The AFL care core evaluation instrument was developed for use by care demonstration projects funded by the AFL program that is administered by the Office of Population Affairs (OPA). The AFL program was enacted in 1981 as Title XX of the Public Health Service Act. Care demonstration projects are designed to provide medical, social and education services to ameliorate the consequences of adolescent childbearing, focusing on adolescent mothers, their infants and other family members.
AFL Care demonstration projects are conducted in a wide variety of sites, including schools, social service agencies, health departments and hospitals that target primarily adolescents 17 years of age and under. AFL demonstration projects stress the importance of family and parent involvement in the delivery of funded services for adolescents.
These instruments have been developed for a number of reasons, first among them, the repeated requests by AFL grantees and evaluators to do so. Additionally, because the evaluations of AFL demonstration projects are conducted independently, the data collected from one project to another vary and the Office of Adolescent Pregnancy Programs (OAPP) has no way to track performance of the program, as a whole, on a number of indicators that are particularly relevant in terms of the purpose of the Title XX statute and responsiveness to Department of Health and Human Services (DHHS) and OAPP priorities. As the core instruments are integrated into individual project evaluations, OAPP will be better able to monitor the direction and progress of the program and direct future funding resources to approaches that have demonstrated effectiveness, as well as track the performance measures that have been developed in response to recommendations from the Office of Management and Budget’s recent evaluation of the program.
All AFL Care demonstration projects funded in fiscal year 2005 and beyond will be required to use this core evaluation instrument. Sites also may add additional questions if they choose. Projects funded prior to fiscal year 2005 will be encouraged to use the core instrument in their evaluations, but it will not be required.
There are two versions of the baseline AFL care core evaluation instrument, one for adolescents who enter the AFL project after their infant’s birth and one for adolescents who enter while still pregnant. The follow-up instrument is the same for both categories of entry into the project and was designed to detect changes over time.
This version of the core evaluation instrument covers, in addition to basic demographic information: pregnancy outcome and reproductive health status for the adolescent mother; infant health status and care arrangements; the young father’s involvement; the adolescent mother’s goals, parenting practices and attitudes; and her future plans for education and career.
Questions 1 through 11 collect data on age, marital status, race/ethnicity, current living arrangements, education status, and sources of financial support. Program interventions are likely to vary, as are their impacts, depending on the age of the adolescent mother and, in some cases, her race/ethnicity. In seeking to ameliorate the consequences of adolescent pregnancy and parenthood, the AFL program places great emphasis on helping Care demonstration project clients build a stable family life for themselves and their infants. Thus, questions on marital status, living arrangements, education, employment, and sources of financial support are included to determine client position, as well as any progress, on these indicators of stability and productivity.
Questions 12 through 18 collect data on pregnancy outcome and infant health. These data are of considerable interest to the OPA, as preterm delivery, birth weight, access to pediatric care, and duration of breastfeeding are all important indicators of infant health status; healthy infants are a major goal of the AFL program.
Questions 19 through 23 collect data on the infant’s living and care arrangements, as well as interactions between infant and mother. These social data provide additional information on infant well-being.
Questions 24 through 27 collect data on the young father’s involvement in the life of the adolescent mother and the infant. Family is an important consideration in the AFL statute and program; these data will provide some information to assess the extent to which adolescent parents are able to build a supportive environment for their infant.
Questions 28 through 42 collect data on the adolescent mother’s goals, relationships, and feelings about parenting. AFL Care demonstration projects, in their efforts to ameliorate the negative consequences of adolescent childbearing, work with young mothers to help them develop forward looking goals and positive relationships with peers, family and their infants. Postponing a repeat pregnancy, continuing with their education, developing constructive attitudes and competence with respect to parenting, and having positive relationships with friends and family are among the factors important to building a stable future for adolescent mothers.
Questions 43 through 46 collect data on current sexual activity, contraceptive use and reproductive health care. Postponing a repeat pregnancy and access to appropriate reproductive health care are core goals for AFL Care demonstration projects; these data enable project evaluations to assess the success of interventions in achieving those goals.
This version of the core instrument includes, with the exception of the questions about the infant and parenting, the same items as the version discussed above.
This instrument seeks to collect information on attitudes, beliefs and behaviors at both baseline and follow-up, and consequently it repeats all of the same questions as the Core Baseline Questionnaire for Parenting Clients.
Project staff or a project evaluator will administer the baseline core instrument at intake and the follow-up core instrument at 12-months, or at program completion, whichever comes first. Completion of the questionnaires will be voluntary; project clients will be informed that they may refuse to answer any or all of the questions. The instruments are designed to be age-appropriate for clients ages 12-19 with low-literacy levels, and to be administered as pencil-and-paper surveys. Although the surveys are intended to be self-administered, program personnel may also administer them if respondents find the questionnaire too difficult to read.
The respondents should be provided a quiet private area in which to complete the questionnaire. A staff person who is knowledgeable about the questionnaire and administration procedures should be nearby and available to answer any question respondents may have. This includes reading the questions to the respondent, should they request it.
Once the survey is completed it should be immediately placed in the secure area designated by the site IRB and HIPAA procedures. The staff person who oversees the administration of the questionnaire should check with the client to see if they have any questions, or if they need to discuss any feeling or issues brought up by completing the questionnaire.
Prior to administering the instrument to any clients, the program must obtain active consent from the client to participate in the questionnaire. Additionally, clients under the age of 18 must have the consent of a parent or legal guardian to participate in the questionnaire. To this end, all respondents must read (or have read to them) and sign an IRB approved consent form. Sample consent forms that contain all of the OAPP required information is contained in Appendix A (for clients) and Appendix B (for parents of clients under the age of 18). The appended consent forms represent the minimum protections required. Local IRBs may choose to add additional language and protections.
If local evaluators choose to use this questionnaire with control/comparison groups, they are required to obtain consent from all of the parties discussed above using the same protocols.
OAPP authorizes AFL Care programs to offer non-cash incentives (e.g., gift cards, incentives) of a value of up to $10.00 to each program participant who participates in filing out the core questionnaires. The incentives are to be offered at both baseline and follow-up data collection. OAPP will consider this an approved use of grant funds. If a program’s local IRB determines that incentives are not to be offered, OAPP will defer to the local IRB’s determination.
The following section provides question by question (QxQs) clarification on the meaning and intent of each of the survey questions. This will allow program service providers to accurately respond to any queries that respondents have regarding how they should answer particular questions. The version of the instrument used for the QxQs is the baseline data collection instrument for parenting clients. This instrument contains all of the questions present across all three instruments. Although the item numbers may vary between the baseline instruments, the specifications remain the same. There are several questions for which clarification does not seem and necessary; therefore none is provided.
1. Client ID: ____ ____ ____ ____ ____ ____
2. Site Number: ____ ____ ____ ____ ____ ____
3. Entry Date: ____ ____ ____ ____ ____ ____
Q1. The site should create a unique ID for each client that does not directly identify the client. This ID should be maintained in the client’s protected confidential file, so that they can be matched for baseline and follow-up data collection. The site IRB and HIPAA privacy board will need to determine additional site-specific confidentiality protections. |
Q2. The site ID number will be provided by OPA, OAPP AFL Grantee Project Officer. |
If the respondent has more than one child,
all questions refer to their most recent child.
|
AFL Care Program Survey
Demographics
1. Age (in years only): _________
Q1. Round to the nearest whole year. Do not use fractions or decimals. |
2. What is your marital status?
CHECK ONE RESPONSE
Single, never married............................. 
1
Married................................................ 2
Separated or divorced............................ 3
Widowed.............................................. 4
Other................................................... 5
Q2. Select only the most recent event, e.g., was divorced, but has since remarried = married |
3. What are your current living arrangements?
CHECK YES OR NO FOR EACH
| Yes | No |
|---|
a. . Alone..................................................................... | 1 | 2 |
b. With spouse........................................................... | 1 | 2 |
c. . With own mother (include stepmother)...................... | 1 | 2 |
d. . With own father (include stepfather).......................... | 1 | 2 |
e. . With baby’s father | 1 | 2 |
f. .. With baby’s father’s mother...................................... | 1 | 2 |
g. . With baby’s father’s father ....................................... | 1 | 2 |
h. With partner............................................................ | 1 | 2 |
i. With other relatives.................................................. | 1 | 2 |
j. With friends............................................................ | 1 | 2 |
k. In a group home/institution....................................... | 1 | 2 |
l. In a foster home...................................................... | 1 | 2 |
m. Other..................................................................... | 1 | 2 |
Q3. Select all that apply. There is no minimum time that the respondent has to reside in the various situations for any given selection. |
4. Are you Hispanic or Latino?
Yes............................. 1
No............................... 2
Q4. Respondents are often confused by the sequencing of this and the following questions. Ask the respondents to answer them as best they can – as separate questions. |
5. What is your race?
CHECK ALL THAT APPLY
White................................................... 1
Black................................................... 2
Asian................................................... 3
Native Hawaiian or Other Pacific Islander... 4
American Indian.................................... 5
Q5. Any and all combinations of categories can be chosen |
6. What is your current school status?
CHECK ONE RESPONSE
In school or GED program......................................... 1
Graduated from high school or completed GED........... 2
Dropped out of school............................................... 3
Other....................................................................... 4
Q6. Select only the most recent event, e.g., dropped out of school, but planning on beginning GED program = dropped out of school. |
7. What is the highest grade you completed:
CHECK ONE RESPONSE
8th grade or below.................................. 1
9th grade............................................... 2
10th grade............................................. 3
11th grade............................................. 4
12th grade............................................. 5
Some college....................................... 6
College degree or more.......................... 7
Don’t know........................................... 97
Q7. Select the grade actually completed, not the grade they are about to complete. |
8. Have you ever been in a job training program?
Yes............................. 1
No............................... 2 
SKIP TO QUESTION 9
8a. Did you ever complete a job training program?
Yes............................. 1
No............................... 2
Currently attending job training program........ 3
Q8. & Q8a.
Respondents can answer yes to Q8. and indicate that they are also currently attending a job training program. |
9. How many hours do you work per week?
Hours per week (Enter 00 if not employed)________
Q9. Use a numeric answer -- not text, e.g., do not write “part-time”. |
10. What is your main source of financial support?
CHECK ONE RESPONSE
Own job............................................... 1
Spouse or partner................................. 2
Parents................................................ 3
Public assistance................................. 4
Other relatives...................................... 5
Other................................................... 6
Q10. Choose the largest single source, even if it does not provide >50% total income. |
11. Do you receive money or assistance from any of the following sources?
CHECK YES OR NO FOR EACH
| Yes | No |
|---|
a. . Medicaid................................................................ | 1 | 2 |
b. . Food stamps.......................................................... | 1 | 2 |
c. . WIC....................................................................... | 1 | 2 |
d. TANF..................................................................... | 1 | 2 |
e. . Social Security....................................................... | 1 | 2 |
f. .. Unemployment or Workers’ Compensation................ | 1 | 2 |
g. General Assistance or other aid................................ | 1 | 2 |
h. Child support.......................................................... | 1 | 2 |
i. Own job.................................................................. | 1 | 2 |
j. Spouse or partner.................................................... | 1 | 2 |
k. Parent(s)................................................................ | 1 | 2 |
l. Other..................................................................... | 1 | 2 |
Q11. Yes or no should be selected for each of the categories.
Some respondents are confused by the term TANF. There may be a need to explain this term if they unfamiliar with it. |
About Your Pregnancy…
These next questions are about your pregnancy.
12. An early delivery is one that occurs at 36 weeks or earlier in pregnancy. As far as you know, did you have an early delivery?
Yes............................. 1
No............................... 2
Don’t know................... 97
13. How did you deliver your baby?
Vaginal delivery............................... 1
Cesarean delivery............................ 2
About Your Child…
These next questions are about your child.
14. How much did your child weigh at birth?
5½ pounds or more................... 1
Less than 5½ pounds ............... 2
Don’t know............................... 97
15. Since your child was born, about how many times has your child been seen by a doctor, nurse, or other health care professional for a regular check up or “well-baby” visit? This is a visit to the doctor when your child is not sick, but to get checked out or to get vaccinations.
Never........................... 1 SKIP TO QUESTION 17
1-3 times ..................... 2
4 or more times............ 3
Don’t know................... 97
Q15. If respondents are unsure about the type of visit, please clarify that this is not a health event based physician visit. |
16. When was your child’s last “well baby” visit?
CHOOSE THE MOST RECENT
Within the past 3 months......... 1
Within the past 6 months......... 2
Within the past 12 months....... 3
More than a year ago............... 4
Don’t know.............................. 97
Q16. Here again, if respondents are unsure about the type of visit, please clarify that this is not a health event based physician visit. |
17. Is your child currently 3 months in age or older?
Yes............................. 1
No .............................. 2 SKIP TO QUESTION 18
Q17. To answer “yes” the child needs to be at least 3 months old, as opposed to nearly 3 months old. |
17a. Please tell me if your child has had any of the following vaccinations/shots:
CHECK YES OR NO FOR EACH
| Yes | No | Don’t know |
|---|
D-T-P, D-T-A-P, or D-T shot, sometimes called a D-P-T shot, diptheria-tetanus-pertussis shot, baby shot or three in one shot | 1 | 2 | 97 |
Polio vaccine –sometimes called I-P-V. | 1 | 2 | 97 |
H-I-B shot (this for Meningitis) | 1 | 2 | 97 |
Hepatitis B shot | 1 | 2 | 97 |
Q17a. Yes, no or don’t know should be selected for each of the categories. |
18. Did you breastfeed your baby at all?
Yes............................. 1
No .............................. 2 SKIP TO QUESTION 19
Q18. This includes any breastfeeding, even if it was only for a very short time after birth. |
18a. How old was your child when you stopped breastfeeding your child altogether?
Still breastfeeding..................... 1
Less than 1-month old............... 2
1-month old to 2-months old....... 3
3-months old or more................ 4
19. Does your child live with you?
Yes............................. 1 SKIP TO QUESTION 20
Sometimes................... 2 SKIP TO QUESTION 20
No .............................. 3
Q19. This question refers to the current living situation. |
19a. Where does your baby live now?
With the baby’s father............... 1 SKIP TO QUESTION 24
With other relatives .................. 2 SKIP TO QUESTION 24
With adoptive family.................. 3 SKIP TO QUESTION 24
Other....................................... 4 SKIP TO QUESTION 24
Don’t know............................... 97 SKIP TO QUESTION 24
Q19a. This question only applies if the child does not reside with the respondent at all. |
20. In the past four weeks has your child been cared for in any regular arrangement such as a day care, nursery school, play group, babysitter, after school care, relative, or some other child care arrangement? (“Regular” means at least once a week for a month or more.)
Yes............................. 1
No .............................. 2 SKIP TO QUESTION 23
Q20. “Cared for” refers to one or more hours of care because the respondent could not/did not provide care for the child (for any reason). |
21. Who or what has been the primary childcare provider in the past four weeks?
CHECK ONE RESPONSE
Child’s other parent/stepparent..................... 1
Your brother/sister 13 years or older............. 2
Your brother/sister under 13 years old........... 3
Child’s grandparent..................................... 4
Other relative.............................................. 5
Non-relative or babysitter ............................ 6
Day care center.......................................... 7
Nursery/preschool....................................... 8
Family day care ......................................... 9
This program.............................................. 10
Other......................................................... 11
Q21. Choose the largest single source of childcare, even if it does not provide >50% total childcare. |
22. How many hours a week is your child in childcare, including all the different arrangements that you use?
Hours _______
Don’t know................................................. 97
Q22. Use a numeric answer -- not text, e.g., do not write “about a week”. |
23. On how many days per week do you do the following things with your child?
CHECK ONE RESPONSE FOR EACH ACTIVITY
| 0 days | 1 day | 2 days | 3 days | 4 days | 5 days | 6 days | 7 days |
|---|
a. Play games like “peek-a-boo” or “gotcha” | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
b. Sing songs or nursery rhymes | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
c. Read stories | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
d. Tell stories | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
e. Play with toys such as blocks | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
f. Visit relatives | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
g. Hug or show physical attention | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
h. Put (him/her) to bed | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
Q23. This question does not require any minimum duration of time per day for any of these activities. |
About Your Baby’s Father…
These next questions are about your baby’s father.
24. On how many days per week does your child’s father do the following things with your child?
CHECK ONE RESPONSE FOR EACH ACTIVITY
| 0 days | 1 day | 2 days | 3 days | 4 days | 5 days | 6 days | 7 days | Don’t know |
|---|
a. Play games like “peek-a-boo” or “gotcha” | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 97 |
b. Sing songs or nursery rhymes | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 97 |
c. Read stories | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 97 |
d. Tell stories | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 97 |
e. Play with toys such as blocks | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 97 |
f. Visit relatives | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 97 |
g. Hug or show physical attention | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 97 |
h. Put (him/her) to bed | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 97 |
Q24. Question does require any minimum duration of time per day for any of these activities. |
25. Are you married to your baby’s father?
Yes............................. 1 SKIP TO QUESTION 30
No .............................. 2
Q25 - Q29. These questions refer to the father of the respondent’s most recent child. |
26. Do you plan to marry him?
Yes......................................... 1
No .......................................... 2
Don’t know............................... 97
27. Do you and he have a legal agreement regarding child support, alimony, custody, visitation, or where the child lives?
Yes......................................... 1
No .......................................... 2
28. Does he give you money, buy clothes for the baby, pay for doctor visits, or provide other kinds of support?
Yes............................. 1
No .............................. 2
29. Does he help you in other ways, such as watching the baby or helping with the chores?
Yes............................. 1
No .............................. 2
About Your Relationships, Your Goals, and Feelings on Parenting
These next questions are about your relationships with other people, your goals and your feelings about parenting.
30. Looking to the future, do you want to have another baby sometime before finishing high school?
Yes............................. 1
No .............................. 2
Already finished............ 3
Don’t know................... 97
Q.30 If the respondent has left school without graduating, but plans to return, they should answer as though they are in still school. If they left school without graduating, but do not plan to return they should indicate “already finished”. |
31. Looking to the future, do you want to have another baby sometime before marriage?
Yes............................. 1
No .............................. 2
Already married ........... 3
Don’t know................... 97
Q.31 If the respondent does not have any intentions to ever marry, they should answer from the frame of reference of "before marriage". If they are not certain about their intentions to marry, they should choose “don’t know”. |
FOR EACH OF THE FOLLOWING QUESTIONS CHECK ONLY ONE RESPONSE.
32. How much do you agree with the following statement? It is better for a person to get married than to go through life being single.
Strongly agree......................... 1
Agree .................................... 2
Neither agree nor disagree........ 3
Disagree................................. 4
Strongly disagree.................... 5
Don’t know.............................. 7
Q32. This question does not necessarily refer only to how the respondents feel about themselves, rather refers people in general. |
How much do the following statements apply to you?
33. In the last month, I have felt trapped by my responsibilities as a parent.
Strongly agree......................... 1
Somewhat agree .................... 2
Neither agree nor disagree........ 3
Somewhat disagree................. 4
Strongly disagree.................... 5
Q33 – Q36. If the respondents do not have any access to, or contact with, their children and are confused as to how to answer these questions, they should choose “neither agree or disagree”. |
34. I consider being a parent a good thing in my life…
Strongly agree......................... 1
Somewhat agree .................... 2
Neither agree nor disagree........ 3
Somewhat disagree................. 4
Strongly disagree.................... 5
35. I find that taking care of my child(ren) is much more work than pleasure.
Strongly agree......................... 1
Somewhat agree .................... 2
Neither agree nor disagree........ 3
Somewhat disagree................. 4
Strongly disagree.................... 5
36. I enjoy spending time with my child(ren)…
Strongly agree......................... 1
Somewhat agree .................... 2
Neither agree nor disagree........ 3
Somewhat disagree................. 4
Strongly disagree.................... 5
37. How often do you talk to your mother or father about your problems? Or how often do you talk to an adult in the household about your problems?
Almost never........................... 1
Some of the time .................... 2
Usually................................... 3
Almost always........................ 4
Q37. This question can refer to any adults (individuals over the age of 18), including siblings, spouse, boy/girlfriend or roommate. |
38. How much do you stay away from people who might get you into trouble?
Almost never........................... 1
Some of the time .................... 2
Usually................................... 3
Almost always........................ 4
Q38. This question refers to purposefully avoiding contact with individuals who are a negative influence on the respondent’s life. |
Please answer the following statements as they apply to you.
39. You think you should work to get something, if you really want it.
Not at all like you.................... 1
A little like you ....................... 2
Mostly like you........................ 3
Very much like you.................. 4
Q39 & 40. These questions refer to how respondents think of themselves, as opposed to people in general. |
40. You make decisions to help you achieve your goals.
Not at all like you.................... 1
A little like you ....................... 2
Mostly like you........................ 3
Very much like you.................. 4
41. I believe that putting a child up for adoption is a good thing for a young woman to do if she feels she is unable to keep and raise the child herself.
Not at all like you....................
1 A little like you ....................... 2
Mostly like you........................ 3
Very much like you.................. 4
Don’t know.............................. 97
Q41. This question does not necessarily refer only to how the respondents feel about themselves, but rather refers to people in general. |
About Your Future…
Thinking of the future, please answer the following questions:
42. How important is it to you to graduate high school, vocational or trade school?
Not important at all.................. 1
Somewhat important ............... 2
Very important........................ 3
Extremely important................ 4
Already graduated................... 5
Q42 - Q44. These questions refer to how the respondents think of themselves, as opposed to people in general. |
43. On a scale of 1 to 5, where 1 is low and 5 is high, how much do you want to get more education or training such as college, vocational school or a nursing or a teaching certification?
Low | | | | High | Don’t know |
|---|
1 | 2 | 3 | 4 | 5 | 97 |
44. On a scale of 1 to 5, where 1 is low and 5 is high, how important is it for you to get training to get the kind of job you want?
Low | | | | High | Don’t know |
|---|
1 | 2 | 3 | 4 | 5 | 97 |
About Your Health and Healthcare…
These next questions are about your health and healthcare.
45. Are you pregnant now?
Yes............................. 1
No .............................. 2
Don’t know................... 97
46. What is your current form of birth control or protection from sexually transmitted diseases?
CHECK ALL THAT APPLY
No method used..................................................... 1
Abstinence ............................................................ 2 SKIP TO QUESTION 48
Birth control pills ....................................................
3 Condom................................................................. 4
Partner’s vasectomy................................................ 5
Sterilizing operation/tubal ligation ............................ 6
Withdrawal, pulling out............................................ 7
Depo-Provera, injectables ....................................... 8
Norplant................................................................. 9
Rhythm or safe period by calendar............................ 10
Safe period by temperature or cervical mucus test,
natural family planning ...................................... 11
Diaphragm.............................................................. 12
Female condom, vaginal pouch ............................... 13
Foam..................................................................... 14
Jelly or cream......................................................... 15
Cervical cap ........................................................... 16
Suppository............................................................ 17
Today Sponge ....................................................... 18
IUD, coil, loop......................................................... 19
“Morning after” pills or emergency contraception... 20
Other method ........................................................ 21
Respondent sterile.................................................. 22
Respondent’s partner sterile .................................... 23
Lunelle injectable (monthly shot).............................. 24
Contraceptive patch ................................................ 25
Q46. If respondents do not consider themselves sexually active, they should choose “abstinence”. |
47. How would you describe your relationship with your current sexual partner?
Married to him.................................................. 1
Engaged to him ............................................... 2
Living together in a sexual relationship,
but not engaged......................................... 3
Going with him or going steady.......................... 4
Just friends ...................................................... 5
Just met him.................................................... 6
Something else................................................. 7
Don’t know ...................................................... 97
48. In the past 12 months, have you received…
| Yes | No |
|---|
a. a pregnancy test? | 1 | 2 |
b. an abortion? | 1 | 2 |
c. a pap smear? | 1 | 2 |
d. a pelvic exam? | 1 | 2 |
e. prenatal care? | 1 | 2 |
f. post-pregnancy care? | 1 | 2 |
g. counseling for, or been tested or treated for a sexually transmitted disease? | 1 | 2 |
Q48. Yes or no should be selected for each of the categories. |
Thank you for participating in this survey!
All AFL Care sites must submit the questionnaire to their site IRB (and HIPAA Privacy Board if the site is a Covered Entity) prior to initiating data collection. The questionnaire data are to be treated as confidential and maintained in a manner that satisfies the confidentiality requirements set forth by their site IRB (and HIPAA Privacy Board if the site is a Covered Entity). To facilitate confidentiality protections, none of the 18 HIPAA designated identifying data elements are collected on the instruments.
Any and all transmission of case level data must also be done in accordance with confidentiality requirements set forth by their site IRB (and HIPAA Privacy Board if the site is a Covered Entity).
These instruments are designed to meet several research needs. They will allow comparisons of aggregate data across all AFL Care sites, as well as comparisons of clients’ attitudes, knowledge and behavioral intentions against those collected and reported through other national studies. While the comparisons will be limited in scope because the samples are drawn in different ways, the information gleaned will be valuable for the AFL Care service providers. Analysis of the data for required independent evaluation of each project will vary, and be determined, by the individual grantees and their evaluators.
The OPA will require AFL Care demonstration projects to provide tabulations of data on basic demographics and selected questions in the core evaluation instrument in their end-of-year reports. These aggregate data will be used to track progress on the performance measures currently being developed by the OPA in response to OMB’s recommendation.
Many AFL Care grantees struggle to find the resources and expertise to support rigorous evaluations that incorporate random assignment or quasi-experimental comparison group designs. As noted by Carley et al. (2000) it is important that AFL Care grantee evaluations “do more than merely compare clients’ status after participation in the program with their status prior to participation” (p. 3). Evaluations, in general, and those of programs working with adolescents, in particular, require a good comparison group. Absent this group, it is impossible to tell whether changes in clients are attributable to program participation or other factors (e.g., maturation).
One technique for minimizing the costs and burdens associated with establishing a control group (i.e., random assignment) or identifying a local comparison group, is to examine program data in light of national survey statistics or norms. Although this approach has its own weaknesses (e.g., local population characteristics and norms may not correspond to characteristics found in a national database), it can strengthen evaluation designs, such as the pre-post designs with the same participant groups that are found in many AFL Care grantee evaluations (Carley et al., 2000). For example, although solely descriptive in nature, sites can compare attitudes, knowledge and behavioral intentions on key factors such as risk-taking behaviors pre and post program services.
For these reasons, most items in the core evaluation instrument have been drawn from large national surveys that have been successfully administered to youth across the country for many years. Additionally, the instruments were pilot tested at an AFL Care Grantee site to ensure that the questions in the instrument are understood by the respondents. The other national instruments from which most questions were drawn are:
- The National Survey of Family Growth (NSFG)
- The National Longitudinal Survey of Adolescent Health (Add Health)
- Youth Asset Survey (YAS)
- National Immunization Survey (NIS)
- The Fragile Families Baseline (FFBL)
- The Fragile Families Follow-up (FFFU)
Each of these surveys is regularly administered to adolescents, has publicly available data sets (i.e., for the purpose of establishing comparison statistics for specific questions), and has been translated into Spanish. Additionally, with the exception of the Fragile Families Main Survey, some comparison statistics are already available for these surveys in the Sourcebook of Comparison Data for Evaluating Adolescent Pregnancy and Prevention Programs (Carley et al., 2000).
Abt and OAPP also worked jointly to develop several items that could not be found in preexisting surveys. Where this occurred, the items were written in a manner that reflected the language level and tone of the items drawn from the other preexisting surveys.
The following tables detail the original source for each of the questions selected for the instruments. The items are grouped by the primary domains of interest identified through the development process:
- Healthy Mothers
- Healthy Infants
- Stronger Families
- Productive Futures
Instrument Key:
- NSFG = National Survey on Family Growth
- Add = National Longitudinal Survey of Adolescent Health
- YAS = Youth Asset Survey
- NIS = National Immunization Survey
- FFBL = Fragile Families Baseline
- FFFU = Fragile Families Follow-up
Core Domain: |
|---|
AFL Instrument & Question Numbers B = Baseline Pregnant Clients BC = Baseline Parenting Clients F = Follow-up # = Question number | Relevant Indicator | How Quantified | Referent Period | Source Instruments (NSFG unless otherwise indicated) | Question(s) |
|---|
Birth Weight | | | | | |
|---|
| BC | F | Birth weight | <> 5.5 lbs | Last | | BD4 |
Gestational Age | | | | | |
|---|
| BC | F | If DK , gestational age | <> 36 wks | Last | | BC-6, BC-7 |
Delivery | | | | | |
|---|
| BC | F | Pregnancy outcome(s) | Cesarean Birth Vaginal Birth | Last | | BC-1 |
Immunizations | | | | | |
|---|
| BC | F | Has baby received immunizations | Yes/No | By 3 mos | NIS | - |
Well-Baby Check-ups | | | | | |
|---|
| BC | F | Child doctors visit | Number of weeks ago | Last | FFFU | B5 (mod) |
| BC | F | Number of “Well Baby” check-ups | Never, 1-3 times, > 4times | Since Birth | FFFU | B6 |
Breast Feeding | | | | | |
|---|
| BC | F | Breastfed infant at all? | Yes/No | Last | | BH-1 |
| BC | F | How old infant when stopped breast-feeding | Days/Weeks/Months | Last | | BH-5 |
Safe/Stable Home Environment | | | | | |
|---|
| BC | F | Infant living w/respondent | Yes/No | Last | | BG-1 |
| BC | F | Infant living w/others | Biologic father Other relative Adoptive Family Other | Last | | BG-5 (mod) |
| BC | F | Child(ren) in child care | Yes/No | Past 4 weeks | | IG-1 |
| BC | F | Primary child care provider | Other parent Child’s sibling 13+ Child’s sibling <13 Grandparent Other relative Non-relative Day care center AFC Program Nursery/Preschool Family Daycare Head Start Kindergarten /School Before/after-school care Chile alone Other | Past 4 weeks | | IG-2(mod) |
| BC | F | Intensity of child care – all providers | Total all provider hours/week | Typical – past 4 weeks | FFFU | B21a |
Core Domain: |
|---|
Target Indicator B = Baseline Pregnant Clients BC = Baseline Parenting Clients F = Follow-up # = Question number | Relevant Indicator | How Quantified | Referent Period | Source Instruments (NSFG unless otherwise indicated) | Question(s) |
|---|
Pregnancy Complications | | | | | |
|---|
| BC | F | Pregnancy outcome | Cesarean Birth Vaginal Birth | Last | | BC-1 |
| BC | F | If DK , gestational age | <> 36 wks | Last | | BC-6, BC-7 |
Reproductive Health | | | | | |
|---|
B | BC | F | Received reproductive health care: Pregnancy test Abortion Pap smear Pelvic Prenatal care Postnatal care STD test/treatment | Yes/No | Past 12 mos | | FA-3a FA-3b FA-3c FA-3d FA-3e FA-3f FA-3g |
Postpartum Care | | | | | |
|---|
| BC | FU | Received reproductive health care: Pap smear Pelvic Postnatal care STD test/treatment | Yes/No | Past 12 mos | | FA-3c FA-3d FA-3f FA-3g |
Core Domain: |
Target Indicator B = Baseline Pregnant Clients BC = Baseline Parenting Clients F = Follow-up # = Question number | Relevant Indicator | How Quantified | Referent Period | Source Instruments (NSFG unless otherwise indicated) | Question(s) |
Family /Marriage Values | | | | | |
B | BC | F | Better married than single | Agree->disagree | Current | | IH-1 |
Father (figure) Involvement | | | |
