## Telephone District Screening Protocol/Interview

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 Office of Management and Budget (OMB) control

number. The valid OMB control number for this informat ion collection is XXXX

- XXXX

. The time required

to complete this information collection is estimated to average 30 minutes per response

. This information

collection is voluntary. If you have any comments concerning the accuracy of the time estimate(s) or

su ggestions for improving this form, please write to: U.S. Department of Education, Washington, DC 20202

–

4651. If you have comments or concerns regarding the status of your individual submission of this form,

write directly to: Christopher Boccanfuso, U.S. D epartment of Education, Institute of Education Sciences,

Room 506D, 555 New Jersey Ave. NW, Washington, DC 20208

- 5500.



## Draft District Screening Protocol

Intro du ctory script: Thank you for the opportunity to meet with you today and discuss the Impact of an

Early Warning and Intervention Monitoring System (EWIMS) on Student and School Outcomes Study

funded by the Institutes of Educational Science within the U.S. Department of Education. We are very

excited about your district’s interest in the study and are l ooking forward to talking to you about potential

participation of high schools within your district. Participation in this study is voluntary for schools.

Today we will ask you questions about how your district supports schools in working with students who

are at

- risk for not graduating on time.

District Name: District Contact:

_____________

Email: Telephone:

School Characteristics

1. How many high school (serving grades 9

- 12) do you have in your district?

What are the names of those high schools and their graduation rates for the 2012

- 13 academic year?

(note

- pre populated with names, if available)

2. What methodology was used to calculate the graduation rate?Data

- Driven Dropout Prevention Efforts

3. Does your district promote the use of a student information system, an early warning system (EWS),

or another other data tool to identify students who may be at-risk of not graduating from high school

on-time? [interviewer will allow the interviewee to des cribe their process and will select most

appropriate response]

o Yes, we have a district

- wide tool to identify students who may be at-risk of not graduating

and we use the tool in all schools.

o Yes, we have a district

- wide tool to identify students who may be at-risk of not graduating

and we use the tool in some schools.

If yes, please specify which schools:

o No, the district does not promote and/or high schools do not use a tool to identify students

who may be at-risk of not gr aduating.

o I'm not sure.

4. Can you please describe the tool:

5. Does your district have an early warning system team or group of individuals that focuses on students

who are identified as at risk of not graduating from high school? [interviewer wi ll allow the

interviewee to describe their process and will select most appropriate response]

o Yes, the district has a team that focuses on students who are identified as at risk of not

graduating from high school.

o No, there is no team at the district or hi gh school levels.

o Other

If yes, specify who serves on this team:

6. Does your district have a policy or practice on how schools should assign at-risk students to supports

and/or interventions?Specifically, how is data used within this process (e.g. how often and to what extent?)

Does this vary by school? If so, how?

7. Does your district have a system for schools to monitor individual high school student s' progress in

interventions/supports to which they are assigned?

o Yes

o No

o Unsure

If "yes," please specify which high schools use it:

8. If your district monitors students' progress in interventions/supports to which they are assigned, what

data a re used in this process? [interviewer will allow the interviewee to describe their process and will

check all that apply]

o Attendance

o State assessment results

o Course performance

o Data from students' classroom teachers

o Core course performance

o Data from other adults who interact with the student (e.g., counselors, coaches, etc.)

o Credits earned

o Behavior referrals

o Behavior suspensions

o Information from the at-risk (flagged) student

o Information from at-risk (flagged) students' parent/guardian

o OtherIf "other," pl ease specify:

9. Is there anything else you would like to share with us about how your district approaches dropout

prevention interventions and strategies?