Sexual Risk Avoidance Education National Evaluation: Co-regulation Guidance Pilot Study

SRAENE – Core Components Evaluation, Co-Regulation Strategies, Instrument 3

OMB Control No: 0970-0356

Expiration Date: 01/31/2027

Sexual Risk Avoidance Education National Evaluation 2.0

Facilitator post-coaching pulse check [web-based]

Thank you in advance for taking this survey! This study is sponsored by the Administration for Children and Families (ACF) within the U.S. Department of Health and Human Services and is being conducted by Mathematica. The purpose of this short survey is to learn about your experience with the coaching you received on using the co-regulation strategies. The information you provide will help ACF learn about and improve coaching on the co-regulation strategies.

Your participation in this survey is voluntary. There are no risks or benefits associated with completing the survey, which should take about 5 minutes. We will not collect any personal information (for example, your name, email, or phone number) as part of the survey. Your answers will remain private, except as required by law, and no staff at your organization will see your individual responses. We hope you answer all survey questions, but you may skip any question you do not want to answer.

If you have any questions or comments about this information collection, contact Melissa Thomas, the survey director, at mthomas@mathematica-mpr.com or (609) 275-2231. If you have any questions or concerns about your rights as a study participant, please contact the Health Media Lab Institutional Review Board at (202) 246-8504.

If you agree to participate in this survey, click NEXT to begin. If you do not agree to participate, please close out of this window.

1. Overall, how satisfied were you with the coaching you received on the use of co-regulation strategies?

• Not at all satisfied

• Somewhat satisfied

• Satisfied

• Very satisfied

2. Which part(s) of coaching do you find most helpful? (check all that apply)

• Reminders to use the co-regulation strategies

• Reviewing how to use the co-regulation strategies

• Discussing challenges

• Planning or generating ideas for using co-regulation strategies in upcoming lessons

• Other, please specify

3. Which part(s) of coaching do you think could be improved? (check all that apply)

   • Reminders to use the co-regulation strategies

   • Reviewing how to use the co-regulation strategies

   • Discussing challenges

   • Planning or generating ideas for using co-regulation strategies in upcoming lessons

   • Other, please specify

4. Please tell us how much you agree or disagree with the following statements. There are no right or wrong answers so please do your best to answer honestly.

	Select one only
	Strongly disagree	Disagree	Agree	Strongly agree
The coaching calls helped answer my questions about the co-regulation strategies.	1 	2 	3 	4 
The coaching calls helped me to better use the co-regulation strategies.	1 	2 	3 	4 
The coaching calls were a good use of my time.	1 	2 	3 	4 
I improved as a facilitator as a result of the coaching calls.	1 	2 	3 	4 

5. Anything else you’d like to add?

THE PAPERWORK REDUCTION ACT OF 1995

This collection of information is voluntary and will be used to provide the Administration for Children and Families with information to help refine and guide program development in the area of adolescent pregnancy prevention. Public reporting burden for the collection of information is estimated to average 5 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 OMB number and expiration date for this collection are OMB #: 0970-0356, Exp: 01/31/2027. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Melissa Thomas at mthomas@mathematica-mpr.com..

DRAFT 05/29/25 Mathematica^® Inc. 2