
	SunWise Program

Teacher and School Nurses Survey

The Boston University Cancer Prevention & Control Center is working with EPA/SunWise to evaluate your experience with the teaching of the SunWise School Program. Can you kindly take a few minutes to answer the following questions? Your answers will go a long way toward helping us improve SunWise.

About You

To establish that you are a SunWise registered teacher or a school nurse, please enter either:

SunWise Class ID:

Your Name:

Your School:

Check here if you want to be anonymous. Your personal information will be removed from the survey.

Your Participation in SunWise

Grade(s) you teach:

Did your class take part in any SunWise activities this past year?

Yes No

If you did not have a chance to teach SunWise program,skip to Suggestions

If Yes, please estimate how many students received SunWise teaching:

How much class time was spent on SunWise: (# of minutes)

I. Overall Satisfaction:

1. Please rank the children's overall satisfaction with the SunWise program.

Least Satisfied						Most Satisfied
	1	2	3	4	5

2. Please rank your overall satisfaction with the SunWise program.

Least Satisfied						Most Satisfied
	1	2	3	4	5

II. Cross-Curricular Classroom Lessons (SunWise Tool Kit)

3. Overall the Tool Kit was at:


Too low a level	Just about at the right level	Too advanced

4. Of the following, I completed selected activities in (please check all that apply):

Science	Mathematics
Physical Education	English
Social Studies	Health

5. What were the children's 2 favorite activities?

1:
2:

6. Did the SunWise Tool Kit effectively help students learn about the risk of overexposure to the sun?

Not helpful						Very helpful
	1	2	3	4	5

7. Did the SunWise Tool Kit help students learn how they can effectively protect themselves from overexposure to the sun?

Not helpful						Very helpful
	1	2	3	4	5

8. Did the SunWise Tool Kit help you learn about the risk of overexposure to the sun?

Not helpful						Very helpful
	1	2	3	4	5

III. UV Index/UV Meter/Frisbee Use

9. Did your class use the Internet site to gather and/or input UV Index data?

Yes No

10. If you requested a handheld UV meter, did you use it?

Yes No

If yes, how often?
If no, why not? (Please explain)

11. Was the UV Frisbee an effective teaching tool?

Yes No

Please describe

IV. Infrastructure Enhancements

12. Did you organize any school-wide sun safety activities?

Yes No

If yes, Please explain

13. Did any of your school's policies change as a result of your efforts with SunWise?

Yes No

If yes, Please explain

V. Personal Behaviors

14. Have you changed your sun protection behaviors as a result of your participation in SunWise?

Yes No

VI. Suggestions

15. What information, materials, or resources would you suggest we add, delete or change?

16. Have you developed any enhancement activities/lessons for use with SunWise that you would be willing to share?

VII. Future Participation

17. Would you like to continue your participation in SunWise for the next school year?

Yes No

18. Would you be willing to share your materials with another faculty member?

Yes No

19. How receptive would you be to new units on:

a) Safety of tanning beds?

Not very receptive

Somewhat receptive

Very receptive

b) Helping children resist need for tanning?

Not very receptive

Somewhat receptive

Very receptive

c) Educating parents about sun protection?

Not very receptive

Somewhat receptive

Very receptive

The public reporting and record-keeping burden for this collection of information is estimated to average 30 minutes per response. Burden means the total time, effort, or financial resources expended by persons to generate maintain, retain, disclose, or provide information to or for a federal agency. 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. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, OIC/OEI, U. S. Environmental Protection Agency (2822), 1200 Pennsylvania Ave., NW, Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, 725 17th Street, NW, Washington, DC 20503, Attention: Desk Officer for EPA. Include the EPA ICR number and OMB control number in any correspondence

OMB Control No. 2060-0439




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