 i. Encouraged families to attend parent-teacher conferences? 1 2 3 4 5 j. Encouraged family participation in parent teacher organization (PTO) meetings? 1 2 3 4 5 150. Are students at this school involved in developing school or classroom rules? Yes 1 No 2 The next questions ask about community service and service-learning. Community service is unpaid work that helps the community. Service-learning is a particular type of community service that is designed to meet specific learning objectives for a course. 151. Does your school provide community service opportunities for students? Yes 1 No 2-->SKIP TO Q153 152. At your school, is community service… Yes No a. Required for all students? 1 2 IF Q152A IS “YES,” THEN SKIP TO Q153. b. Required for students in specific grades? 1 2 c. Required for students who meet specific criteria, for example honor students? 1 2 d. Voluntary for all students? 1 2 153. Does your school provide service-learning opportunities for students? Yes 1 No 2-->SKIP TO Q155 154. At your school, is service-learning… Yes No a. Required for all students? 1 2 IF Q154A IS “YES,” THEN SKIP TO Q155. b. Required for students in specific grades? 1 2 c. Required for students in specific courses? 1 2 155. Does your school participate in a program in which family or community members serve as role models to students or mentor students, such as the Big Brothers/Big Sisters program? Yes 1 No 2 SHPPS 2006 is designed to gather information on many aspects of students’ experiences while at school, including experiences that might affect the development of healthy lifestyles. The next questions ask about physical activity. ANSWER Q156 FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q164. I would like to ask about times when students participate in regularly scheduled recess at this school. Please do not include activities that students engage in during physical education class. 156. In what grade or grades do students participate in regularly scheduled recess during the school day? MARK ALL THAT APPLY Kindergarten 0 1ST Grade 1 2ND Grade 2 3RD Grade 3 4TH Grade 4 5TH Grade 5 6TH Grade 6 None 7-->SKIP TO Q164 157. On average, how many days per week are the students scheduled to have recess? _______Days/Week 158. On average, how many minutes each day do students spend in recess? _______Minutes 159. About how many classes have regularly scheduled recess immediately before lunch? None 1 Less than half 2 Half 3 More than half 4 All 5 160. About how many classes have regularly scheduled recess immediately after lunch? None 1 Less than half 2 Half 3 More than half 4 All 5 161. Are faculty and staff at this school allowed to exclude students from all or part of recess as punishment for bad behavior? Yes 1 No 2-->SKIP TO Q163 162. Are faculty and staff at this school discouraged from excluding students from all or part of recess as punishment for bad behavior? Yes 1 No 2 163. Do students participate in regular physical activity breaks, outside of physical education class and recess, during the school day? Yes 1 No 2 ANSWER Q164 FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO Q165. 164. Do students participate in regular physical activity breaks, outside of physical education class, during the school day? Yes 1 No 2 165. Does your school support or promote walking or biking to and from school? Yes 1 No 2 The next questions ask about influences on students’ dietary behavior while at school. 166. Are faculty and staff at this school prohibited from using food or food coupons as a reward for good behavior or good academic performance? Yes 1-->SKIP TO THE INTRODUCTION TO Q168 No 2 167. Are faculty and staff at your school discouraged from using food or food coupons as a reward for good behavior or good academic performance? Yes 1 No 2 Next, I’ll ask about policies your school might have adopted on foods offered at specific events or venues. Do not include foods offered in the cafeteria, vending machines, or school store. 168. Has this school adopted a policy stating that, if food is served at student parties, fruits or vegetables will be among the foods offered? Yes 1 No 2 School does not have student parties 3 169. Has this school adopted a policy stating that, if food is served in after-school or extended day programs, fruits or vegetables will be among the foods offered? Yes 1 No 2 School does not have after-school or extended day programs 3 170. Has this school adopted a policy stating that fruits or vegetables will be among the foods offered at concession stands? Yes 1 No 2 School does not have concession stands 3 171. Junk foods are foods which provide calories primarily through fats or added sugars and have minimal amounts of vitamins and minerals. Has your school adopted a policy prohibiting junk foods from being offered at student parties? Yes 1 No 2 School does not have student parties 3 172. Has your school adopted a policy prohibiting junk foods from being offered in after- school or extended day programs? Yes 1 No 2 School does not have after- school or extended day programs 3 173. Has your school adopted a policy prohibiting junk foods from being offered at concession stands? Yes 1 No 2 School does not have concession stands 3 The next questions ask about foods and beverages available in vending machines, school stores, canteens, or snack bars. 174. Can students purchase food or beverages from... Yes No a. One or more vending machines at the school? 1 2 b. A school store, canteen, or snack bar? 1 2 IF Q174A AND Q174B ARE “NO,” SKIP TO Q183. IF Q174A IS “NO” AND Q174B IS “YES,” SKIP TO Q177. IF Q174A IS “YES,” CONTINUE TO Q175. 175. How many vending machines can students purchase food or beverages from during school hours? ______ 176. How many vending machines can students purchase food or beverages from outside of school hours? ______ 177. Can students purchase the following from vending machines or school stores? Yes No a. Chocolate candy 1 2 b. Other kinds of candy 1 2 c. Cookies, crackers, cakes, pastries, or other baked goods that are not low in fat 1 2 d. Salty snacks that are not low in fat, such as regular potato chips 1 2 e. Ice cream or frozen yogurt that is not low in fat 1 2 f. 2% or whole milk (plain or flavored) 1 2 g. Water ices or frozen slushes that do not contain juice 1 2 IF Q177A – G ARE “NO,” SKIP TO Q179. 178. Can students purchase these items... Yes No a. Before classes begin in the morning? 1 2 b. During any school hours when meals are not being served? 1 2 c. During school lunch periods? 1 2 179. Can students purchase the following from vending machines or school stores? Yes No a. Low-fat cookies, crackers, cakes, pastries, or other low-fat baked goods 1 2 b. Salty snacks that are low in fat, such as pretzels, baked chips, or other low-fat chips 1 2 c. Bread sticks, rolls, bagels, pita bread, or other bread products 1 2 d. Low-fat or fat-free ice cream, frozen yogurt, or sherbet 1 2 e. Low-fat or non-fat yogurt 1 2 f. Fruits or vegetables, not juice 1 2 g. 100% fruit juice 1 2 h. 100% vegetable juice 1 2 i. 1% or skim milk 1 2 j. Bottled water 1 2 IF Q179A – J ARE “NO,” SKIP TO Q181. 180. Can students purchase these items... Yes No a. Before classes begin in the morning? 1 2 b. During any school hours when meals are not being served? 1 2 c. During school lunch periods? 1 2 181. Can students purchase the following from vending machines or school stores? Yes No a. Soda pop or fruit drinks that are not 100% juice 1 2 b. Sports drinks, such as Gatorade™ 1 2 IF Q181A AND B ARE “NO,” SKIP TO Q183. 182. Can students purchase these items... Yes No a. Before classes begin in the morning? 1 2 b. During any school hours when meals are not being served? 1 2 c. During school lunch periods? 1 2 183. During the past 12 months, have any organizations at this school, such as student clubs, sports teams, or the PTA sold food at school or in the community to raise money? Yes 1 No 2-->SKIP TO Q188 184. During the past 12 months, have any of the following items been sold as part of fund- raising for any school organization? Yes No a. Chocolate candy 1 2 b. Other candy 1 2 c. Soda pop or fruit drinks that are not 100% juice 1 2 d. Sports drinks, such as Gatorade™ 1 2 e. Cookies, crackers, cakes, pastries, or other baked goods that are not low in fat 1 2 IF Q184A – E ARE “NO,” SKIP TO Q186. 185. Could students purchase these items... Yes No a. Before school classes began in the morning? 1 2 b. During any school hours when meals were not being served? 1 2 c. During school lunch periods? 1 2 186. During the past 12 months, have any of the following items been sold as part of fund- raising for any school organization? Yes No a. Fruits or vegetables 1 2 b. 100% fruit juice or vegetable juice 1 2 c. Low-fat cookies, crackers, cakes, pastries, or other low-fat baked goods 1 2 IF Q186A – C ARE “NO,” SKIP TO Q188. 187. Could students purchase these items... Yes No a. Before classes began in the morning? 1 2 b. During any school hours when meals were not being served? 1 2 c. During school lunch periods? 1 2 188. Does this school hold fund raiser nights at fast food restaurants where a portion of the sales made on a particular night benefit the school? Yes 1 No 2 IF Q181A AND Q181B ARE “NO,” ANSWER Q189. OTHERWISE, SKIP TO Q190. 189. Does this school sell soft drinks to students in any venue? Please include sports drinks, soda pop, or fruit drinks that are not 100% juice. Yes 1 No 2-->SKIP TO Q193 190. Does your school receive a specified percentage of soft drink sales receipts? Yes 1 No 2-->SKIP TO Q192 191. Does your school receive incentives, such as cash awards or donations of equipment, supplies, or other donations, once receipts total a specified amount? Yes 1 No 2 192. Is your school prohibited from selling soft drinks produced by more than one company? Yes 1 No 2 193. Are soft drink companies allowed to advertise soft drinks, such as sports drinks, soda pop, or fruit drinks... Yes No N/A a. On vending machines? 1 2 3 b. Elsewhere in the school building? 1 2 c. On school grounds, including on the outside of the school building, on playing fields, or other areas of the campus? 1 2 d. On school buses or other vehicles used to transport students? 1 2 194. At this school, are candy, meals from fast food restaurants, or soft drinks promoted through the distribution of products, such as t-shirts, hats, and book covers to students? Yes 1 No 2 The next questions ask about school health councils, committees, or teams. 195. Is there one or more than one group—for example, a school health council, committee, or team—at this school that offers guidance on the development of policies or coordinates activities on health topics? Yes 1 No 2-->SKIP TO THE INTRODUCTION TO Q199 196. Do any of these groups address... Yes No a. Tobacco use prevention? 1 2 b. Alcohol or other drug use prevention? 1 2 c. Food service or nutrition? 1 2 d. Physical education or physical activity? 1 2 ANSWER E-G FOR MIDDLE/JUNIOR HIGH AND SENIOR HIGH SCHOOL ONLY. OTHERWISE, SKIP TO H. e. Pregnancy prevention? 1 2 f. Human immunodeficiency virus (HIV) prevention? 1 2 g. Other sexually transmitted disease (STD) prevention? 1 2 h. Violence prevention? 1 2 i. Injury prevention and safety? 1 2 j. Health education? 1 2 k. Health services? 1 2 l. Mental health or social services? 1 2 m. The psychological and social environment, or school climate? 1 2 n. Faculty and staff health promotion? 1 2 o. Family and community involvement in school health programs? 1 2 p. Physical school environment? 1 2 q. Crisis preparedness, response, and recovery? 1 2 r. Management of chronic health conditions, such as asthma or diabetes? 1 2 SHOW CARD 12 197. Looking at this card, please tell me who is represented on any school health council, committee, or team. MARK ALL THAT APPLY Health education teachers 1 Physical education teachers 2 Health services staff 3 Nutrition or food service staff 4 Mental health or social services staff 5 District or school administrators 6 Students 7 Students’ families 8 Community members 9 Representatives from the local health department 10 Representatives from local social services agencies 11 Local health care providers 12 Representatives from local health organizations, such as the local Red Cross chapter 13 For the next question, please think about the school health council, committee, or team that met the most during the past 12 months. 198. During the past 12 months, how many times has this group met? Less than one time 1 One or two times 2 Three or four times 3 Five or six times 4 More than six times 5 The next questions ask about materials your school might have used to assess your school’s health and safety policies and programs. 199. Has your school used… Yes No a. The School Health Index from the Centers for Disease Control and Prevention? 1 2 b. Another self-assessment guide? 1 2 200. Currently, does someone at your school oversee or coordinate school health, for example a school health coordinator? “School health” might include health education, physical education, health services, food service, school policy and environment, mental health and social services, faculty and staff health promotion, or family and community involvement. Yes 1 No 2 201. My supervisor may wish to call you to ask about how I conducted this interview. Would you please tell me a telephone number where we might reach you starting with the area code? ( ) - 1) Daytime or 2) Evening/Weekend Thank you very much for taking the time to complete this interview. If you would like more information about this study or would like clarification of any questions in this questionnaire, please call Tonja Kyle or Lori Gross at (800) 287-1815.