Determining School Level Impact Measures SLIMs Elizabeth Coke

Determining School Level Impact Measures (SLIMs) Elizabeth Coke Haller School Health Team Leader Program Development and Services Branch Division of Adolescent and School Health

Internal DASH Workgroup • Surveillance, Evaluation and Research Branch (SERB): – Nancy Brener – Leah Robin • Research and Application Branch (RAB): • Program Development and Services Branch (PDSB): – John Canfield – Alan Penrod – Dave Poehler • Office of the Director (OD): – Pete Hunt – Holly Conner – Anu Pejavara – Beth Stevenson

Documenting Impact of DASH Funded Projects Outputs Short-Term Effects/Outcomes Intermediate Effects/Outcomes Funded Partner Activities Effective policies and practices implemented Reduced risk behaviors, increased protective behaviors School-Level Impact Measures (School Health Profiles) Youth Risk Behavior Survey Process Evaluation (Indicators for School Health Programs) Communicating Impact (Success Stories)

Activity 1 - Accountability In your state team: • Select a REPORTER and RECORDER • Discuss the following questions – WHO are we accountable to? – HOW has our team demonstrated accountability to decision makers? – What BARRIERS do we face when demonstrating accountability to decision makers?

Determining School Level Impact Measures (SLIMs) Objectives: Participants will: • Identify the purpose and uses of SLIMs • Explore an example SLIMs framework • Critique SLIMs criteria and categories • Develop draft SLIMs for each category • Identify next steps in refining SLIMs process

School Level Impact Measures (SLIMs) • Measures the percentage of schools in a state or community that have adopted a policy or implemented a practice that is recommended by CDC, based on research findings, to address a critical health problem faced by children and adolescents.

School Level Impact Measures (SLIMs) • Beginning in 2008, DASH-funded states and cities will be required to identify a limited number of school level impact measures (SLIMs) which they will target for improvement. • Funded Partners will set SMART objectives for the selected SLIMs and monitor progress in reaching those objectives.

Why might performance measures be helpful to assess the impact of agency activities at the school level? • Discuss with your team, record your best ideas. • Be prepared to share 1 -2 examples with the full group.

Why Programs Need SLIMs • Need to focus and demonstrate impact – Limited and reduced federal dollars – Demonstrate effective programming/outcomes • Reach decision makers with the importance of your work – Demonstrate that your work impacts the health of children in schools – Demonstrate your passion for the work you do • Be a catalyst – Make change happen in alternative ways – Focus work plans to reflect key priorities – Make school health manageable and more effective; Work Smarter Not Harder!

SLIMs Are: • Used to establish objectives in your work plan • Used to document improvement in school health activities at the school level • Selected by the funded partners for each priority area

Determining School Level Impact Measures (SLIMs) Objectives: Participants will: • Identify the purpose and uses of SLIMs • Explore an example SLIMs framework • Critique SLIMs criteria and categories • Develop draft SLIMs for each category • Identify next steps in refining SLIMs process

Sample SLIM Matrix Categories Coordination and Collaboration Program Activities Policy Priority Populations Cross Cutting 2 -3 2 -3 PA/PE 2 -3 2 -3 Nutrition 2 -3 2 -3 Tobacco 2 -3 2 -3 HIV 2 -3 2 -3 Topic Areas

SLIM Proposed Categories Category 1: Coordination and Collaboration Category 2: Program Activities Category 3: Policy Category 4: Priority Populations

SLIM Proposed Health Topics • Cross-Cutting • HIV • Physical Activity & Physical Education • Nutrition • Tobacco • Asthma

SLIM Example • Category: Policy Topic Area: Tobacco • SLIM: The percentage of schools that have an “ideal” tobacco use prevention policy prohibiting all tobacco use by all students, staff and visitors on school property, in school vehicles, and at off campus school-sponsored events. • SLIM Objective: Increase from ( ) to ( ) by ( ). • Items: Profiles Questions 20 -23, Principal Questionnaire, 2006 School Health Education Profiles

SLIM Example Question • This SLIM is derived from multiple questions asked in Profiles. • To determine whether this SLIM is met, all parts of all questions 20 -23 must be answered with a response of “yes. ” The questions include: – adoption of a policy prohibiting tobacco use; – policy prohibiting the use of each type of tobacco by students, faculty/staff and visitors; – prohibiting use during all times of the day by students, faculty/staff and visitors; and – prohibiting use in all locations by students, faculty/staff and visitors.

Determining School Level Impact Measures (SLIMs) Objectives: Participants will: • Identify the purpose and uses of SLIMs • Explore an example SLIMs framework • Critique SLIMs criteria and categories • Develop draft SLIMs for each category • Identify next steps in refining SLIMs process

Activity 2 Creating SLIMs: Defining Criteria and Categories

Criteria to Assess SLIMs • Link to Health Outcomes • Measurable • Perceived Importance (i. e. stakeholders, CDC, Funded Partners, Congress) • Clear Link to DASH Funded Activities • Feasible (i. e. cost, time) • Impact on School Health Policies & Programs • Others We May Need?

Activity 2 a - Assessing SLIM Criteria In your state team: • Select a REPORTER and RECORDER • Discuss the following questions – What criteria are missing? – What criteria are not useful? Why? – Reflect on the Accountability Activity. • Record feedback on worksheet

Activity 2 b – Assessing SLIM Criteria In your state team join another state team • Select a REPORTER and RECORDER from each team • Compare responses and record 3 -5 consensus items for each question – Record on chart paper and post – Be sure to identify state team name and a contact person to direct questions to – Review posted information during the break • Be prepared to summarize in large group after break

Let’s Take A Break!

Activity 2 b Processing — Assessing SLIM Criteria Large Group Summary

Determining School Level Impact Measures (SLIMs) Objectives: Participants will: • Identify the purpose and uses of SLIMs • Explore an example SLIMs framework • Critique SLIMs criteria and categories • Develop draft SLIMs for each category • Identify next steps in refining SLIMs process

SLIM Proposed Categories Category 1: Coordination and Collaboration Category 2: Program Activities Category 3: Policy Category 4: Priority Populations

Activity 3 - Category Jigsaw In your state team: 1. Number off - 1 to 4 (may have more than 1 of each number) 2. Take the “SLIMs Categories Descriptions Sheet” on Tables 3. Individually and silently, #1 read Category 1, #2 read Category 2 and so on - be prepared to teach your teammates

Activity 3 - Category Jigsaw In your state team: 4. After reading categories and definitions assigned to you, find 2 example SLIMs that match your assigned category 5. When you hear the chime, teach other what you learned, highlight key concepts and SLIM matches 6. Be prepared to share in large group

Category Feedback • Discuss the SLIM Categories in your state team to determine what categories may be missing – Can the priorities of your program be covered in these 4 categories? – If not, what categories need to be added? – Record notes on handout provided and be prepared to share in large group

Activity 3 – Category Feedback Large Group Processing: Jigsaw and Categories

Determining School Level Impact Measures (SLIMs) Objectives: Participants will: • Identify the purpose and uses of SLIMs • Explore an example SLIMs framework • Critique SLIMs criteria and categories • Develop draft SLIMs for each category • Identify next steps in refining SLIMs process

Activity 4 Developing SLIMs

Activity 4 - Developing SLIMs With your state team • Assign one team member to each of the 5 topic areas • Note and jot down the room # for your assigned topic – HIV Room: – CC Room: – PA/PE Room: – Nutrition Room: – Tobacco Room:

Developing SLIMS - The Process Tools: • Assigned Topic Area • Criteria • Categories • Examples of SLIMs • Process: • Develop 2 -3 SLIMs for your topic area/category • Use criteria and examples as a guide

Sample SLIM • The percentage of schools that provide parents/families with information on comprehensive health education.

Developing SLIMS Discuss with your Topic/Category Team: • Is it in alignment with criteria? • Thoughts about possible data source for measuring? • Could the SLIM be measured by one or more questions added to Profiles?

Activity 4 - Developing SLIMs Breakout Rooms by Topic Area • Record 1 draft SLIMs per template • Each categorical group will work to draft 23 SLIMs • Determine the best SLIM and post on chart paper • Report SLIM to the topic group • Post paper in main training room

Let’s Take A Break! ~ Teams Return to Main Training Room

Processing SLIMs Development • Look at draft SLIMs • Process SLIMs development activity – Pluses – Wishes • Other comments about the process or results

Determining School Level Impact Measures (SLIMs) Objectives: Participants will: • Identify the purpose and uses of SLIMs • Explore an example SLIMs framework • Critique SLIMs criteria and categories • Develop draft SLIMs for each category • Identify next steps in refining SLIMs process

CDC’s Next Steps for SLIMs CDC will: • Finalize Criteria, Categories, and SLIMs developed from this training • Identify an external workgroup of Funded Partners • Share with DASH Senior Management and the internal committee • Review SLIMs and compare with available data sources • Develop new data sources for SLIMs • Conduct pilot in 2007

REMEMBER… CDC will: • Refine Profiles to accommodate SLIMS • Gather consensus from funded partners • Welcome feedback and questions CDC-DASH Goal: A limited set of SLIMs will be choosen from a menu for each priority area (i. e. CSHP, HIV, Asthma)

We NEED You! • Review and provide feedback on draft SLIMs • Provide feedback on the new Profiles questions • Review tools • Review online system for collecting SLIMs • Develop SLIMs Pilot Plan for 2007

We NEED You! Volunteers needed! • Fill out the note card on the table if you are interested in participating – Name, Agency and Role/Title – Topic preference; (1) Cross-Cutting, (2) HIV (3) Nutrition, (4) Tobacco, (5) Physical Activity and Physical Education, (6) Asthma – Turn card into Eliz Haller by the end of the training tomorrow

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