Form H Survey

OMB #: 0925-0542

Expiration Date: 4-30-08

FORM H

Brain Power!

The NIDA Junior Scientists Program

Grades 2/3

Survey for Treatment Teachers

As part of your agreement to participate as a teacher in the treatment group of the Brain Power! curriculum intervention, please fill out this questionnaire. It is intended to take no longer than 30 minutes. Thank you.

1. Including this year, how long have you been teaching? (Please circle one response for each item.)

Number of years	0-5 years	6-11 years	12-17 years	18-23 years	24 years or more
a. Teaching	1	2	3	4	5
b. Teaching current grade.	1	2	3	4	5
c. Teaching at this school.	1	2	3	4	5

2. Did you use the Brain Power! curriculum in the following grades? (Please circle one response for each item.)

Yes No

a. Kindergarten 1 2

b. First grade 1 2

c. Second grade 1 2

d. Third grade 1 2

e. Fourth grade 1 2

f. Fifth grade 1 2

g. Sixth grade 1 2

h. Seventh grade 1 2

i. Eighth grade 1 2

3. What is your certification status? (Please circle one.)

Certified 1

Probationary (including those with temporary teaching certification) 2 (Skip to Question 5)

Emergency 3 (Skip to Question 5)

Other (please specify): 4 (Skip to Question 5)

4. In what area(s) are you certified? (Please circle all that apply.)

a. Elementary education 1

b. Early childhood education 2

c. Reading 3

d. Special education 4

e. Bilingual education 5

f. Other (please specify) 6

5. Are you:

Male? 1

Female? 2

6. What is your age? (Please circle one.)

Less than 25 1

25-35 2

36-45 3

46-55 4

56-65 5

65 or older 6

7. What is your current level of education? (Please circle one.)

Bachelor’s degree 1

Bachelor’s degree plus additional graduate course credit(s) 2

Master’s degree 3

Master’s degree plus additional graduate course credit(s) 4

Professional degree 5

This section includes questions about your classroom instruction and about your own knowledge of neurobiology.

8. If you had not participated in the Brain Power! curriculum intervention, would you have included instruction in any of the following topics during this school year (2005–2006) anyway? (Please circle one on each line.)

Topic	Yes, would have included instruction	No, would not have included instruction
a. The steps of scientific inquiry	1	2
b. The four major parts of the brain and their function	1	2
c. Nerve cell communication (neurotransmission)	1	2
d. Helpful medicines and harmful drugs	1	2
e. Effects of aspirin or Tylenol, fluoride, immunizations, and antibiotics on the body	1	2
f. Effects of nicotine on the body	1	2
g. Definition of addiction and characteristics of addiction	1	2
h. Effects of cocaine, marijuana, and/or alcohol use on the brain and body	1	2

9. If you answered “yes” to any of the topics in Question 9 a–h, approximately how much time did you plan to spend on each over the course of this school year? (Please circle one.)

1 to 3 hours 1

4 to 6 hours 2

7 to 8 hours 3

More than 8 hours 4

11. How would you describe your knowledge in each of the following topics prior to and after teaching the Brain Power! curricula? (Please circle one response for each item in Column I to describe your knowledge prior to teaching the curriculum and one response for each item in Column II to describe your knowledge after teaching the curriculum.)

Topic	Column I. Knowledge prior to teaching					Column II. Knowledge after teaching
	Modest or very little amount	Fair or moderate amount	Signifi- cant or sizable amount			Modest or very little amount	Fair or moderate amount	Signifi- cant or sizable amount
a. Names of major regions of the brain	1	2	3			1	2	3
b. Specific responsibilities of each brain region	1	2	3			1	2	3
c. The parts of a neuron and their individual functions	1	2	3			1	2	3
d. The process of neurotransmission	1	2	3			1	2	3
e. The role of neurotransmitters	1	2	3			1	2	3
f. The effect of drugs on neurotransmitters	1	2	3			1	2	3
g. The effects of marijuana on the brain	1	2	3			1	2	3
h. The effects of cocaine, caffeine, and other stimulants on brain chemistry	1	2	3			1	2	3
i. The effects of nicotine on the body	1	2	3			1	2	3
j. The effect of nicotine on neurotransmission	1	2	3			1	2	3
k. The effect of aspirin, acetaminophen, fluoride, immunizations, and antibiotics on the body	1	2	3			1	2	3
l. The process of scientific inquiry	1	2	3			1	2	3
m. Health recommendations for children (diet, exercise, sleep)	1	2	3			1	2	3
n. Long-term effects of alcoholism	1	2	3			1	2	3
o. Characteristics of addiction	1	2	3			1	2	3

This section includes questions about the content of the Brain Power! curriculum, usage, modifications, and participation.

12. How would you rate the following aspects of the Brain Power! curriculum content overall? (Please circle one on each line.)

Curriculum content	Excellent	Good	Fair	Poor	Unaccep-table
a. Relevance to your students	1	2	3	4	5
b. Ability to maintain student interest	1	2	3	4	5
c. Appropriateness for designated grade level	1	2	3	4	5
d. Ability to challenge students	1	2	3	4	5

13. To what extent do you agree or disagree with the following statements about the Brain Power! materials? Mark NA if did not use the materials or have no opinion. (Please circle one on each line.)

Statement	Strongly agree	Agree	Disagree	Strongly disagree	NA
a. The curricular materials were easy to use in general	1	2	3	4	5
b. Any material that was new to me was explained with enough detail and context to be understood clearly	1	2	3	4	5
c. The directions for teachers were easy to understand and follow	1	2	3	4	5
d. The background information supplied was sufficient for teaching purposes	1	2	3	4	5
e. The student materials required (but not included with the curriculum package) were easily available in my school	1	2	3	4	5
f. The steps recommended in the teacher’s guide for Preparation were vague and/or unclear.	1	2	3	4	5
g. The Discussion Questions were helpful in developing and extending student understanding	1	2	3	4	5
h. The trading cards were inviting and fun for students, while reinforcing key concepts	1	2	3	4	5
i. Extension activities made appropriate and relevant links to other subject areas	1	2	3	4	5
j. Assessment questions provided useful checks for student understanding	1	2	3	4	5
k. Resources for Teachers and Resources for Students were valuable extended learning opportunities	1	2	3	4	5
l. Student handouts required little or no revision before student use	1	2	3	4	5

14. Besides the main activity, which of the following components of the Brain Power! curriculum did you use? Which ones did you use most often? (Please circle one response for each item in Column I. If you circle “Yes” in Column I, please also answer “Yes” or “No” in Column II.)

	Column I.		Column II.
	Have used		Use most often
	Yes	No	Yes	No
a. Discussion questions	1	2	1	2
b. Extension ideas	1	2	1	2
c. Assessment suggestions	1	2	1	2
d. Resources for teachers	1	2	1	2
e. Resources for students	1	2	1	2
f. Video or CD segments	1	2	1	2
g. Trading cards	1	2	1	2

15. Did you make any modifications to any of the lesson modules?

Yes 1

No 2 (Skip to Question 17)

16. If you answered “Yes” to Question 15, which of the following ways did you modify the curriculum? (Please circle one on each line.)

Yes No

a. I did the main activity, but substituted different student materials as needed (i.e., used cornstarch in the “goo” experiment; used interlocking shapes as opposed to Play-doh to make the brain model) 1 2

b. I stayed true to the key concepts in the student handouts or trading cards, but made my own to better suit the needs of my students. 1 2

c. I did the main activity, but then added an additional class activity that reinforced the same concepts 1 2

d. I stayed true to the key concepts of the main activity, but developed a different activity by which to teach them 1 2

e. I cut out some of the steps in the Procedure instructions to save time. 1 2

f. I took more than the recommended one or two days to teach one or more of the modules 1 2

g. I changed the order of the activities as presented in the Procedure instructions to make more sense 1 2

h. I deleted material since I had covered similar material earlier in the year 1 2

i. I added content material since it helped students to bridge prior learning 1 2

j. Other (specify) 1 2

17. What was the primary reason you chose to participate in the Brain Power! curriculum study? (Please circle one.)

Desire to teach my students more about the dangers of drug abuse and the
importance of a healthy brain 1

Prompting by school administration or department leaders 2

Incentives associated with participation (stipend, curricular materials, student
t-shirts) 3

Interest in being a part of a randomized study 4

Other (specify) 5

This section includes questions about strengths and improvements to the Brain Power! curriculum, as well as implementation issues.

18. Which of the following do you consider strengths of the Brain Power! curriculum? (Please circle one on each line.)

Yes No

a. Ready-to-use lesson modules 1 2

b. Engaging hands-on activities 1 2

c. The user-friendly ancillary materials (trading cards, posters, student handouts) 1 2

d. The entertaining and instructive student video 1 2

e. The positive reinforcement for students (i.e., award certificates, verbal praise in the video, written praise on student handouts) 1 2

f. Realistic timeframes in which to complete lessons 1 2

g. Potential to teach students valuable and perhaps life-saving information 1 2

h. Relevance to student experiences 1 2

i. Alignment to current state/district/national standards 1 2

j. Other (specify) 1 2

19. In which of the following ways could the Brain Power! curriculum use improvement? (Please circle one on each line.)

Yes No

a. Time estimations to complete each module 1 2

b. Selection of hands-on activities 1 2

c. Selection of materials for use in experiments or tasks 1 2

d. Selection of content 1 2

e. Links to web-based resources or other technology applications 1 2

f. Links to other subject areas 1 2

g. Assessment suggestions and/or assessment instruments 1 2

h. Video quality 1 2

i. Parental materials 1 2

j. Teacher’s guide organization/usability 1 2

k. Student handout usability 1 2

l. Trading card usability 1 2

m. Other (specify) 1 2

20. Which of the following potential obstacles below hindered full implementation of the Brain Power! curriculum? (Please circle one on each line.)

Yes No

a. Lack of supportive school (or district) leadership 1 2

b. Lack of inclusion with current science curriculum 1 2

c. Misalignment with state or local standards 1 2

d. Concerns about the appropriateness of the curriculum 1 2

e. Concerns about the effectiveness of the curriculum 1 2

f. Lack of program relevance to students 1 2

g. Lack of adequate time for instruction 1 2

h. Lack of necessary content knowledge to teach curriculum well 1 2

i. Lack of necessary materials/resources to complete activities sufficiently 1 2

j. Personal comfort level in teaching the material 1 2

k. Other (specify) 1 2

This last section includes questions about parental communications, student learning, and engagement.

21. Throughout the time that you implemented the Brain Power! lessons, approximately how many total parental contacts were made relative to the curriculum (either teacher-initiated or parent-initiated)? (Circle only one.)

None 1 (Skip to Question 23.)

1 to 2 2

3 to 4 3

5 to 6 4

7 or more 5

22. If you marked anything other than “none” in Question 21, what was the nature of most parental communication? (Please circle one on each line.)

Yes No

a. Questions about the content of the materials 1 2

b. Concerns about the appropriateness of materials 1 2

c. Questions or concerns about how to make best use of the suggestions in the parent newsletter or how to get involved with the material at home 1 2

d. Questions regarding specific websites listed in the parent newsletter 1 2

e. Concerns that children may be considering drug use 1 2

f. Questions about how to talk to child about drugs 1 2

g. Other (specify) 1 2

23. To what extent were students engaged in each of the following modules? (Please circle one on each line.)

Module

Not engaged

Somewhat engaged

Extensively engaged

a. Module 1: Ooey Gooey! Making Sense of Scientific Inquiry! 1 2 3

b. Module 2: Brains in a Box: What Your Brains Can Do 1 2 3

c. Module 3: Sending and Receiving Messages 1 2 3

d. Module 4: Medicines and Drugs:
What’s Helpful, What’s Harmful 1 2 3

e. Module 5: The Science Behind Smoking 1 2 3

f. Module 6: What Drugs Really Do 1 2 3

24. What is the relative amount you feel the majority of students learned about each topic addressed in the Brain Power! curriculum? Mark NA if you did not address a particular topic. (Please circle one on each line.)

Topic	Learned negligible amount	Learned little amount	Learned fair amount	Learned significant amount	NA
a. The four steps of scientific inquiry	1	2	3	4	5
b. The four major parts of the brain and their functions	1	2	3	4	5
c. Nerve cell communication (neurotransmission)	1	2	3	4	5
d. Helpful medicines and harmful drugs	1	2	3	4	5
e. Effects of aspirin or Tylenol, fluoride, immunizations, and antibiotics on the body	1	2	3	4	5
f. Effects of nicotine on the body	1	2	3	4	5
g. Definition of addiction and characteristics of addiction	1	2	3	4	5
h. Effects of cocaine, marijuana, and/or alcohol use on the brain and body	1	2	3	4	5

25. Which of the following statements best describes your overall experience using the Brain Power! curriculum? (Circle only one.)

I enjoyed teaching the curriculum and found it useful for my students 1

I enjoyed teaching the curriculum and found it useful for my students, but feel
the program needs a few minor adjustments 2

I think the curriculum has merit, but needs substantial revision in terms of
student engagement and student learning 3

I think the curriculum has merit, but needs substantial revision in terms of
appropriateness of content 4

Other (please specify) 5

26. Given the opportunity, which of the following statements best describes whether or not you would teach the curriculum again? (Circle only one.)

I would easily teach the curriculum again 1

I would teach it again given a few minor adjustments 2

I would not teach the curriculum again since students were not engaged and
appeared to learn little 3

I would not teach the curriculum again due to curriculum/standards alignment
issues 4

I would not teach the curriculum again due to time constraints 5

Other (please specify) 6

THANK YOU!

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