PREP Studies of Performance Measures and Adult Preparation Subjects (PMAPS)

INSTRUMENT #1

PREP STUDIES OF PERFORMANCE MEASURES
AND ADULTHOOD PREPARATION SUBJECTS

Inquiry on the Usefulness of Personal Responsibility Education Program (PREP) Performance Measures

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Inquiry on the Usefulness of Personal Responsibility Education Program (PREP) Performance Measures

THE PAPERWORK REDUCTION ACT OF 1995

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, 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. The information collected will help policy makers, program providers and other stakeholders understand the experiences of youth today and identify ways to reduce risky behaviors. This information will also inform programs on how best to serve their participants. The collection of this information is voluntary and responses will be kept private to the extent allowed by law. The OMB number for this information collection is XXXX-XXXX and the expiration date is XX/XX/XXXX.

INSTRUCTIONS: FYSB welcomes feedback from our grantees on which measures are the most useful to them. For each of the categories and items listed below, please indicate the ways in which your program uses the data currently or might use the data in the future. When responding to the items, please consider all of the users of performance measures including yourself as the grantee, your subawardees (if any), your evaluator, your partner organizations, or others who may use the measures or consider doing so in the future. An open-ended question at the end provides the opportunity to further comment on the measures if you wish to do so.

1. Do you currently use or would you use data from items on demographics to…

Demographic measures include those items asking about age, race, ethnicity, grade, and language.

	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

2. Do you currently use or would you use data from the item on sexual orientation to…

The measure on sexual orientation asks whether participants think of themselves as gay or lesbian, straight, bisexual, something else, or they are unsure.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

3. Do you currently use or would you use data from the items on gender identity to…

Gender identity measures include items asking participants their sex assigned at birth on their birth certificate (i.e., biological sex) and how participants describe their gender identity.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

4. Do you currently use or would you use data from the item on special populations to…

The special populations measure asks whether participants are currently in foster care, adjudicated, couch surfing, living in a place not meant to be a residence, or living in emergency shelter.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

5. Do you currently use or would you use data from items on sexual activity to…

Sexual activity measures include items asking whether participants ever had vaginal sex, number of times had vaginal sex in the past 3 months, and number of partners in the past 3 months.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

6. Do you currently use or would you use data from items on pregnancy to…

Pregnancy measures include items asking whether participants have ever been or gotten someone pregnant and, if so, the number of times.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

7. Do you currently use or would you use data from items on adulthood preparation to…

Adulthood preparation measures include items asking about participants’ perceptions of the effects of PREP on their preparation for adulthood in the areas of adolescent development, healthy relationships, healthy life skills, parent/child communication, education and career success, and financial literacy.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

8. Do you currently use or would you use data from items on sexual intentions to…

Sexual intentions measures include items asking about intention to have sex in the next 3 months and intention to use condoms and/or birth control in the next 3 months.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

9. Do you currently use or would you use data from items on contraception to…

Contraception measures include items asking whether participants used condoms, birth control, both (or neither) during vaginal sex in the past 3 months.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

10. Do you currently use or would you use data from items on HIV or STI risk to…

HIV and STI risk measures include items asking whether participants ever had oral sex or anal sex, number of times and number of partners in the past 3 months, use of condoms or dental dams, and intentions regarding oral and/or anal sex. These items would not be collected from middle-school participants.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

11. Do you currently use or would you use data from items on participant satisfaction to…

Participant satisfaction measures include items asking whether participants were interested in the materials, felt material was clearly presented, that discussions and activities were helpful, had the chance to ask questions, and felt respected.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

12. Do you currently use or would you use data from items on bullying/teasing to…

Bullying/teasing measures include items asking whether participants felt bullied or picked on, or witnessed someone else being bullied or picked on.	SELECT ONE RESPONSE PER ROW
	YES	NO
a. Manage your program?	1 □	0 □
b. Make program improvements?	1 □	0 □
c. Work with funders?	1 □	0 □
d. Work with policy makers?	1 □	0 □
e. Work with partners?	1 □	0 □
f. Disseminate results?	1 □	0 □
g. Other?	1 □	0 □

13. Please use the space below to provide any additional comments regarding how you use or plan to use data from the performance measures.

Thank you for completing this survey!