Indicators for School Health Programs: HIV Prevention through State Education Agencies Fiscal Year: March 1, 2007 – February 29, 2008 Division of Adolescent and School Health Program Announcement No. 03004: Improving the Health, Education, and Well-Being of Young People Through Coordinated School Health Programs I.POLICY 1.During FY07, did your HIV prevention project DEVELOP (or revise or assist in developing) model policies, policy standards, or other policy materials for district or school staff on the following topics? A.HIV education for students. YES NO B.Infection control/universal precautions for all school staff. YES NO C.Maintaining confidentiality of HIV-infected students and staff. YES NO D.Certification requirements for teachers of HIV education (e.g., passing a state test in topic area). YES NO E. Other model policies, policy standards, or other policy materials. YES NO 2.During FY07, did your HIV prevention project DISTRIBUTE to district or school staff established or model policies, policy standards, or other policy materials on the following topics? (Choose one for each topic.) A.HIV education for students. (Choose one.) YES NO—we have such policies but have not distributed them during FY07.  Skip to 2B NO—we do not have such policies. Skip to 2B IF YES, provide the total: 1.Number of districts reached directly 2.Number of hits on web site (if applicable) 3.Number of listservs, Internet mailing lists, or discussion boards used (do not list number of e-mails posted but the number of electronic distribution lists used) B.Infection control/universal precautions for all school staff. (Choose one.) YES NO—we have such policies but have not distributed them during FY07.  Skip to 2C NO—we do not have such policies.  Skip to 2C IF YES, provide the total: 1.Number of districts reached directly 2.Number of hits on web site (if applicable) 3.Number of listservs, Internet mailing lists, or discussion boards used (do not list number of e-mails posted but the number of electronic distribution lists used) C.Maintaining confidentiality of HIV-infected students and staff. (Choose one.) YES NO—we have such policies but have not distributed them during FY07.  Skip to 2D NO—we do not have such policies.  Skip to 2D IF YES, provide the total: 1.Number of districts reached directly 2.Number of hits on web site (if applicable) 3.Number of listservs, Internet mailing lists, or discussion boards used (do not list number of e-mails posted but the number of electronic distribution lists used) D.Certification requirements for teachers of HIV education. (Choose one.) YES NO—we have such policies but have not distributed them during FY07.  Skip to 2E NO—we do not have such policies.  Skip to 2E IF YES, provide the total: 1.Number of districts reached directly 2.Number of hits on web site (if applicable) 3.Number of listservs, Internet mailing lists, or discussion boards used (do not list number of e-mails posted but the number of electronic distribution lists used) E.Other established or model policies, policy standards, or other policy materials. (Choose one.) YES NO—we have such policies but have not distributed them during FY07.  Skip to 3 NO—we do not have such policies.  Skip to 3 IF YES, 1.Specify policy topic 2.Number of districts reached directly 3.Number of hits on web site (if applicable) 4.Number of listservs, Internet mailing lists, or discussion boards used (do not list number of e-mails posted but the number of electronic distribution lists used) 3.During FY07, did your HIV prevention project provide PROFESSIONAL DEVELOPMENT to district or school staff that included information on established or model policies, policy standards, or other policy materials? YES NO Skip to 4 If YES, provide the total: A.Number of professional development events focusing only on HIV policy B.Number of participants in professional development events focusing only on HIV policy C.Number of professional development events that combined HIV policy with other topic(s) (include only professional development in which activities or a portion of the event focused specifically on HIV policy) D.Number of participants in professional development events that combined HIV policy with other topics E.Number of schools reached directly F.Number of districts reached directly G.Number of regional support units reached directly (if applicable) H.Number of external partners reached directly H1.Please specify type, e.g., CBO, Health Agencies 4.During FY07, did your HIV prevention project provide INDIVIDUALIZED TECHNICAL ASSISTANCE to district or school staff on established or model policies, policy standards, or other policy materials? YES NO Skip to 5 If YES, provide the total: A.Number of schools reached directly B.Number of districts reached directly C.Number of regional support units reached directly (if applicable) D.Number of external partners reached directly D1.Please specify type II. CURRICULA & INSTRUCTION 5.During FY06, did your HIV prevention project DEVELOP (or revise or assist in developing) any of the following on HIV prevention for district or school staff: health education standards, exemplary curricula, frameworks, or guidance? YES NO 6.During FY07, did your HIV prevention project DISTRIBUTE to district or school staff any of the following on HIV prevention: health education standards, exemplary curricula, frameworks, or guidance? (Choose one.) YES NO—we have health education standards, exemplary curricula, frameworks, or guidance on HIV prevention but have not distributed them during FY07.  Skip to 7 NO—we do not have health education standards, exemplary curricula, frameworks, or guidance on HIV prevention.  Skip to 7 If YES, provide the total: A.Number of schools reached directly B.Number of districts reached directly C.Number of regional support units reached directly (if applicable) D.Number of external partners reached directly D1.Please specify type E.Number of hits on web site (if applicable) F.Number of listservs, Internet mailing lists, or discussion boards used (do not list number of e-mails posted but the number of electronic distribution lists used) 7.During FY07, did your HIV prevention project provide PROFESSIONAL DEVELOPMENT to district or school staff on exemplary HIV curricula or instruction? (e.g., training on selected curricula; the importance of scientifically accurate information; characteristics of effective HIV prevention programs; effective instructional strategies; or aligning HIV prevention programs to meet health education standards.) YES NO Skip to 8 If YES, provide the total: A.Number of professional development events focusing only on HIV curricula or instruction B.Number of participants in professional development events focusing only on HIV curricula or instruction C.Number of professional development events that combined HIV curricula or instruction with other topic(s) (include only professional development in which activities or a portion of the event focused specifically on exemplary HIV curricula or instruction) D.Number of participants in professional development events that combined HIV curricula or instruction with other topics E.Number of schools reached directly F.Number of districts reached directly G.Number of regional support units reached directly (if applicable) H.Number of external partners reached directly H1.Please specify type 8.During FY07, did your HIV prevention project conduct PROFESSIONAL DEVELOPMENT to district or school staff on any specific HIV prevention education curricula and/or programs for youth? YES NO Skip to 9 If YES, please provide the name of the curricula or programs: A.Name of program A1.total number of participants B.Name of program B1.total number of participants C.Name of program C1.total number of participants D.Name of program D1. total number of participants E.Name of program E1.total number of participants 9.During FY07, did your HIV prevention project provide INDIVIDUALIZED TECHNICAL ASSISTANCE to district or school staff on HIV curricula or instruction? (e.g., help in reviewing, revising, developing, selecting, or implementing instructional materials for HIV prevention) YES NO Skip to 10 If YES, provide the total: A.Number of schools reached directly B.Number of districts reached directly C.Number of regional support units reached directly (if applicable) D.Number of external partners reached directly D1.Please specify type 10.During FY07, which of the following topics were emphasized by your HIV prevention project in curricula or instruction? A.Abstinence from sexual intercourse as the only sure way of preventing HIV transmission YES NO B.Abstinence from IV drug use as the only sure way of preventing HIV transmission YES NO C.Proper and consistent use of condoms among sexually active youth as a method of reducing the risk of HIV transmission YES NO D.Influencing social norms to prevent HIV infection YES NO E.Developing individual and interpersonal skills for preventing HIV infection (e.g., goal setting, decision making, refusal, negotiation, communication, advocacy) YES NO F.The relationship between HIV prevention and other STD prevention or pregnancy prevention YES NO G.The relationship between HIV prevention and prevention of alcohol or other drug use YES NO H.How to implement universal precautions YES NO III. ASSESSMENT OF STUDENT PERFORMANCE 11.In FY07, did your HIV prevention project DEVELOP (or revise or assist in developing) for district or school staff frameworks or guidelines that include how to assess or measure, at the classroom level, students’ knowledge and skills regarding HIV prevention? YES NO 12.In FY07, did your HIV prevention project DISTRIBUTE to school staff frameworks or guidelines that include how to assess or measure, at the classroom level, students’ knowledge and skills regarding HIV prevention? This does not include materials on how to conduct the Youth Risk Behavior Survey (YRBS) or the School Health Profiles (Profiles). (Choose one.) YES NO—we have frameworks or guidelines about how to assess or measure, at the classroom level, students’ knowledge and skills regarding HIV prevention, but have not distributed them in FY07. NO—we do not have materials about how to assess or measure at the classroom level, students’ knowledge and skills regarding HIV prevention. 13.In FY07, did your HIV prevention project conduct PROFESSIONAL DEVELOPMENT to district or school staff that included information about how to assess or measure, at the classroom level, students' knowledge and skills regarding HIV prevention? This does not include training on how to conduct the Youth Risk Behavior Survey (YRBS) or the School Health Profiles (Profiles). YES NO Skip to 14 If YES, provide the total: A.Number of professional development events focusing on health education assessment, including HIV prevention (include only professional development in which activities or a portion of the event focused specifically on assessing student performance related to HIV prevention) B.Number of participants from professional development events focusing on health education assessment, including HIV prevention (include only professional development in which activities or a portion of the event focused specifically on assessing student performance related to HIV prevention) C.Number of professional development events focusing on health education assessment D.Number of participants from all professional development events focusing on health education assessment E.Number of schools reached directly F.Number of districts reached directly G.Number of regional support units reached directly (if applicable) H.Number of external partners reached directly H1.Please specify type 14.In FY07, did your HIV prevention project provide INDIVIDUALIZED TECHNICAL ASSISTANCE to district or school staff that included information about how to assess or measure, at the classroom level, students' knowledge and skills regarding HIV prevention? YES NO Skip to 15 If YES, provide the total: A.Number of schools reached directly B.Number of districts reached directly C.Number of regional support units reached directly (if applicable) D.Number of external partners reached directly D1.Please specify type IV. EXTERNAL COLLABORATION 15.During FY07, did your HIV prevention project COLLABORATE with any external partners? YES NO Skip to 16 If YES, choose YES or NO for each of the following external partners: A.Agencies serving primarily African-American youth YES NO B.Agencies serving primarily Hispanic youth YES NO C.Agencies serving primarily American Indian/Alaskan Native youth YES NO D.Agencies serving primarily Asian/Pacific Islander youth YES NO E.Agencies serving primarily sexual minority youth YES NO F.AIDS service community organizations YES NO G.Alcohol and drug rehabilitation facilities YES NO H.CDC-funded local education agency HIV projects YES NO I.Community organizations serving parents and families (this does not include internal school parent groups such as the PTA) YES NO J.Education organizations (e.g., advocacy, service, professional, or membership associations) YES NO K.Faith or religious organizations YES NO L.Health organizations (e.g., advocacy, service, professional, or membership associations) YES NO M.HIV Community Planning Groups (CPG) YES NO N.Juvenile corrections facilities YES NO O.National organizations funded by CDC to assist with HIV prevention efforts YES NO P.Organizations that focus exclusively on abstinence YES NO Q.Other national organizations YES NO R.State health department YES NO S.State heath coalitions or networks YES NO T.Universities and other institutions of higher education YES NO U.Youth representing schools or communities YES NO V.Youth-serving community organizations YES NO W.Other types of external partners not listed above YES NO W1.Please specify (If additional space is needed to list “other types of external partners not listed above,” please label them X-Z.) 16.During FY07, which of the following descriptions best describes your state education agency's relationship with the state CDC-sponsored Community Planning Group (CPG) for HIV prevention? (Choose one.) A.No one from the sEA attends the meetings B.An sEA staff member attends meetings to observe, but has no formal role C.An sEA staff member attends and serves as a content expert or technical advisor, but does not have any voting privileges D.An sEA staff member attends meetings and has voting privileges E.Other (please specify) V.TARGETING PRIORITY POPULATIONS 17.In FY07, did your HIV prevention project implement programmatic activities to specifically target any of the following youth? Materials, professional development and individualized technical assistance may be specific to preventing HIV, or may focus on reaching, serving, communicating with, or providing services for members of the priority populations listed below. If more than one priority population is specifically targeted in materials, professional development, or individualized technical assistance, report each group included, below. (Choose YES or NO in each box.) A. African-American youth A1. Materials Distribution YES NO A2.Professional Development YES NO A3.Individualized Technical Assistance YES NO B. Asian/Pacific Islander youth B1. Materials Distribution YES NO B2.Professional Development YES NO B3.Individualized Technical Assistance YES NO C. Hispanic youth C1. Materials Distribution YES NO C2.Professional Development YES NO C3.Individualized Technical Assistance YES NO D. American Indian/Alaskan Native youth D1. Materials Distribution YES NO D2.Professional Development YES NO D3.Individualized Technical Assistance YES NO E. Sexual minority youth E1. Materials Distribution YES NO E2.Professional Development YES NO E3.Individualized Technical Assistance YES NO (If NO to all responses, skip to 21.) 18.For the materials, professional development, or individualized technical assistance that you provided to school staff specifically targeting priority populations, what topics were included? (Choose all that apply.) A.Reaching members of priority populations to provide educational programs or services B.Providing culturally or linguistically competent educational programs or services C.Understanding the HIV prevention needs of members of priority populations D.Building the skill of school administrators, faculty, or staff to address members of priority populations E.Other E1.Please specify (If NO to all professional development questions in 17, skip to 20) 19.During FY07, describe the PROFESSIONAL DEVELOPMENT to district or school staff that your HIV prevention project provided that focused on improving the quality of HIV prevention for specific priority populations: A.Number of professional development events that focused on improving the quality of HIV prevention for specific priority populations B.Number of schools reached directly C.Number of districts reached directly D.Number of regional support units reached directly (if applicable) E.Number of external partners reached directly E1.Please specify type (If NO to all individualized technical assistance questions in 17, skip to 21) 20.During FY07, describe the INDIVIDUALIZED TECHNICAL ASSISTANCE to district or school staff that your HIV prevention project provided to reach specific priority populations: A.Number of schools reached directly B.Number of districts reached directly C.Number of regional support units reached directly (if applicable) D.Number of external partners reached directly D1.Please specify type 21.If your HIV prevention project implemented any programmatic activities that directly targeted other youth in high risk situations, please select from the list the categories of youth that were specifically targeted. A.Homeless youth B.Runaway youth C.Youth not in school and unemployed D.Youth requiring drug or alcohol rehabilitation E.Youth who interface with the juvenile corrections system F.Medically indigent youth G.Youth requiring mental health services H.Youth in foster homes I.Migrant farm worker youth J.Gay or lesbian youth K.Youth with STDs, especially genital ulcer disease L.Sexually abused youth M.Sexually active youth N.Pregnant youth O.Youth seeking counseling and testing for HIV infection P.Youth with signs and symptoms of HIV infection or AIDS without alternative diagnosis Q.Youth who barter or sell sex R.Youth who use illegal injected drugs (including crack cocaine) VI. PROJECT PLANNING 22.In FY07, what evaluation activities did you conduct? A.Conducted formative evaluation YES NO B.Created a logic model YES NO C.Wrote SMART objectives YES NO D.Conducted process evaluation YES NO E.Conducted outcome evaluation YES NO F.Other YES NO F1.Please specify) 23.In FY07 what coordinated school health program components were integrated with your HIV prevention activities? A. Health education YES NO B. Physical education YES NO C. Health services YES NO D. Counseling/psychological/social services YES NO E. School nutrition services YES NO F. Staff health promotion YES NO G. Parent/community involvement YES NO H. Healthy school environment/policy YES NO 24.How many school districts do you have in your state? 25.How many regional support units do you use to support HIV prevention? (if applicable) VII. OTHER INFORMATION & ACTIVITIES 26.In FY07, did you make PRESENTATIONS that focused on policy, curriculum, or student assessment related to HIV prevention? YES NO Skip to 27 If yes: A.How many presentations did you make focused on policy, curriculum, or student assessment related to HIV prevention? B.How many presentations did you make on HIV prevention in the context of coordinated school health? C.Please SELECT all audiences to whom you presented in FY07: 1.District-level staff or administrators YES NO 2.School-level staff or administrators YES NO 3.Staff or students at universities or other institutions of higher education YES NO 4.Community-based organization staff YES NO 5.State or local health agency staff YES NO 6.Legislators YES NO 7.Parents/parent groups YES NO 8.School-aged youth YES NO 9.Other YES NO 9A.Please specify 27.In FY07, did you provide PRE-SERVICE LEARNING events that focused on policy, curriculum, or student assessment related to HIV prevention? YES NO Skip to 28 If yes: A.How many pre-service learning events did you provide focused on policy, curriculum, or student assessment related to HIV prevention? 28.Is there information that we asked for in this year’s Indicators that you estimated or guessed at? YES NO Skip to 29 A.What kind of information did you estimate or guess at? 1.Distribution of print materials YES NO 2.Distribution of electronic materials YES NO 3.Professional development events YES NO 4.Individualized technical assistance YES NO 5.Presentations YES NO B.On what topics did you estimate or guess at information? 1.Policies YES NO 2.Curricula and instruction YES NO 3.Assessment of student performance YES NO 29.Is there information that we asked for in this year’s Indicators that you did not collect at all? YES NO Skip to 30 A. What kind of information did you not collect at all? 1.Distribution of print materials YES NO 2.Distribution of electronic materials YES NO 3.Professional development events YES NO 4.Individualized technical assistance YES NO 5.Presentations YES NO B.On what topics did you not collect information at all? 1.Policies YES NO 2.Curricula and instruction YES NO 3.Assessment of student performance YES NO 30.During FY07, did your HIV prevention project conduct any additional, noteworthy, major activities to improve HIV policies, curriculum, instruction, assessment, or collaborations? Did these activities focus on improving the quality of HIV prevention for African-American, Hispanic, American Indian/Alaskan Native, Asian/Pacific Islander youth, or youth in high risk situations? Please describe in an attached narrative. 31.Please describe in an attached narrative, one specific improvement to your HIV prevention program during FY07 that occurred as a result of your evaluation activities. 32.Please provide information about any additional professional development events or materials distribution activities not captured by the questions above. In particular, please report on activities in meetings or conferences not sponsored by your agency and for which you could not collect information on participants or recipients of materials. 33.Please provide any additional general comments or information in the space below.