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ORGANIZATION: GIFFORD YOUTH ACTIVITY CENTER/MENTAL HEALTH ASSOCIATION <br /> PROGRAM: MENTAL HEALTH SERVICES FOR CHILDREN & FAMILIES <br /> FUNDER: CHILDREN'S SERVICES ADVISORY COMMITTEE <br /> F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) <br /> 1 . DEMOGRAPHICS: What information (data elements) will you need to collect in order <br /> to accurately describe your target population including demographics (age, gender, and <br /> ethnic background) required by the funder in Section H? What are the pieces of <br /> information that qualify them for your target population? How do you document their <br /> need for services or their "unacceptable condition requiring change" from Section Bl ? <br /> A "Mental Health Services Referral Form" will be utilized by GYAC staff and parents to <br /> identify problem behaviors and/or mental health needs of the child. Parents may also request <br /> services on the form. The Mental Health Counselor will then follow-up on the referrals and <br /> schedule for services. The referral form will provide basic demographics regarding age, gender, <br /> mental health issues, etc. <br /> 2. MEASURES: What data elements will you need t0 collect to show that you have <br /> achieved (or made progress toward) your Measurable Outcomes in Section D? What <br /> tools or items are you using as measures (grades, survey scores, attendance, absences, <br /> skill levels) for your program? Are you getting baseline information from a source on <br /> your Collaboration List in Section E? Are there results from your Activities in Section <br /> D that need to be documented? How often do you need to collect or follow-up on this <br /> data? <br /> Data will be collected on a weekly, monthly, and quarterly basis utilizing the following <br /> measures: <br /> • Pre/post tests to determine comprehension of teaching materials regarding feelings, <br /> emotions, and anger. <br /> • Number of conflicts between youth which are mediated and result in positive resolutions. <br /> • Progress reports, provided by parents, teachers and youth, regarding specific behavioral <br /> and/or mental health issues. <br /> • Satisfaction surveys, obtained from parents and teens, regarding mental health services <br /> received. <br /> 10 <br />