Item 50.

(Answer at baseline. It will be automatically filled in by the database at follow-up.) Write in the month and year (as MM/YYYY) when you first started serving participants with this Alternative Drug-Free Activities prevention intervention strategy, including all cycles.

Item 51.

(Answer at baseline. It will be automatically filled in by the database at follow-up.) Answer either “yes” or “no” to indicate whether the alternative drug-free activities are targeted at a specific group, such as high school students, college students, etc. If you answer “no” you will skip to item 66.

Item 52.

(Answer at baseline. It will be automatically filled in by the database at follow-up.) Answer either “yes” or “no” to indicate whether these are recurring activities, in which the same group of people is served over multiple prevention intervention strategy sessions.

Item 53.

(Answer at baseline. It will be automatically filled in by the database at follow-up.) Answer either “yes” or “no” to indicate whether this prevention intervention strategy was implemented in a series of cycles, in which a new group of participants is served on a regular schedule, such as a new school year. If you answer “no” you will automatically skip to item 54.

Item 53a.

(Answer at baseline. It will be automatically filled in by the database at follow-up.) Select the one response that best describes what the cycles in item 53 are based upon. If other than the options offered, select “other” and describe.

Item 54.

(Answer at baseline. It will be automatically filled in by the database at follow-up.) Select the one response that indicates how you would classify this prevention intervention strategy as delivered according to the Institute of Medicine categories. Universal strategies are designed for everyone in the eligible population, both the general public and all members of specific eligible groups. Universal strategy recipients are not identified on the basis of individual risk. Selective strategies are targeted to individuals or a subgroup of the population whose risk of developing a disorder is significantly higher than average. Indicated strategies are designed for persons who are identified as having minimal but detectable signs or symptoms or precursors of some illness or condition, but whose condition is below the threshold of a formal diagnosis of the condition.


Item 55.

(Answer at baseline and follow-up.) Select all that apply to the format of the alternative drug-free activities prevention intervention strategy during this reporting period. If in a format not listed, select “other” and describe.

Item 56.

(Answer at baseline and follow-up.) Select all the choices that indicate the types of participants served by this prevention intervention strategy during this reporting period. If another category not listed applies, check “other” and describe.

Item 57.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number how many groups of participants started the alternative drug-free activities prevention intervention strategy during this reporting period. Do not include groups counted in previous reporting periods.

Item 58.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number how groups of participants completed the alternative drug-free activities prevention intervention strategy during this reporting period. Do not include groups counted in previous reporting periods.

Item 59.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number the total number of sessions provided for all groups of participants in the alternative drug-free activities prevention intervention strategy during this reporting period.

Item 60.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number the total number of
hours provided for all groups of participants in the alternative drug-free activities prevention intervention strategy during this reporting period.

Item 61.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number the total number of new participants who were served by this prevention intervention strategy during this reporting period. New participants are participants who had not received or participated in the prevention intervention in previous reporting periods and were therefore not previously counted. If you are unsure of the exact number of new participants, respond with your best estimate. If none, enter 0. You will automatically skip to the end of the subform.

Items 62 a-c.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write in as a whole number how many of the new participants served by this prevention intervention strategy during this reporting period were in each gender group listed in a-c. The sum of the numbers in a-c should equal the total number of new participants reported in item 61.

Items 63.a-e

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number the total number of new participants served by this prevention intervention strategy during this reporting period; to indicate how many were in each of the age groups listed below in a-e. The sum of a-e equal the total number of new participants reported in item 61.

Items 64 a-h.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number the total number of new participants served by this prevention intervention strategy during this reporting period that were in each of the racial groups listed in a-h below. The sum of the numbers in a-h should equal the total number of new participants reported in item 61. You will have an opportunity to report ethnicity in the next item. Ethnicity is counted separately from race. For example, if you targeted African Americans of Hispanic ethnicity, they would be counted in both the Hispanic ethnicity category and the race category under African American.



Items 65.a-c

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number the total number of new participants served by this prevention intervention strategy during this reporting period, that were listed in ethnic groups a-c. The sum of a-c should equal the number of new participants reported in item 61.

Item 66.

(Answer at baseline and follow-up. You may add into the database on an ongoing basis at any time, or enter at the end of reporting period.) Check “yes” or “no” to indicate whether you conducted drug-free events (concerts, festivals/fairs, picnics, sporting events) during this reporting period that were not targeted to specific groups of participants during this reporting period. If “no” you will automatically skip to the end of this subform.

Item 67.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number the total number of drug free events that were conducted during this reporting period.

Item 68.

(Answer at baseline and follow-up. You may add numbers into the database on an ongoing basis at any time, or enter all at the end of reporting period.) Write as a whole number the total number of people who were reached through the drug free events during this reporting period.