1894-0001 Evidence Form

U.S. Department of Education
Evidence Form

OMB No. 1894-0001
Exp. 07/31/2019

1. Level of Evidence
Select the level of evidence of effectiveness for which you are applying. See the Notice Inviting Applications for the relevant definitions.
Promising Evidence
Moderate Evidence
Strong Evidence
2. Citation and Relevance
Fill in the chart below with the appropriate information about the studies that support your application.
A. Citation

B. Relevant Finding(s)

C. Overlap of Populations and/or Settings

Instructions for Evidence Form

1. Level of Evidence. Check the box next to the level of evidence for which you are applying. See the Notice Inviting Applications for the evidence definitions.
2. Citation and Relevance. Fill in the chart for each of the studies you are submitting to meet the evidence standards. If allowable under the program you are applying
for, you may add additional rows to include more than four citations. (See below for an example citation.)
a. Citation. Provide the full citation for each study you are using as evidence. If the study has been reviewed by the WWC, please include the rating it received, the
WWC review standards version, and the URL link to the description of that finding in the WWC reviewed studies database. Include a copy of the study or a URL
link to the study, if available. Note that, to provide moderate or strong evidence, you must cite a publicly available, original study of the effectiveness of a
component of your proposed project on a student outcome or other relevant outcome.
b. Relevant Finding(s). Describe: 1) the project component included in the study that is also a component of your proposed project, 2) the student outcome(s) or
other relevant outcome(s) that are included in both the study and in the logic model (theory of action) for your proposed project, and 3) the study finding(s)
supporting a favorable relationship between a project component and a relevant outcome. Cite page and table numbers from the study, where applicable.
c. Overlap of Population and/or Settings. Explain how the population and/or setting in your proposed project are similar to the populations and settings included
in the relevant finding(s). Cite page numbers from the study, where applicable.

EXAMPLE: For Demonstration Purposes Only
A. Citation

B. Relevant Finding(s)

Bettinger, E.P., & Baker, R. (2011). The
The intervention in the study is a form of college mentoring called student
effects of student coaching in college: An
coaching. Coaches helped with a number of issues, including prioritizing
evaluation of a randomized experiment in
studies and identifying barriers and ways to overcome them. Coaches were
student mentoring. Stanford, CA: Stanford encouraged to contact their assignees by either phone, email, text messaging,
University School of Education. Available at or social networking sites (pp. 8-10). The proposed project for Alpha Beta
https://ed.stanford.edu/sites/default/files/betti Community College students will train professional staff and faculty coaches
nger_baker_030711.pdf
on the most effective way(s) to communicate with their mentees, suggest topics
for mentors to talk to their mentees, and be aware of signals to prevent
Meets WWC Group Design Standards
withdrawal or academic failure.
without Reservations under review standards
2.1 (http://ies.ed.gov/ncee/wwc/Study/72030). The relevant outcomes in the study are student persistence and degree
completion (Table 3, p. 27), which are also included in the logic model for the
proposed project.

C. Overlap of Population and Settings
The full study sample consisted of “13,555 students
across eight different higher education institutions,
including two- and four-year schools and public, private
not-for-profit, and proprietary colleges.” (p. 10) The
number of students examined for purposes of retention
varied by outcome (Table 3, p. 27). The study sample
overlaps with Alpha Beta Community College in terms of
both postsecondary students and postsecondary settings.

This study found that students assigned to receive coaching and mentoring
were significantly more likely than students in the comparison group to remain
enrolled at their institutions (pp. 15-16, and Table 3, p. 27).

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 1894-0001. The time required to complete this information collection is estimated to vary
from 1 to 4 hours per response, with an average of 1.5 hours per response, including the time to review instructions, search existing data sources, 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. 20202-4537. If you have comments or concerns regarding the status of your individual submission of this form, write directly to the Office of Innovation
and Improvement, U.S. Department of Education, 400 Maryland Avenue, S.W., Washington, D.C. 20202