Form 1 SRAE Performance Reporting System Data Entry Form

OPRE Descriptive Study - Sexual Risk Avoidance Education Program Performance Analysis Study (SRAE PAS) [Descriptive Study - Performance Measures]

Instrument 3_SRAE Performance Reporting System Data Entry Form_ rev 8-7_ForOMB_Clean

Instrument 3 - Performance Reporting Data Entry Form

OMB: 0970-0536

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instrument 3


SRAE performance reporting system data entry form

The 137 estimated grantees will report measures on participant demographics, behaviors, intentions, perceived effects, and program experiences; attendance, reach, and dosage; implementation challenges and needs for technical assistance; and structure, cost, and support for program implementation. The contractor (Public Strategies) and subcontractor (Mathematica) have developed this tool for grantees to use to collect data originating from subawardee providers and to organize all of the grantee-, provider-, and program-level performance measures data elements for submission into the SRAE Performance Measures Portal. The contractor is developing separate tools to support grantees in their submission of the data originating from the entry and exit surveys (Instruments #1 and #2). However, these tools are considered voluntary and to be used at the discretion of the grantees. Grantees may elect to use alternative means to collect the data that will be submitted. The only requirement will be that all grantees enter the required measures into the Portal systematically, and for that they will (1) use an online form that contains all of the items in this instrument and (2) upload data files containing the items in Instruments #1 and #2.


Measures of Structure, Cost, and Support for Program Implementation

REPORT PERIOD

[reporting period]

Grantee:

Enter grantee name



SRAE Operational Status Related to COVID-19

Did your SRAE program experience any interruptions of operations or services due to COVID-19?

Y/N

If yes:


For how long did the program experience interruptions of operations or services due to COVID-19?

Number of months:a ______

Were your operations able to resume to full pre COVID-19 capacity?

Y/N

If not, what is the percent capacity of operations at present?

%

aThe SRAE Performance Measures Portal will include hover text to remind grantees about the reporting period (Sept. 2019 – Oct. 2020) when responding this question.


Funding


Total amount of SRAE grant funding obligated (including any carryover funds) during [reporting period]

$

Percentage of total funding obligated for:

Percent of funding obligated

Direct service provision (youth programming)

%

Training, technical assistance, and monitoring conducted at the grantee level

%

Evaluation and/or research

%

Administrative purposes at the grantee level

%



Grantee Staffing

Count

Number of grantee staff involved in overseeing SRAE before COVID-19 occurred


Did the number of staff involved in overseeing SRAE decrease due to COVID-19?

Y/N

If yes: how many staff were affected?


Number of grantee FTEs involved in overseeing SRAE before COVID-19 occurred


Did the number of FTEs involved in overseeing SRAE decrease due to COVID-19?

Y/N

If yes: how many FTEs were affected?




Grantee Observation, Training and Technical Assistance

Y/N

Grantee or its designee observed program delivery to monitor quality and fidelity to program models


Type of organization that conducted observations:

Y/N

Type of Organization – Observations

Grantee


Developer


Training or technical assistance partner


Evaluation partner


Program provider


Grantee or its designee provided technical assistance to support program implementation


Type of organization that provided technical assistance:

Y/N

Type of Organization – TA

Grantee


Developer


Training or technical assistance partner


Evaluation partner


Program provider


Grantee or its designee conducted training of facilitators who deliver the program (or of other staff who might train facilitators)


Type of organization that conducted program facilitator training:

Y/N

Type of Organization – Training

Grantee


Developer


Training or technical assistance partner


Evaluation partner


Program provider




Number of providers

Count

Number of providers funded


Number of new providers



Target number of youth to be served by the grantee (in the original application or approved by your project officer)

Count

Target number of youth




Measures of Structure, Cost, and Support for Program Implementation


REPORT PERIOD

[reporting period]

Grantee:

Enter grantee name

Provider:

Enter provider name


Funding

Amount

SRAE annual award amount (for current grant year)

$

Amount of non-SRAE funding received during current reporting year to support SRAE programming

$




Y/N

Is provider new for the [reporting year]?


Did provider serve youth during the [reporting year]?




Facilitators

Count

Number of SRAE facilitators working for provider


Number of SRAE facilitators trained in delivering core curriculum


Number of SRAE facilitators observed once


Number of SRAE facilitators observed at least twice



Measures of Structure, Cost, and Support for Program Implementation


REPORT PERIOD

[reporting period]

Grantee:

Enter grantee name

Provider:

Enter provider name



Use the scale at the right to indicate how the provider assessed the implementation challenges below.


Not a Problem

Somewhat a problem

A serious problem

Implementation Challenges

Recruiting youth




Keeping youth engaged




Getting youth to attend regularly




Recruiting qualified staff




Ensuring facilitators understand content




Covering program content




Staff turnover




Negative peer reactions




Youth behavioral problems




Natural disasters




Program facilities




Obtaining buy-in or support from key stakeholders




Parent support or engagement




Other











Use the scale at the right to indicate if the provider has expressed interest in receiving technical assistance for the implementation factors below.

Not interested, already received

Not Interested

Somewhat Interested

Very Interested

Needs for Technical Assistance

Recruiting youth





Keeping youth engaged in program sessions





Getting youth to attend regularly





Recruiting qualified staff





Training facilitators





Retaining staff





Minimizing negative peer reactions





Addressing youth behavioral issues





Obtaining buy-in or support from key stakeholders





Evaluation (e.g., how to select or manage an evaluator, data collection, data analysis, and report writing)





Parent support and engagement





Other

















Measures of Structure, Cost, and Support for Program Implementation


REPORT PERIOD

[reporting period]

Grantee:

Enter grantee name

Provider:

Enter provider name

Program:

Enter program name


Program Delivery


Number of intended program delivery hours


Core curriculum


Indicate which SRAE topics are addressed by this core curriculum:

Y / N

SRAE topics covered through core curriculum

Teaching the benefits of:


Advantage of refraining from nonmarital sexual activity


Self-regulation


Goal setting


Success sequence for poverty prevention*


Healthy relationships


Resisting:


Sexual coercion


Dating violence


Other youth risk behaviors, such as alcohol, tobacco, and other drug use





Other program elements that address SRAE topics

Are there any other program elements – such as supplemental curriculum, guest speakers, or other program activities that are not part of the core curriculum – that address SRAE topics?


Indicate which SRAE topics are addressed through supplemental program elements:


SRAE topics covered through supplemental program elements

Teaching the benefits of:


Refraining from nonmarital sexual activity


Self-regulation


Goal setting


Success sequence for poverty prevention*


Healthy relationships


Resisting:


Sexual coercion


Dating violence


Other youth risk behaviors, such as alcohol, tobacco, and other drug use


*Success sequence for poverty prevention – The three steps that young adults should take to improve the likelihood of successful economic outcomes when reaching adulthood. The steps include, but are not limited to, graduating from high school, working a full time job, and waiting until age 21 or later to get married and have children (SRAE 2019 Funding Opportunity Announcement).



Measures of Structure, Cost, and Support for Program Implementation


REPORT PERIOD

[reporting period]

Grantee:

Enter grantee name

Provider:

Enter provider name

Program:

Enter program name


Indicate which, if any, of the following youth groups are target populations for the provider’s program

Y / N

Target Population

Youth in high-need geographic areas


Youth in foster care


Homeless or runaway youth


Youth living with HIV/AIDS


Pregnant or parenting youth


Hispanic/Latino youth


African American youth


Native American youth




Youth in adjudication systems


Male youth


Out of school or dropout youth


Youth in residential treatment for mental health issues


Trafficked youth



Measures of Attendance, Reach, and Dosage


REPORT PERIOD

[reporting period]

Grantee:

Enter grantee name

Provider:

Enter provider name

Program:

Enter program name



Enter the number of youth during the reporting period who:

Enter Count

Reach


Total (unduplicated)

Before COVID-19a

Since COVID-19

Attended at least one program session




Number of middle school participants




Number of high school participants




Program Setting

Attended a session in school during school




Attended a session in school after school




Attended a session in a community-based organization




Attended a session in a clinic




Attended a session in a foster care setting




Attended a session in a juvenile detention center




Attended a session in a residential mental health treatment facility




Attended a session onlineb




Attended a session in another setting




Attendance/Dosage

Completed at least 75 percent of the scheduled program hours




aThe data submission portal will include hover text with the clarifying language, “Please think about the date stay-at-home orders were implemented or schools closed, etc.”

bOnline includes any programming that is facilitated online rather than by an in-person facilitator, regardless of the physical setting where participants are located.




Indicate whether more than 50 percent of youth attending the program were:

Y / N



Majority population

In foster care




Homeless or runaway




Pregnant or parenting




In adjudication systems










Enter the appropriate count below

Enter Count



Parent Involvement

Number of youth’s parents and other caring adults who attended at least one program session during the reporting period





Measures of Attendance, Reach, and Dosage


REPORT PERIOD

[reporting period]

Grantee:

Enter grantee name

Provider:

Enter provider name

Program:

Enter program name




Cohort

Enter a unique identifier for each cohort that received the program during this reporting period.

1

2

3

4

5

6

7

8

9

etc.

Did the cohort complete the program during the reporting period (Y/N)?











For those cohorts that completed the program during the reporting period, how many hours of programming, overall, were delivered?











Did SRAE programming end prematurely for the cohort due to COVID-19? (Y/N)











If programming for this cohort ended prematurely due to COVID-19, enter the number of intended program hours that was delivered to the cohort at the point implementation ended.











Did SRAE program implementation shift from in-person to online programming for the cohort due to COVID-19? (Y/N)











If programming for this cohort shifted to an online format, enter the percentage of participants who shifted to online SRAE programming. (If an exact percentage is not readily available, please enter your best estimate.)















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AuthorMATHEMATICA
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File Created2021-01-11

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