Attachments L-Q Parent Program Fidelity 6th Grade Sessio

Form Approved

OMB No. 0920-0941

Exp. Date: 6/30/2015

Public reporting burden of this collection of information is estimated to average 15 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 Information Collection Review Office, 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-0941).

Attachment L:

Parent Program Fidelity 6th Grade Session 1

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Parent Curriculum – 6th Grade, Session 1 – Why Do Parents Matter?

Attendance Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Parent Name / Guardian Names – Last, First, Initial	Name of Child in Program	Name of Child in Program

Parent Curriculum – 6th Grade, Session 1 – Why Do Parents Matter?

Session Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Please indicate if you completed the following activities:

Activity	Yes	Yes w/ changes	No
Welcomed participants and facilitated introductions			
Introduced Parents Matter! for Dating MattersTM			
Distributed parent handbooks and explained how they will be used			
Explained how proverbs and quotations will be used in the six sessions			
Facilitated overview and discussion of goals for Parents Matter! for Dating MattersTM using Slides 1-5 and Posters 1-3			
Introduced overview of the sessions			
Facilitated discussion of general ground rules and expectations			
Completed Icebreaker, Part 1			
Completed Icebreaker, Part 2			
Presented and discussed Video 1: “Kids Discuss Their Goals in Life”			
Introduced and explained the “Pyramid Of Success” using Slides 6-7			
Facilitated discussion on the changes that occur during adolescence using Slides 8-13			
Introduced the Buddy Concept			
Presented and discussed Video 2: “Pressures Children Will Face”			
Facilitated the node linking map activity			
Presented and discussed Video 3: “HIV-Positive Youth”			
Facilitated a discussion on what parents can do			
Presented and discussed Video 4: “Day in the Life of a Child”			
Facilitated discussion on the importance of focusing on children 9- to 12-years-old using Slides 14-18			
Reviewed the rationale for the intervention			
Provided a session review			
Introduced and explained homework			
Closed session			

Please indicate if any of the following challenges interfered with your ability to implement the session. Check all that apply.

Not enough time.	
I did not have the needed materials.	
Parents did not appear to understand the session.	
I was uncomfortable discussing some of the topics.	
Parents were uncomfortable discussing some of the topics.	
Some part of the session was difficult for parents (i.e., role plays, discussing relationship issues and topics, homework).	
Other more pressing session demands.	
Other – please specify____________________________________	

Describe any changes you made to the session activities.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.

1. How engaged were the parents in the session?

_________________________________________________________________________________________________

5

Fully Engaged

1

Not at all Engaged/Bored

2

3

Somewhat Engaged

4

2. Overall, how do you think the session went today, in terms of your facilitation and the participation of parents?

_________________________________________________________________________________________________

5

Excellent

1

Very Poor/ Horrible

2

Poor

3

Fair

4

Good

3. How well do you think the parents understood the session material?

_________________________________________________________________________________________________

5

Excellent/

Complete Understanding

1

Did Not Understand

2

Poor

3

Fair

4

Good

4. How well did the session material fit into the allotted time period? (check the box for the statement that is most applicable for this session)

• Session was too packed; not enough time to complete all activities and discussions

• Session was somewhat packet; able to complete most but not all activities and discussions

• Session was timed perfectly; able to complete all activities and discussions

• Session ended before 90 minutes were up; not enough material was provided for the session

Form Approved

OMB No. 0920-0941

Exp. Date: 6/30/2015

Public reporting burden of this collection of information is estimated to average 15 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 Information Collection Review Office, 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-0941).

Attachment M:

Parent Program Fidelity 6th Grade Session 2

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Parent Curriculum – 6th Grade, Session 2 – Parenting Positively

Attendance Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Parent / Guardian Names – Last, First, Initial	Name of Child in Program	Name of Child in Program

Parent Curriculum – 6th Grade, Session 2 – Parenting Positively

Session Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Please indicate if you completed the following activities:

Activity	Yes	Yes w/ changes	No
Welcomed participants back			
Facilitated an icebreaker			
Delivered a review and introduction			
Briefly reviewed general ground rules			
Facilitated a review of Session 1			
Facilitated a review of homework assignments from Session 1			
Introduced Session 2			
Presented and discussed Video 5: “How Are Your Parents Important to You?”			
Facilitated discussion on effective parenting practices			
Facilitated discussion on strategies for strengthening the parent-child relationship using Slides 1-4			
Presented and discussed Video 6: “Parent and Child Interactions” (with pauses for discussion)			
Facilitated discussion on characteristics of good communication			
Reviewed good communication skills using Slides 5-8			
Facilitated opportunity for participants to practice good communication skills			
Facilitated discussion on supervision			
Presented and discussed Video 7: “Child Supervision” (with pauses for discussion)			
Facilitated discussion on the personal supervision plan, using Slide 9			
Introduced and explained homework			
Provided a session review			
Closed session, referring to Poster 6			

Please indicate if any of the following challenges interfered with your ability to implement the session. Check all that apply.

Not enough time.	
I did not have the needed materials.	
Parents did not appear to understand the session.	
I was uncomfortable discussing some of the topics.	
Parents were uncomfortable discussing some of the topics.	
Some part of the session was difficult for parents (i.e., role plays, discussing relationship issues and topics, homework).	
Other more pressing session demands.	
Other – please specify____________________________________	

Describe any changes you made to the session activities.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.

7. How engaged were the parents in the session?

_________________________________________________________________________________________________

5

Fully Engaged

1

Not at all Engaged/Bored

2

3

Somewhat Engaged

4

8. Overall, how do you think the session went today, in terms of your facilitation and the participation of parents?

_________________________________________________________________________________________________

5

Excellent

1

Very Poor/ Horrible

2

Poor

3

Fair

4

Good

3. How well do you think the parents understood the session material?

_________________________________________________________________________________________________

5

Excellent/

Complete Understanding

1

Did Not Understand

2

Poor

3

Fair

4

Good

8. How well did the session material fit into the allotted time period? (check the box for the statement that is most applicable for this session)

• Session was too packed; not enough time to complete all activities and discussions

• Session was somewhat packet; able to complete most but not all activities and discussions

• Session was timed perfectly; able to complete all activities and discussions

• Session ended before 90 minutes were up; not enough material was provided for the session

Form Approved

OMB No. 0920-0941

Exp. Date: 6/30/2015

Public reporting burden of this collection of information is estimated to average 15 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 Information Collection Review Office, 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-0941).

Attachment N:

Parent Program Fidelity 6th Grade Session 3

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Parent Curriculum – 6th Grade, Session 3 – Parents Are Educators

Attendance Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Parent /Guardian Names– Last, First, Initial	Name of Child in Program	Name of Child in Program

Parent Curriculum – 6th Grade, Session 3 – Parents Are Educators

Session Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Please indicate if you completed the following activities:

Activity	Yes	Yes w/ changes	No
Welcomed participants back			
Facilitated icebreaker			
Completed Introduction and Review			
Facilitated brief review of ground rules			
Facilitated review of homework assignment from Session 2			
Facilitated a review of Session 2			
Facilitated discussion to reinforce the importance of supervision and parental influence using Posters 7-9			
Introduced Session 3			
Presented and discussed Video 8: “Teens Discuss Sex”			
Facilitated discussion on the realities of adolescent sexual relationships and behavior			
Implemented participant activity on adolescent relational and sexual behavior			
Reviewed and discussed additional facts about adolescent sexual behavior using Slides 2-3			
Introduced and discussed why parents should be relationship and sex educators for their children			
Presented and discussed Video 9: “Teachable Moments”			
Facilitated a discussion on the role of parents as relationship and sex educators using Slides 4-9			
Presented and discussed Video 10: “Talking About Sex”			
Facilitated discussion on what it means to be sexually healthy using Slides 10-11			
Facilitated discussion on what parents can do to help their adolescent become sexually healthy using Slides 12-15			
Introduced and explained homework			
Provided a session review			
Closed session			

Please indicate if any of the following challenges interfered with your ability to implement the session. Check all that apply.

Not enough time.	
I did not have the needed materials.	
Parents did not appear to understand the session.	
I was uncomfortable discussing some of the topics.	
Parents were uncomfortable discussing some of the topics.	
Some part of the session was difficult for parents (i.e., role plays, discussing relationship issues and topics, homework).	
Other more pressing session demands.	
Other – please specify____________________________________	

Describe any changes you made to the session activities.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.

13. How engaged were the parents in the session?

_________________________________________________________________________________________________

5

Fully Engaged

1

Not at all Engaged/Bored

2

3

Somewhat Engaged

4

14. Overall, how do you think the session went today, in terms of your facilitation and the participation of parents?

_________________________________________________________________________________________________

5

Excellent

1

Very Poor/ Horrible

2

Poor

3

Fair

4

Good

3. How well do you think the parents understood the session material?

_________________________________________________________________________________________________

5

Excellent/

Complete Understanding

1

Did Not Understand

2

Poor

3

Fair

4

Good

12. How well did the session material fit into the allotted time period? (check the box for the statement that is most applicable for this session)

• Session was too packed; not enough time to complete all activities and discussions

• Session was somewhat packet; able to complete most but not all activities and discussions

• Session was timed perfectly; able to complete all activities and discussions

• Session ended before 90 minutes were up; not enough material was provided for the session

Form Approved

OMB No. 0920-0941

Exp. Date: 6/30/2015

Public reporting burden of this collection of information is estimated to average 15 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 Information Collection Review Office, 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-0941).

Attachment O:

Parent Program Fidelity 6th Grade Session 4

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Parent Curriculum – 6th Grade, Session 4 – I Think I Can, I Know I Can

Attendance Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Parent /Guardian Names – Last, First, Initial	Name of Child in Program	Name of Child in Program

Parent Curriculum – 6th Grade, Session 4 – I Think I Can, I Know I Can

Session Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Please indicate if you completed the following activities:

Activity	Yes	Yes w/ changes	No
Completed Welcome and Review			
Welcomed participants to the session			
Briefly reviewed the general ground rules			
Facilitated a review of the homework assignment			
Facilitated a review of the key concepts discussed in Session 3			
Segued to a discussion on how parents communicate messages through their behavior using the provided statement			
Opened the session by referring to Posters 10-12			
Facilitated exercise and discussion on the difficulties associated with discussing relationships and sexual issues			
Facilitated exercise on difficult sex-related questions			
Facilitated discussion on difficult sex-related questions			
Completed optional small group interaction (time permitting)			
Introduced a discussion on the importance of parents communicating relationship and sexual values			
Facilitated small group activities using the discussion topics provided			
Facilitated discussion on the five tools for talking with children about relationships and sex using Slides 1-4			
Implemented the exercise, “Examples of Parent-Child Communication About Relationships and Sex” using Video 11: “Teachable Moments”			
Implemented the role-play, “Discussing More Difficult Topics”			
Facilitated discussion to assist parents in figuring out what to say (i.e., topics parents should discuss) using Slides 5-6			
Facilitated discussion on when parents should talk to their children about being ready for relationships and sex, with reference to Poster 12			
Introduced and explained homework			
Provided a session review			
Closed session			

Please indicate if any of the following challenges interfered with your ability to implement the session. Check all that apply.

Not enough time.	
I did not have the needed materials.	
Parents did not appear to understand the session.	
I was uncomfortable discussing some of the topics.	
Parents were uncomfortable discussing some of the topics.	
Some part of the session was difficult for parents (i.e., role plays, discussing relationship issues and topics, homework).	
Other more pressing session demands.	
Other – please specify____________________________________	

Describe any changes you made to the session activities.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.

19. How engaged were the parents in the session?

_________________________________________________________________________________________________

5

Fully Engaged

1

Not at all Engaged/Bored

2

3

Somewhat Engaged

4

20. Overall, how do you think the session went today, in terms of your facilitation and the participation of parents?

_________________________________________________________________________________________________

5

Excellent

1

Very Poor/ Horrible

2

Poor

3

Fair

4

Good

3. How well do you think the parents understood the session material?

_________________________________________________________________________________________________

5

Excellent/

Complete Understanding

1

Did Not Understand

2

Poor

3

Fair

4

Good

16. How well did the session material fit into the allotted time period? (check the box for the statement that is most applicable for this session)

• Session was too packed; not enough time to complete all activities and discussions

• Session was somewhat packet; able to complete most but not all activities and discussions

• Session was timed perfectly; able to complete all activities and discussions

• Session ended before 90 minutes were up; not enough material was provided for the session

Form Approved

OMB No. 0920-0941

Exp. Date: 6/30/2015

Public reporting burden of this collection of information is estimated to average 15 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 Information Collection Review Office, 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-0941).

Attachment P:

Parent Program Fidelity 6th Grade Session 5

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Parent Curriculum – 6th Grade, Session 5 – Parents Are Role Models

Attendance Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Parent / Guardian Names – Last, First, Initial	Name of Child in Program	Name of Child in Program

Parent Curriculum – 6th Grade, Session 5 – Parents Are Role Models

Session Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Please indicate if you completed the following activities:

Activity	Yes	Yes w/ changes	No
Completed Welcome and Review			
Welcomed participants back			
Briefly reviewed the general ground rules			
Facilitated brief review of Session 4 using Slides 1-4			
Facilitated a review of the homework assignment			
Introduced session 5, with reference to Posters 13-14			
Presented and discussed Video 12: “Children See, Children Do”			
Facilitated discussion on healthy and unhealthy relationships			
Discussed healthy and unhealthy relationships using Slides 1-2			
Implemented continuum activity, which was designed to assist in understanding healthy and unhealthy relationship behaviors			
Discussed teen dating violence (one type of unhealthy relationship) using Slides 3-4			
Presented and discussed Video 13: “Causing Pain: Real Stories of Dating Abuse and Violence”			
Facilitated discussion on the realities of unhealthy relationships			
Implement the participant activity on facts associated with teen dating violence			
Reviewed additional information about teen dating violence and unhealthy relationships using Slides 5-8			
Facilitated discussion on why parents should be relationship and sex educators			
Introduced the review and discussion of the importance of parents as relationship and sex educators			
Implemented a role-play exercise to assist parents in feeling more comfortable addressing difficult topics with their children			
Facilitated a review of previous information on why parents are the best relationship and sex educators			
Facilitated discussion on what parents can do to help their children have healthy relationships			
Referred parents to page 63 in the Parent Handbook for resources on teen dating violence			
Provided a session review			
Introduced and explained homework			
Closed session			

Please indicate if any of the following challenges interfered with your ability to implement the session. Check all that apply.

Not enough time.	
I did not have the needed materials.	
Parents did not appear to understand the session.	
I was uncomfortable discussing some of the topics.	
Parents were uncomfortable discussing some of the topics.	
Some part of the session was difficult for parents (i.e., role plays, discussing relationship issues and topics, homework).	
Other more pressing session demands.	
Other – please specify____________________________________	

Describe any changes you made to the session activities.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.

25. How engaged were the parents in the session?

_________________________________________________________________________________________________

5

Fully Engaged

1

Not at all Engaged/Bored

2

3

Somewhat Engaged

4

26. Overall, how do you think the session went today, in terms of your facilitation and the participation of parents?

_________________________________________________________________________________________________

5

Excellent

1

Very Poor/ Horrible

2

Poor

3

Fair

4

Good

3. How well do you think the parents understood the session material?

_________________________________________________________________________________________________

5

Excellent/

Complete Understanding

1

Did Not Understand

2

Poor

3

Fair

4

Good

20. How well did the session material fit into the allotted time period? (check the box for the statement that is most applicable for this session)

• Session was too packed; not enough time to complete all activities and discussions

• Session was somewhat packet; able to complete most but not all activities and discussions

• Session was timed perfectly; able to complete all activities and discussions

• Session ended before 90 minutes were up; not enough material was provided for the session

Form Approved

OMB No. 0920-0941

Exp. Date: 6/30/2015

Public reporting burden of this collection of information is estimated to average 15 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 Information Collection Review Office, 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-0941).

Attachment Q:

Parent Program Fidelity 6th Grade Session 6

Dating Matters: Strategies to Promote Healthy Teen Relationships™ Initiative

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Parent Curriculum – 6th Grade, Session 6 – Moving Forward

Attendance Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Parent / Guardian Names – Last, First, Initial	Name of Child in Program	Name of Child in Program

Parent Curriculum – 6th Grade, Session 6 – Moving Forward

Session Log

Implementer Name: Last Name: _________________________ First Name______________________ Initial:___

Implementer Survey ID: _______________________________ School Number: ____________________________

Program Year: _______________________________________ Session Number: ___________________________

Please indicate if you completed the following activities:

Activity	Yes	Yes w/ changes	No
Completed Welcome and Review			
Welcomed the children and their parents to the session			
Oriented children to their room and the session			
Briefly reviewed the ground rules			
Facilitated a brief review of Session 5 using Slide 1			
Completed a review of the homework assignment			
Discussed Posters 15-17 and their relevance for the session			
Reviewed the characteristics of effective parent-child communication using Slides 2-5			
Implemented parent-child activity on communication practice			
Facilitated discussion on peer pressure			
Facilitated discussion on the four-step parenting plan for peer pressure, using Slides 6-7			
Facilitated peer pressure situations role-play			
Implemented parent-child exercise by showing and discussing Video 14: “The Pressures Teens Face”			
Provided a review of topics covered over the six weeks of the group using Slides 8-17			
Reviewed the information in the Parent Handbook to which parents can refer for future reference			
Closed the session			

Please indicate if any of the following challenges interfered with your ability to implement the session. Check all that apply.

Not enough time.	
I did not have the needed materials.	
Parents did not appear to understand the session.	
I was uncomfortable discussing some of the topics.	
Parents were uncomfortable discussing some of the topics.	
Some part of the session was difficult for parents (i.e., role plays, discussing relationship issues and topics, homework).	
Other more pressing session demands.	
Other – please specify____________________________________	

Describe any changes you made to the session activities.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.

31. How engaged were the parents in the session?

_________________________________________________________________________________________________

5

Fully Engaged

1

Not at all Engaged/Bored

2

3

Somewhat Engaged

4

32. Overall, how do you think the session went today, in terms of your facilitation and the participation of parents?

_________________________________________________________________________________________________

5

Excellent

1

Very Poor/ Horrible

2

Poor

3

Fair

4

Good

3. How well do you think the parents understood the session material?

_________________________________________________________________________________________________

5

Excellent/

Complete Understanding

1

Did Not Understand

2

Poor

3

Fair

4

Good

24. How well did the session material fit into the allotted time period? (check the box for the statement that is most applicable for this session)

• Session was too packed; not enough time to complete all activities and discussions

• Session was somewhat packet; able to complete most but not all activities and discussions

• Session was timed perfectly; able to complete all activities and discussions

• Session ended before 90 minutes were up; not enough material was provided for the session

Please think about the overall implementation of the program and tell us your answers to the following questions.

1. How much time (excluding travel time) did you spend on facilitation of the parent curriculum sessions?

Time spent preparing for and facilitating the session:___________________ hours per week

2. How much travel time and mileage did you spend on facilitation of the parent curriculum sessions?

Travel time:______________________minutes per week

Mileage:_________________________miles per week

3. What is your annual salary? Please check the box that is most applicable.

• $0 to $9,999

• $10,000 to $19,999

• $20,000 to $29,999

• $30,000 to $39,999

• $40,000 to $49,999

• $50,000 to $59,999

• $60,000 to $69,999

• $70,000 to $79,999

• $80,000 to $89,999

• $90,000 to $99,999

• $100,000 or above

4. How much time (excluding travel time) did you parents typically spend on sessions (this includes group time and home time)?

Time spent on the sessions:___________________ hours per week