Form Approved OMB No: 0920-0445 Expiration Date: 10/31/2002 Physical Education District Questionnaire Physical Education District Questionnaire Questions Standards and Guidelines 1 - 4 Elementary School Instruction 5 - 11 Elementary School Recess 12 - 13 Middle/Junior High School Instruction 14 - 21 Senior High School Instruction 22 - 29 Adapted Physical Education 30 Student Assessment 31 - 45 Use of Protective Gear 46 Physical Activity and Discipline 47 - 50 Staffing and Staff Development 51 - 55 Physical Education Collaboration 56 - 57 Physical Education Promotion 58 Physical Education Evaluation 59 Interscholastic Sports Coaches 60 - 61 Physical Education Coordinator 62 - 70 Public reporting burden for this collection of information is estimated to average 40 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-24, Atlanta, GA 30333; Attention PRA (0920-0445). Special Instructions 1. This questionnaire focuses on your district practices and policies. 2. When we use the word “policy,” we mean any mandate issued by the local school board or other local agency that affects physical education in schools throughout your district. Please consider any policies officially adopted at the district level. These include policies developed by your district, or those based on model policies developed by your state or elsewhere. 3. We recognize that there may be some exceptions, but please answer the questions based on what is customary in your district. Please do not consider school practices or policies when answering the questions. (We will ask about school practices and policies when we collect information from schools across the country.) 4. Please do not include policies that are solely related to instruction on physical activity topics provided within health education curricula. 5. Unless the question specifically asks about regularly scheduled recess periods, do not include recess periods when answering questions about “physical education” or “physical activity.” 6. If you would like more information about this study or would like clarification of any questions in this survey, please call Tim Smith at 1-800-647-9664, extension 6095. Standards and Guidelines 1. Has your district adopted a policy stating that schools will follow any national, state, or district physical education standards or guidelines? These might cover topics such as the goals and objectives of physical education or expected student outcomes. Yes 1 ==> Skip to Question 3 No 2 2. Has your district adopted a policy encouraging (e.g., in memoranda or guidelines) schools to follow any national, state, or district physical education standards or guidelines? Yes 1 No 2 ==> Skip to Question 5 3. Are these physical education standards or guidelines based on the National Standards for Physical Education? Yes 1 No 2 Don’t know 3 4. Which of the following methods does your district use to improve school compliance with these physical education standards or guidelines? HED010 HED010 Yes No a. Staff development for physical education teachers 1 2 b. Monitoring student achievement 1 2 c. Submission of written reports by schools 1 2 d. Teacher evaluations or classroom monitoring 1 2 e. Teachers mentoring other teachers 1 2 Elementary School Instruction 5. Has your district adopted goals, objectives, or expected outcomes for elementary school physical education? If your district does not include any elementary schools, mark this box ? and skip to Question 14. Yes 1 No 2 ==> Skip to Question 7 6. Do these goals or objectives for elementary school physical education specifically address each of the following student outcomes? HES022 Yes No a. Knowledge of the benefits of physical activity 1 2 b. Knowledge of the principles of exercise, that is frequency, intensity, and duration 1 2 c. Positive attitudes toward physical activity 1 2 d. Regular participation in physical activity 1 2 e. Maintenance of a healthy fitness level 1 2 f. Development of fundamental motor skills such as running, skipping, throwing, or striking 1 2 g. Development of specialized motor skills such as catching with a glove, a swim stroke, or a tennis serve 1 2 h. Demonstration of responsible personal and social behavior in physical activity settings 1 2 7. Has your district adopted a policy stating that elementary schools will teach physical education? HES017 Yes 1 No 2 ==> Skip to Question 10 8. Based on policies adopted by your district, how much physical education (excluding recess) are students required to receive while in elementary school? Districts use many ways to describe these requirements, such as minutes per week, hours per quarter, or hours per year. If it is more convenient for you, please mark the “Requirements enclosed” box and include a copy of your requirements when you return this questionnaire. If your district does not have specified time requirements for elementary school students, mark this box ? and skip to Question 9. Requirements enclosed ? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 9. Based on policies adopted by your district, can elementary school students be exempted from physical education requirements for one grading period or longer for each of the following reasons? If your district does not have exemption policies for elementary school students, mark this box ? and skip to Question 10. Yes No a. Religious reasons 1 2 b. Permanent physical disability 1 2 c. Cognitive disability 1 2 d. High physical competency test score 1 2 e. Participation in other school activities such as band, chorus, or cheerleading 1 2 f. Participation in community sports activities 1 2 g. Participation in community service activities 1 2 10. Has your district developed its own curricula for elementary school physical education? Yes 1 No 2 11. During the past 2 years, has your district provided the following information or materials for elementary school physical education? HED034 Yes No a. A list of one or more recommended elementary school physical education curricula 1 2 b. Elementary school physical education curricula 1 2 c. A chart describing the scope and sequence of instruction for physical education 1 2 d. Lesson plans or learning activities for physical education 1 2 e. Plans for how to assess or evaluate students in physical education 1 2 Elementary School Recess 12. Does your district require or recommend that elementary schools provide students with regularly scheduled recess? Require 1 Recommend 2 Neither 3 ==> Skip to Question 14 13. How many minutes per day of recess are required or recommended for elementary school students? If your district does not have specified time requirements or recommendations for recess for elementary school students, mark this box ? and skip to Question 14. Mark ? one box. Less than 10 minutes per day 1 10 to 19 minutes per day 2 20 to 29 minutes per day 3 30 or more minutes per day 4 Middle/Junior High School Instruction 14. Has your district adopted goals, objectives, or expected outcomes for middle/junior high school physical education? If your district does not include any middle/junior high schools, mark this box ? and skip to Question 22. Yes 1 No 2 ==> Skip to Question 16 15. Do these goals or objectives for middle/junior high school physical education specifically address each of the following student outcomes? HES022 Yes No a. Knowledge of the benefits of physical activity 1 2 b. Knowledge of the principles of exercise, that is frequency, intensity, and duration 1 2 c. Positive attitudes toward physical activity 1 2 d. Regular participation in physical activity 1 2 e. Maintenance of a healthy fitness level 1 2 f. Development of fundamental motor skills such as running, skipping, throwing, or striking 1 2 g. Development of specialized motor skills such as catching with a glove, a swim stroke, or a tennis serve 1 2 h. The ability to perform a wide variety of movement forms at a basic skill level 1 2 i. The ability to perform two or more movement forms at an advanced level 1 2 j. Demonstration of responsible personal and social behavior in physical activity settings 1 2 16. Has your district adopted a policy stating that middle/junior high schools will teach physical education? HES017 Yes 1 No 2 ==> Skip to Question 20 17. Based on policies adopted by your district, how much physical education are students required to receive while in middle/junior high school? Districts use many ways to describe these requirements, such as minutes per week, hours per quarter, or hours per year. If it is more convenient for you, please mark the “Requirements enclosed” box and include a copy of your requirements when you return this questionnaire. If your district does not have specified time requirements for middle/junior high school students, mark this box ? and skip to Question 18. Requirements enclosed ? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 18. Has your district adopted a policy stating that middle/junior high schools will include lifetime physical activities in their physical education program? By “lifetime activities,” we mean those that can be done during adulthood because they generally need only one or two people. Examples include walking, jogging, bicycling, racquet sports, and swimming. Yes 1 No 2 19. Based on policies adopted by your district, can middle/junior high school students be exempted from physical education requirements for one grading period or longer for each of the following reasons? If your district does not have exemption policies for middle/junior high school students, mark this box ? and skip to Question 20. Yes No a. Religious reasons 1 2 b. Permanent physical disability 1 2 c. Cognitive disability 1 2 d. High physical competency test score 1 2 e. Enrollment in other courses, such as math or science 1 2 f. Participation in school sports 1 2 g. Participation in other school activities such as band, chorus, or cheerleading 1 2 h. Participation in vocational training 1 2 i. Participation in community sports activities 1 2 j. Participation in community service activities 1 2 20. Has your district developed its own curricula for middle/junior high school physical education? Yes 1 No 2 21. During the past 2 years, has your district provided the following information or materials for middle/junior high school physical education? HED034 Yes No a. A list of one or more recommended middle/junior high school physical education curricula 1 2 b. Middle/junior high school physical education curricula 1 2 c. A chart describing the scope and sequence of instruction for physical education 1 2 d. Lesson plans or learning activities for physical education 1 2 e. Plans for how to assess or evaluate students in physical education 1 2 Senior High School Instruction 22. Has your district adopted goals, objectives, or expected outcomes for senior high school physical education? If your district does not include any senior high schools, mark this box ? and skip to Question 30. Yes 1 No 2 ==> Skip to Question 24 23. Do these goals or objectives for senior high school physical education specifically address each of the following student outcomes? HES022 Yes No a. Knowledge of the benefits of physical activity 1 2 b. Knowledge of the principles of exercise, that is frequency, intensity, and duration 1 2 c. Positive attitudes toward physical activity 1 2 d. Regular participation in physical activity 1 2 e. Maintenance of a healthy fitness level 1 2 f. Development of fundamental motor skills such as running, skipping, throwing, or striking 1 2 g. Development of specialized motor skills such as catching with a glove, a swim stroke, or a tennis serve 1 2 h. The ability to perform a wide variety of movement forms at a basic skill level 1 2 i. The ability to perform two or more movement forms at an advanced level 1 2 j. Demonstration of responsible personal and social behavior in physical activity settings 1 2 24. Has your district adopted a policy stating that senior high schools will teach physical education? HES017 Yes 1 No 2 ==> Skip to Question 28 25. Based on policies adopted by your district, how much physical education are students required to receive while in senior high school? Districts use many ways to describe these requirements, such as minutes per week, hours per quarter, or hours per year. If it is more convenient for you, please mark the “Requirements enclosed” box and include a copy of your requirements when you return this questionnaire. If your district does not have specified time requirements for senior high school students, mark this box ? and skip to Question 26. Requirements enclosed ? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 26. Has your district adopted a policy stating that senior high schools will include lifetime physical activities in their physical education program? By “lifetime activities,” we mean those that can be done during adulthood because they generally need only one or two people. Examples include walking, jogging, bicycling, racquet sports, and swimming. Yes 1 No 2 27. Based on policies adopted by your district, can senior high school students be exempted from physical education requirements for one grading period or longer for each of the following reasons? If your district does not have exemption policies for senior high school students, mark this box ? and skip to Question 28. Yes No a. Religious reasons 1 2 b. Permanent physical disability 1 2 c. Cognitive disability 1 2 d. High physical competency test score 1 2 e. Enrollment in other courses, such as math or science 1 2 f. Participation in school sports 1 2 g. Participation in other school activities such as ROTC, band, chorus, or cheerleading 1 2 h. Participation in vocational training 1 2 i. Participation in community sports activities 1 2 j. Participation in community service activities 1 2 28. Has your district developed its own curricula for senior high school physical education? Yes 1 No 2 29. During the past 2 years, has your district provided the following information or materials for senior high school physical education? HED034 Yes No a. A list of one or more recommended senior high school physical education curricula 1 2 b. Senior high school physical education curricula 1 2 c. A chart describing the scope and sequence of instruction for physical education 1 2 d. Lesson plans or learning activities for physical education 1 2 e. Plans for how to assess or evaluate students in physical education 1 2 Adapted Physical Education 30. Has your district adopted a policy stating that schools will implement the following measures to meet the physical education needs of students with permanent physical or cognitive disabilities? Yes No a. Mainstreaming into regular physical education as appropriate 1 2 b. Providing adapted physical education as appropriate 1 2 c. Using modified equipment in regular physical education 1 2 d. Using modified facilities in regular physical education 1 2 e. Using teaching assistants in regular physical education 1 2 f. Including physical education in individualized education plans (IEPs) 1 2 Student Assessment The following questions ask about student assessment that your district requires or recommends. 31. Does your district require or recommend that elementary schools give each of the following types of tests? Require Recommend Neither a. Written tests of students’ knowledge related to physical education 1 2 3 b. Skill performance tests related to physical education 1 2 3 32. Does your district require or recommend that elementary schools test students’ fitness levels? Require 1 Recommend 2 Neither 3 ==> Skip to Question 36 33. Does your district require or recommend that elementary schools use each of the following fitness tests? Require Recommend Neither a. Chrysler Fund/AAU Physical Fitness Program 1 2 3 b. Fitnessgram 1 2 3 c. National Youth Physical Fitness Program (U.S. Marines Youth Foundation) 1 2 3 d. President’s Challenge (President’s Council on Physical Fitness and Sports) 1 2 3 e. Youth Fitness Test (YMCA) 1 2 3 f. A state-developed fitness test 1 2 3 34. Has your district adopted a policy encouraging (e.g., in memoranda or guidelines) elementary schools to use students’ fitness test results in the following ways? Yes No a. Develop individualized physical activity plans 1 2 b. Determine recipients of fitness awards 1 2 c. File them in the school record 1 2 d. Share them with the student’s parents or guardians 1 2 35. Has your district adopted a policy stating that elementary schools will submit data on students’ fitness test results to the district? Yes 1 No 2 36. Does your district require or recommend that middle/junior high schools give each of the following types of tests? Require Recommend Neither a. Written tests of students’ knowledge related to physical education 1 2 3 b. Skill performance tests related to physical education 1 2 3 37. Does your district require or recommend that middle/junior high schools test students’ fitness levels? Require 1 Recommend 2 Neither 3 ==> Skip to Question 41 38. Does your district require or recommend that middle/junior high schools use each of the following fitness tests? Require Recommend Neither a. Chrysler Fund/AAU Physical Fitness Program 1 2 3 b. Fitnessgram 1 2 3 c. National Youth Physical Fitness Program (U.S. Marines Youth Foundation) 1 2 3 d. President’s Challenge (President’s Council on Physical Fitness and Sports) 1 2 3 e. Youth Fitness Test (YMCA) 1 2 3 f. A state-developed fitness test 1 2 3 39. Has your district adopted a policy encouraging (e.g., in memoranda or guidelines) middle/junior high schools to use students’ fitness test results in the following ways? Yes No a. Develop individualized physical activity plans 1 2 b. Determine recipients of fitness awards 1 2 c. File them in the school record 1 2 d. Share them with the student’s parents or guardians 1 2 40. Has your district adopted a policy stating that middle/junior high schools will submit data on students’ fitness test results to the district? Yes 1 No 2 41. Does your district require or recommend that senior high schools give each of the following types of tests? Require Recommend Neither a. Written tests of students’ knowledge related to physical education 1 2 3 b. Skill performance tests related to physical education 1 2 3 42. Does your district require or recommend that senior high schools test students’ fitness levels? Require 1 Recommend 2 Neither 3 ==> Skip to Question 46 43. Does your district require or recommend that senior high schools use each of the following fitness tests? Require Recommend Neither a. Chrysler Fund/AAU Physical Fitness Program 1 2 3 b. Fitnessgram 1 2 3 c. National Youth Physical Fitness Program (U.S. Marines Youth Foundation) 1 2 3 d. President’s Challenge (President’s Council on Physical Fitness and Sports) 1 2 3 e. Youth Fitness Test (YMCA) 1 2 3 f. A state-developed fitness test 1 2 3 44. Has your district adopted a policy encouraging (e.g., in memoranda or guidelines) senior high schools to use students’ fitness test results in the following ways? Yes No a. Develop individualized physical activity plans 1 2 b. Determine recipients of fitness awards 1 2 c. File them in the school record 1 2 d. Share them with the student’s parents or guardians 1 2 45. Has your district adopted a policy stating that senior high schools will submit data on students’ fitness test results to the district? Yes 1 No 2 Use of Protective Gear 46. Has your district adopted a policy requiring that students wear appropriate protective gear when engaged in the following activities? Yes No a. Physical activities during physical education 1 2 b. Intramural sports 1 2 c. Interscholastic sports 1 2 a. Physical Activity and Discipline 47. Has your district adopted a policy that prohibits schools from using physical activity (e.g., laps or push-ups) to punish students for bad behavior in physical education? Yes 1 ==> Skip to Question 49 No 2 48. Does your district discourage (e.g., in memoranda or guidelines) schools from using physical activity to punish students for bad behavior in physical education? Yes 1 No 2 49. Has your district adopted a policy that prohibits schools from excluding students from all or part of physical education as punishment for bad behavior in another class? Yes 1 ==> Skip to Question 51 No 2 50. Does your district discourage (e.g., in memoranda or guidelines) schools from excluding students from all or part of physical education to punish students for bad behavior in another class? Yes 1 No 2 Staffing and Staff Development 51. Based on policies adopted by your district, what is the required student-to-teacher ratio for physical education in each of the following grade levels? If your district has not adopted a policy for a grade level, please mark the “No policy” box. Students per No schools teacher No policy at this level a. Elementary school _____ 1 2 b. Middle/junior high school _____ 1 2 c. Senior high school _____ 1 2 52. Has your district adopted a policy stating that newly-hired staff who teach physical education at each of the following levels will have undergraduate or graduate training in physical education or a related field? No schools Yes No at this level a. Elementary school 1 2 3 b. Middle/junior high school 1 2 3 c. Senior high school 1 2 3 53. Has your district adopted a policy stating that newly-hired staff who teach physical education at each of the following levels will be certified, licensed, or endorsed by the state to teach physical education? HED075 If your state does not offer certification, licensure, or endorsement to teach physical education at a level, please mark the “Not offered” box in the last column. Not No schools Yes No offered at this level a. Elementary school 1 2 3 4 b. Middle/junior high school 1 2 3 4 c. Senior high school 1 2 3 4 54. Has your district adopted a policy stating that each school will have someone to oversee or coordinate physical education at the school (e.g., a lead physical education teacher)? Yes 1 No 2 55. During the past 2 years, has your district provided any funding for or offered staff development on each of the following topics to those who teach physical education? HED076 This might include workshops, conferences, continuing education, graduate courses, or any other kind of in-service. Yes No a. Methods to increase the amount of class time students are physically active 1 2 b. Methods to promote gender equity in physical education and sports 1 2 c. Using technology such as computers, video cameras, or heart rate monitors for physical education 1 2 d. Encouraging family involvement in physical activity 1 2 e. Administering or using fitness tests 1 2 f. Helping students develop individualized physical activity plans 1 2 g. Injury prevention and first aid 1 2 h. Teaching physical education to students with permanent physical or cognitive disabilities 1 2 i. Teaching individual or paired activities or sports 1 2 j. Teaching team or group activities or sports 1 2 k. Teaching movement skills and concepts 1 2 l. Assessing or evaluating student performance in physical education 1 2 m. Developing and using student portfolios for physical education 1 2 Physical Education Collaboration 56. During the past 12 months, have district physical education staff worked on physical education activities with each of the following groups? Yes No a. District health education staff 1 2 b. District health services staff 1 2 c. District mental health or social services staff 1 2 d. District food service staff 1 2 57. During the past 12 months, have district physical education staff worked on physical education activities with staff or members from each of these organizations? Yes No a. Local health department 1 2 b. Local hospital 1 2 c. Local mental health or social services agency 1 2 d. Health organization, such as the American Heart Association or the American Cancer Society 1 2 e. Local colleges or universities 1 2 f. Local businesses 1 2 g. Local parks or recreation department 1 2 h. Local youth organization, such as the Y, Boys or Girls Clubs, or the Boy Scouts or Girl Scouts 1 2 i. Local health or fitness club 1 2 Physical Education Promotion 58. During the past 12 months, has your district done each of the following activities to promote school physical education programs? Yes No a. Provided families with information on the school physical education program 1 2 b. Met with a parents’ organization, such as the PTA, to discuss the physical education program 1 2 c. Invited family members to tour the physical education facilities 1 2 d. Offered any physical education or physical activity programs to families 1 2 Physical Education Evaluation 59. During the past 2 years, have the following aspects of your district physical education program been evaluated? Yes No a. Student satisfaction with the physical education program 1 2 b. Family satisfaction with the physical education program 1 2 c. Physical education policies 1 2 d. Physical education curricula 1 2 e. Physical education staff development or in-service programs 1 2 Interscholastic Sports Coaches The following questions ask about interscholastic sports coaches in your district. 60. Has your district adopted a policy stating that head coaches of interscholastic sports will meet each of the following criteria? Yes No a. Have previous coaching experience in any sport 1 2 b. Have previous coaching experience in the sports they will be coaching 1 2 c. Have a teaching certificate 1 2 d. Complete a coaches’ training course 1 2 e. Be certified in first aid 1 2 f. Be certified in cardiopulmonary resuscitation (CPR) 1 2 g. Be employed by the school or school district 1 2 61. During the past 2 years, has your district provided any funding for or offered staff development to coaches of interscholastic sports? Yes 1 No 2 Physical Education Coordinator 62. Currently, does someone in your district oversee or coordinate physical education? Yes 1 No 2 ==> That is the last question. Thank you very much for taking the time to complete this questionnaire. 63. Are you this person? Yes 1 No 2 ==> That is the last question. Thank you very much for taking the time to complete this questionnaire. 64. Do you have an undergraduate degree? Yes 1 No 2 ==> Skip to Question 70 65. What did you major in? Mark ? all that apply. Physical education and health education combined 1 Physical education 2 Health education 3 Other education 4 Kinesiology 5 Exercise physiology 6 Exercise science 7 Other 8 66. Do you have an undergraduate minor?HEC059 Yes 1 No 2 ==> Skip to Question 68 67. What did you minor in? Mark ? all that apply. Physical education and health education combined 1 Physical education 2 Health education 3 Other education 4 Kinesiology 5 Exercise physiology 6 Exercise science 7 Other 8 68. Do you have a graduate degree? Yes 1 No 2 ==> Skip to Question 70 69. In what area or areas? Mark ? all that apply. Physical education and health education combined 1 Physical education 2 Health education 3 Other education 4 Kinesiology 5 Exercise physiology 6 Exercise science 7 Other 8 70. Are you certified, licensed, or endorsed by the state to teach physical education at each of the following grade levels? If your state does not offer certification, licensure, or endorsement to teach physical education at a level, please mark the “Not offered” box in the last column. Not Yes No offered a. Elementary school 1 2 3 b. Middle/junior high school 1 2 3 c. Senior high school 1 2 3 If you would like to provide any additional comments, please use the space below. Thank you very much for taking the time to participate in this study. Additional Comments Please return this questionnaire to: Don Evers Research Triangle Institute P.O. Box 12194 Research Triangle Park, NC 27709 Physical Education District Questionnaire - Final Version — Revised: 10/26/99 2 Physical Education District Questionnaire - Final Version — Revised: 10/26/99 Elementary School Instruction Physical Education District Questionnaire - Final Version — Revised: 10/26/99 Middle/Junior High School Instruction Senior High School Instruction Student Assessment Physical Education Coordinator