WWC Intervention Form, Long Form

What Works Clearinghouse

Form01_InterventionNominationLong_rev

WWC Intervention Form, Long Form

OMB: 1850-0788

Document [doc]
Download: doc | pdf


Submit a Study, Intervention, or Topic

The What Works Clearinghouse (WWC) strives to put evidence into the hands of educators, policymakers, researchers, and the public so that they can make choices about educational interventions (programs, products, practices, and policies) based on high-quality scientific research.

WWC Reports provide information on the evidence of the effectiveness of educational interventions and can be used to inform education decision-making, improve educational practices, and enhance student outcomes.

The WWC has announced topics for the WWC Reports. The topics chosen for systematic review reflect a wide range of our nation's most pressing education issues. These topics are:

The Character Education topic review is underway. For this review cycle, the WWC accepted study and/or intervention submissions until September 15, 2005. Studies and interventions submitted after this date will be included in the next review cycle.

The Dropout Prevention topic review is underway. For this review cycle, the WWC accepted study and/or intervention submissions until March 31, 2006. Studies and interventions submitted after this date will be included in the next review cycle.

  • Early Childhood Education—Interventions for Improving Preschool Children's School Readiness
    Curricula and practices designed for use in center-based settings with 3- to 5-year-old children who are not yet in kindergarten, with a primary focus on cognitive and language competencies associated with school readiness (language, literacy, math, and cognition). The review includes center-based early childhood education interventions designed to improve the school readiness skills of preschool children with developmental delays or diagnosed disabilities. These may be inclusive interventions used with all children or targeted interventions designed specifically for children with developmental delays or diagnosed disabilities.
    Early Childhood Education abstract

The Early Childhood Education topic review is underway. For this review cycle, the WWC accepted study and/or intervention submissions until February 28, 2006. Studies and interventions submitted after this date will be included in the next review cycle.

The English Language Learning topic review is underway. For this review cycle, the WWC accepted study and/or intervention submissions until October 14, 2005. Studies and interventions submitted after this date will be included in the next review cycle.

The Elementary School Math topic review is underway. For this review cycle, the WWC accepted study and/or intervention submissions until April 1, 2006. Studies and interventions submitted after this date will be included in the next review cycle.

The Middle School Math topic review is underway. For this review cycle, the WWC accepted study and/or intervention submissions until October 31, 2005. Studies and interventions submitted after this date will be included in the next review cycle.

  • Reading—Interventions for Beginning Reading
    Reading interventions for students in grades K-3 (or ages 5-8) that are intended to increase skills in
    alphabetics (phonemic awareness, phonological awareness, print awareness and phonics), reading fluency, comprehension (vocabulary and reading comprehension), or general reading achievement. Reading abstract

The Beginning Reading topic review is underway. For this review cycle, the WWC accepted study and/or intervention submissions until October 31, 2005. Studies and interventions submitted after this date will be included in the next review cycle.

A topic is defined by the intended outcome (for example, improving literacy skills), the intended population (for example, elementary school students from low-income backgrounds), and the types of interventions (for example, particular programs, products, practices, or policies) that may produce the intended outcome for that population.
 

Nomination Type

We welcome your suggestions for specific interventions related to current WWC Reports, studies or study citations on the effects of educational interventions within these topics, and/or nominations for other interventions, studies, or future topics that you would like to see considered for review by the WWC. You can also nominate a specific intervention, such as a particular curriculum, rather than an entire class of interventions, such as math curricula.
 

What information would you like to submit to the WWC at this time?

A specific intervention (program, product, practice, or policy) that could be reviewed for a current or future WWC Report.

An actual study or citation of a study on the effects of one or more interventions within a current or future WWC Report topic.

A nomination for a future WWC Report topic.



Intervention Nomination Form

Thank you for choosing to submit an educational intervention (program, product, practice, or policy) that you would like the What Works Clearinghouse (WWC) to review. We encourage you to print a paper copy of this form in order to review all of the required information before completing the online version. If you have questions about completing this form, or prefer to submit this information in paper form, please contact us at:


What Works Clearinghouse
2277 Research Boulevard, MS 6M
Rockville, MD 20850
Email:
info@whatworks.ed.gov
Phone: 1-866-WWC-9799
Fax: 301-519-6760


 


Intervention Details


Mandatory fields are indicated with an *


Please answer the following questions regarding the intervention(s) you are describing. Skip any questions for which you do not have information. When you have finished describing one intervention, you will be prompted to add any additional interventions until you respond that you don't have any more to add.
 


*What is the title of this intervention?

 


*How would you categorize this intervention? (Check only one)
Program   Product   Practice   Policy


 


* Indicate below the current WWC Report topic(s) to which this intervention relates. (Select all that apply or "Not Relevant.")


Character Education Interventions: Benefits for Character Traits, Behavioral and Academic Outcomes

Curriculum-Based Interventions for Increasing K–12 Math Proficiency: Elementary School

Curriculum-Based Interventions for Increasing K–12 Math Proficiency: High School

Curriculum-Based Interventions for Increasing K–12 Math Proficiency: Middle School

Early Childhood Education

Interventions for Elementary English Language Learners: Increasing English Language Acquisition and Academic Achievement

Interventions for General Beginning Reading Students

Interventions for Students with Beginning Reading Difficulties

Interventions to Reduce Delinquent, Disorderly, and Violent Behavior in Middle and High Schools

Preventing High School Dropout

Programs for Increasing Adult Literacy

Not relevant to current WWC Report topics



 


What is the intended student outcome of this intervention (e.g., increased algebra achievement)?


 



* Are you able to provide detailed information about this intervention?
Yes  No

 


If you answered "No" to the above question, please select one of the options below.
I'd like to submit information about another intervention.
I'd like to submit information about a study.
I'd like to submit information about a topic nomination.
I'd like to end this submission.



Intervention Content Area(s)

Mandatory fields are indicated with an *

* Indicate the content area(s) addressed by this intervention. (Select all that apply or "Not Applicable.")

 Adult Basic Education (ABE)
 Adult Literacy
 Algebra
 Arithmetic
 Arts
 Beginning Reading
 Bilingual Education
 Biology
 Botany
 Calculus
 Career Education
 Character Education
 Chemistry
 Civics
 Computer Science
 Earth Science
 Economics
 English
 English (Second Language)
 Environmental Education
 Fine Arts
 Fluency
 Foreign Languages
 General Educational Development (GED)
 Geography
 Geology
 Geometry
 Government
 Graphic Arts

 Health
 History
 Humanities
 Language Arts
 Limited English Speaking
 Listening
 Literature
 Mathematics
 Music
 Natural Science
 Phonemic Awareness
 Phonics
 Physical Education
 Physics
 Probability
 Psychology
 Reading
 Reading Comprehension
 Reading Strategies
 Science
 Second Languages
 Social Studies
 Sociology
 Speech Communication
 Statistics
 Technology
 Theater Arts
 Trigonometry
 Visual Arts
 Vocational Education
 Writing (Composition)
 Other (Specify)
      
 Not Applicable



 


Intervention Characteristics and Unit Level

Mandatory fields are indicated with an *

* Indicate other characteristics of this intervention. (Select all that apply or "Not Applicable.")

 Ability Grouping
 Accountability
 Advanced Placement
 After School Programs
 Alternative Teacher Certification
 Attendance
 Behavior Problems
 Class Size
 Classroom Techniques
 Compensatory Education
 Comprehensive School Reform
 Computer Assisted Instruction
 Computer Uses in Education
 Crime Prevention
 Curriculum
 Distance Education
 Dropout Prevention
 Educational Technology
 Extended School Year
 Grouping (Instructional Purposes)
 High School Equivalency Programs
 Individualized Education Programs
 Instructional Materials
 Lifelong Learning
 Parent Participation

 Preservice Teacher Education
 Professional Development
 Scheduling
 School Choice
 School Readiness
 School Size
 Socialization
 Special Education
 Student Behavior
 Student Motivation
 Substance Abuse Prevention
 Summer School
 Teacher Education
 Teacher Effectiveness
 Teacher Training
 Technology
 Textbooks
 Transportation
 Truancy Prevention
 Year Round Schools
 Other (Specify)
      
 Not Applicable



 

* At what unit level does this intervention operate? (Select all that apply)

 Classroom
 School
 District

 Other (Specify)
      



 


Intervention Target Population(s)

Mandatory fields are indicated with an *

*Indicate the target populations of this intervention. (Select all that apply or "Not Applicable.")

Student Gender


Female Students

Male Students

Not Applicable




Student Language

Limited English Proficient

Not Applicable


Student Race/Ethnicity

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Not Applicable


Student Disability

Developmentally Disabled Students

Emotionally Disabled Students

Hearing-Impaired Students

Learning Disabled Students

Physically Disabled Students

Students with Multiple Disabilities

Vision-Impaired Students

Speech-Impaired Students

Not Applicable



Student Risk/Disadvantage

At Risk/Disadvantaged Students

Not Applicable



Other (Specify)




Intervention Setting(s)

Mandatory fields are indicated with an *

*Indicate the relevant setting(s) in which this intervention is used. (Select all that apply or "Not Applicable.")

Educational Setting(s)


After School

Preschool

Kindergarten

Elementary School

Middle School

High School

Postsecondary Education

Vocational/Career Education

Adult/Continuing Education

Other (Specify)

Not Applicable




Geographic Setting(s)

All

Great Lakes/Midwest

North Central

Northeast

Northwest

Southeast

South Central

Southwest

Other (Specify)

Not Applicable



Urbanicity

Rural

Suburban

Urban

Not Applicable


 



If known, in what year was this intervention implemented? 



Intervention Statistical Information


 
Please provide any of the following statistical information that you can about the use of this intervention. (Check and/or complete all that apply.)

Allocation Types

Types of Unit(s) Using This Intervention

Number of Unit(s) Using This Intervention

 Districts

 Schools

 Classes

 Individual Students

 Other:


 


Organizational Contact Information

If you choose to provide organizational contact information, mandatory fields are indicated with an *
 


What organization would you suggest we contact for more information about this intervention?



*Organization 1:

Organization 2:

Address 1:

Address 2:

City:

US State or
 

Foreign State/Province:


Zip/Postal Code:

Country:

*Phone:

Fax:


*Email:

URL:


*
I'd like to submit information about another intervention.
I'd like to submit information about a study.
I'd like to submit information about a topic nomination.
I'd like to end this submission.



Contact Information (Optional)

If you choose to provide contact information, the mandatory fields are indicated with an *

If we may contact you about this submission, please provide the information below.


Prefix:

*First Name:

Middle Name:

*Last Name:

Suffix:



Title:

Organization 1:

Organization 2:

Address 1:

Address 2:

City:

US State or
 

Foreign State/Province:


Zip/Postal Code:

Country:

*Phone:

Fax:


*Email:

URL:

 

In what capacity are you currently visiting the What Works Clearinghouse website? (Check only one)

Administrator (principal, dean, department head, superintendent, etc.)

Community Group Member (includes members of the business community, civic organizations, religious organizations, and volunteer groups)

Local Education Agency (district)

State Education Agency

Other Federal Funds Recipient/Applicant (includes contractor, for- or non-profit organization, grantee, etc.)

Foundation Staff Member (includes personnel of organizations that fund grants and education venture capitalists)

Librarian (includes academic, federal, public, special, and state librarians and media specialists)

News/Media

Parent/Family (includes nuclear and extended family and child caregiver)

Policymaker (board of education member; federal, state, or local public official; state or local education agency policymaker; legislator, etc.)

Program Developer/Vendor

Researcher

School Support Staff (includes school guidance counselors, and paraprofessional schools personnel, including technology coordinators)

Student

Teacher (includes teachers and professors of all levels and types of education)

Technical Assistance Provider (includes staff of for- and non-profit education associations, Regional Educational Laboratories, and Professional Development Centers)

Other (Specify) 

Deselect




Submission Confirmation

[After the submission is automatically reviewed by the system to ensure that information has been provided in all the necessary fields, the following information will appear on the screen:]


Thank you for your submission to the What Works Clearinghouse. We will contact you via email if we have any questions about your submission and/or we need additional information.

Should you have questions regarding the status of your submission, please contact us at:


What Works Clearinghouse

2277 Research Boulevard, MS 6M

Rockville, MD 20850

Email: info@whatworks.ed.gov

Phone: 1–866–WWC–9799

Fax: 301–519–6760


Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1850–0788. The time required to complete this information collection is estimated to average 30 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202–4700. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Susan Sanchez, U.S. Department of Education, Institute of Education Sciences, Room 500G, 555 New Jersey Avenue, NW, Washington, DC, Washington, D.C. 20208.


File Typeapplication/msword
AuthorTeresa Duncan
Last Modified ByTeresa Duncan
File Modified2007-03-23
File Created2007-01-22

© 2024 OMB.report | Privacy Policy