Water Toolkit Att E

Attachment E: Feedback Tool (Word Version)

Form approved

OMB No. 0920-0879

Expiration date: 04/30/2017

Welcome!

We are seeking feedback about your experience using the Increasing Access to Drinking Water in Schools toolkit ("Water Toolkit") that was developed by the Center for Disease Control and Prevention’s School Health Branch (CDC/SHB). Your feedback will help us improve the resources we make available to help support students’ access to clean and safe drinking water as part of a healthy school nutrition environment.

We are seeking your input given the role you play in coordinating school-based strategies as part of State Public Health Actions/1305. This data collection is intended for State Health Department or Department of Education/Public Instruction staff only.

Completing this online assessment is voluntary and takes approximately 11 minutes.

As you go through the questionnaire, please respond to the questions from your individual perspective and not that of your department as a whole, unless otherwise indicated.

It is recommended that you finish the data collection in one session, but you have the option to save responses and resume later. Partially completed responses can be saved by closing your browser, and restarted by clicking on the link to the questionnaire for up to 3 weeks after you initially begin.

Please complete the questionnaire by [May date], 2015.

Your privacy is very important to us. The CDC will not publish or share any identifying information about individual respondents with CDC or any partner organizations etc. There are no known risks or direct benefits to you from participating or choosing not to participate in this assessment, but your answers will help the CDC tailor the resources they develop to improve their relevance to you and your efforts to make drinking water more accessible in schools.

If you have questions or feedback about this assessment, please contact Sarah Sliwa at ssliwa@cdc.gov.

To begin, please click next.

1. Do you work in a state, tribal, or territorial health department or the department of education/department of public instruction?

• No [END DATA COLLECTION—SEND TO THANK YOU PAGE]

• Yes. Select which one

• Department of Health

• Department of Education/Department of Public Instruction

2. At which department do you work?

• Department of Health

• Department of Education/Department of Public Instruction

3. For your state’s work on State Public Health Actions/1305, which agency is the direct link to the local education agencies (LEAs)?

• Department of Health

• Department of Education/Department of Public Instruction

4. Which of the following best describes how you work with LEAs/School Districts as part of State Public Health Actions/1305?

• Through a contract or MOU between the Department of Public Health and Department

of Education/Department of Public Instruction, the DOE/DPI does 100% of the school health related work plan activities.

• Through a contract or MOU between the Department of Public Health and Department

of Education/Department of Public Instruction, the two departments partner to complete the school health related work plan activities.

• The State Dept. of Health has a designated School Health contact who does 100% of the school health related work plan activities directly with our targeted LEAs.

• The State Dept. of Health has a designated School Health contact who primarily works indirectly with LEAs through partnerships and subcontracts.

5. As part of the Healthy Hunger-Free Kids Act (HHFKA), schools participating in the National School Lunch and School Breakfast programs are required to make plain drinking water available in the cafeteria at no cost during school meal times.

Beyond this requirement, some LEAs are taking actions to make plain drinking water more accessible to students throughout the school day (e.g., allowing water bottles in classrooms, updating water fountains).

• Our efforts are focused on meeting the HHFKA requirements around drinking water. (skip to Q7)

  

• We are working with some LEAs on efforts to increase access to drinking water throughout the school day.

• I am not sure how we are working with LEAs around promoting students’ access to drinking water. (skip to Q7)

6. [For middle option] How many LEAs are working on this strategy?

• 1-5

• 6-10

• 11-15

• 16-30

• 31-45

• 46-60

• 61-75

• 76-100

• >100

During the 2014-2015 school year, have you received any communications about the “Water Toolkit” from any of the following sources?	Select all that apply
CDC Project Officer
Colleague at the state health department in my state.
Colleague within another state or territorial health department.
Colleague within a local or tribal health department in my state or territory.
Colleague at my state’s department of education.
Colleague at another state department of education
Colleague within a local or tribal department of education
Colleague at a partner organization that contributes to school based activities for 1305
School Administrators (Principals, Superintendents)
School Staff (teachers, coaches)
Parent Organizations (PTA)
Social Media
CDC website
Website, Other
Email-blast, listserv, or e-newsletter
Webinar
Other:_________________________________

8. If you mentioned that saw the toolkit on a website, please specify which website/s.

• Did not see on a website

• Please specify which website/s:______________________________

9. If you mentioned that you heard about the toolkit through email-blast, list-serv, or e-newsletter, please specify which one/s.

• Did not hear about the toolkit through an email-blast/list-serv/e-newsletter

• Please specify which listserv etc.:______________________________

10. If you mentioned that you heard about the toolkit on a webinar, please specify which webinar/s.

• Did not hear about toolkit on a webinar

• Please specify which webinar/s:______________________________

Since the end of September 2014, with which of the following people have you sent/shared, recommended or mentioned the “Water Toolkit”:	Select all that apply
Colleague at the state health department where I work.
Colleague within another state or territorial health department.
Colleague within a local or tribal health department in my state.
Colleague at the state department of education.
Colleague at another state department of education
Colleague within a local department of education
Colleague in a partner organization that contributes to school based activities for 1305
School Administrators (Principals, Superintendents)
School Staff (teachers, coaches)
Parent Organizations (PTA)
A listserv I subscribe to
I have not sent the product to anyone.
Other dissemination channels____________

Using the CDC Water Toolkit

The “Water Toolkit” outlines a step by step process that includes a needs assessment, the development and implementation of a School Water Access Plan, and suggestions for evaluation questions.

11. Have you read the “Water Toolkit”?

• Yes

• No [If no, skip to question 21]

Which of the following steps have you taken since the end of September 2014?	I have taken this step
Disseminate the toolkit to colleagues and potential users
Coordinate/offer trainings to LEAs and/or partner organizations on the “Water Toolkit”
Work with LEAS/schools in LEAs to assemble teams interested in promoting access to water
Work with LEAS/schools in LEAs to review state, district, and school policies and practices around water access
Work with LEAS/schools in LEAs to review federal, state and local water testing requirements and recommendations
Work with LEAS/schools in LEAs to conduct a needs assessment to learn more about current school water environment
Work with LEAS/schools in LEAs to assess students’ and other stakeholders’ (e.g., school administrators, staff, health agency representatives, and families) perceptions about current drinking water and about providing drinking water in the school
Work with LEAS/schools in LEAs to identify key water champions
Work with LEAS/schools in LEAs to develop a school water access plan
Work with LEAS/schools in LEAs to implementing a school water access plan
Work with LEAS/schools in LEAs to develop water promotion strategies
Work with LEAS/schools in LEAs to evaluate progress in access to drinking water
Other:_____________

The “Water Toolkit” outlines a step-by-step process for addressing water access in schools. It also includes appendixes/checklists/and planning questions to help identifying areas to prioritize.

To what extent do you agree with these statements?

14. “This framework helped to advance our efforts to increase access to water in schools.”

1. Disagree strongly

2. Disagree somewhat [skip to q16]

3. Agree somewhat [skip to q16]

4. Agree strongly [skip to q16]

15. Follow up for those who answered 1 to q14.

“You indicated that the step-by-step process was not a very useful framework. Do you have any suggestions for how this could be improved?

16. ”The checklists and planning questions helped us identify areas to prioritize?

1. Disagree strongly

2. Disagree somewhat [skip to q18]

3. Agree somewhat [skip to q18]

4. Agree strongly [skip to q18]

Follow up= if 1

17. Follow up for those who answered 1to q 17.

“You indicated that the appendixes/checklists/planning questions were not useful in prioritizing actions. Do you have any suggestions for how this section could be improved?

18. What do you like the most about the “Water Toolkit”?

• Overview of policies related to water

• Needs assessment checklist

• Planning questions

• Evaluation questions

• Stakeholder interview guide

• Strategies to overcome challenges

• Water testing diagram

• Other ______________

19. Please describe any changes that you’ve noticed or heard about in your targeted LEAs after working through the steps outlined in the “Water Toolkit”.

20. If you have suggestions for making the “Water Toolkit” more useful for you, including any content or resources you’d like to see addressed, please enter them here.

21. With whom are you partnering/working with on efforts to increase students’ access to water in schools?

22. What other tools or resources have you accessed to help you in your work to increase access to water in schools?

• None

• Drink Up

• Rethink Your Drink

• Take Back the Tap

• Water Works: A Guide to Improving Water Access and Consumption in Schools to improve Health and Support Learning

• Keep It Flowing: A Practical Guide to School Drinking Water Planning, Maintenance & Repair

• Prevention Research Center/Harvard School of Public Health Water Access Audit Tool

• Other:____________________

23. What other resources would help you in your work to increase access to water in schools?

Thank you for taking time to complete this questionnaire!

Your responses will help CDC to improve the usefulness of its products to increase access to water in schools.

To learn more about the CDC Water Access in Schools Toolkit, please visit [LINK]

Public reporting burden of this collection of information is estimated to average 11 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, MS D-74, Atlanta, Georgia 30333: ATTN: PRA (0920-0879).