Att H - Revision Changes

Att H_Desc of Chgs to Questionnaires.doc

Indicators of the Performance of Local, State, Territorial, and Tribal Education Agencies in HIV, Coordinated School Health and Asthma Management for Adolescent and School Health Programs

Att H - Revision Changes

OMB: 0920-0672

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Attachment H


Description of Changes to Revised (FY2011-FY2013) Questionnaires



There are four questionnaires for FY2010 data collection. These versions have had previous OMB approval. Two questionnaires to HIV-prevention program activities among LEAs and SEAs/TEAs, the third pertains to CSHP/PANT activities among SEAs, and the fourth pertains to asthma management program activities among LEAs. FY2010 data are scheduled for transmission 06/01/2011. The revised versions of the forms will be implemented in FY2011 and will apply to information transmitted to CDC for FY2011 (data are scheduled for transmission 06/01/2012) and FY2012 (data are scheduled for transmission 06/03/2013).


The changes made for this revision to the FY2011 questionnaires were designed to better align the questionnaires with other guidance from DASH on priority activities. General changes include:

  • Adding questions for each content area that directly align with the School Level Impact Measures for that FOA priority area.

  • Revising questions on the “development” of resources and materials to include a question that specifically asks if the respondents’ agencies “have” such resources and materials (in the event they were not developed in the current fiscal year).

  • Revising questions on information not collected or estimated to better reflect a respondent’s agency’s need for technical assistance.

  • Consolidating questions about the number of schools, districts, regional support units, and external agency partners reached. This change was made to reduce the burden on the respondent.

  • Deleting all questions about (and references to) “information sessions.” This change was made to reduce the burden on the respondent.

  • Deleting all questions related to “types of external agency partners reached.” This change was made to reduce the burden on the respondent.

  • Renumbering questions to provide better clarity on flow of the questionnaire.


Changes will be implemented in FY2011. All changes were made in an effort to maximize the value and use of the data collected. Additions to the questionnaire were balanced by deletions to the questions. As a result, changes are not expected to affect burden estimates for the instruments. Feedback from CDC/DASH staff was instrumental in creating and refining the questionnaire.



File Typeapplication/msword
File TitleAttachment I
AuthorFHH6
Last Modified ByThelma Elaine Sims
File Modified2011-03-30
File Created2011-03-30

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