Number of Different Classes of This Curriculum You Taught This School Year

School: Teacher:

Number of different classes of this curriculum you taught this school year:

Today’s date: / /

MonthDayYear

Project Northland - Power Lines

We would like to know about your experiences with using Project Northland. It is important for us to understand which components of the curriculum you used and to what degree. Your information will help us understand which components are most doable and which are more difficult to implement. Please complete one checklist that covers all of the classes of this curriculum you taught during the school year and return the checklist directly to the Planning and Implementation coordinator in your community. Your responses will be shared with the Planning and Implementation coordinator and with the Department of Human Services for the purposes of planning and follow-up. Please clearly mark your answers with a .

1. Were you trained in implementing the Power Lines curriculum?

1 Yes 2 No

1. Did you introduce the students to the shared leadership class structure?

1 Yes 2 No

1. Did you teach all lessons in the order they are included in the curriculum?

1 Most of the time 2 Sometimes 3 Rarely

1. Did facilitators or other peer leaders, not the teacher, present all of the lessons designated as student led in the curriculum?

1 Most of the time 2 Sometimes 3 Rarely

1. Did your class complete group projects?

1 Yes 2 No

1. Did you use the Home Team components?

1 Most of the time 2 Sometimes 3 Rarely

1. Did your class review the time capsules they developed last year?

1 Yes 2 No

Overall implementation

1. If you made any changes to the curriculum, please describe below:

1. What type of support would be helpful for future classes?

Satisfaction

1. How appropriate do you feel the following aspects of Power Lines were for middle school students?

1. Content

1. Language level

1. Worksheets/activities

1. Do you agree or disagree with the following statements about Power Lines?

1. Students were interested in the information.

1. Students learned something new from the curriculum.

1. The curriculum was easy for students to understand.

1. Students asked relevant questions about the material.

1. The materials to assist me in teaching the curriculum were easy to understand.

1. I was comfortable teaching the curriculum.

1. I was comfortable answering students’ questions.

1. I was able to fit the curriculum into my class schedule.

1. I feel the curriculum is a useful tool to help prevent teen alcohol use.

1. I would recommend this curriculum to other teachers.

1. I would like to continue to teach this curriculum next year.

1. What do you see as the best thing about this curriculum?

1. Do you have any suggestions for improving the curriculum in your classroom?

Curriculum implementation checklistWilder Research, September 2015