2023/2024 DiSH-MT Participant Survey

Thanks for your interest in DiSH-MT! In order to gauge the effectiveness of this program and ensure the content is driven by Montana’s school health personnel, please complete this survey before you attend your first DiSH-MT session of the 2023/2024 school year.

DiSH-First-Time-Attendee 2023/2024

General Information

Name

First Last

In how many schools do you work?

One school

Two schools

Three schools

Four schools

More than four schools

I do not work in a school

Please tell us about where you work and your role.

Please tell us about the school you work with? (Select all that apply).

Pre-K

Elementary school

Middle school / Junior high

High school

Other

What is your role at this school? (Select all that apply).

Nurse

Teacher

Coach

Front desk/administrative

Counselor

Other

Please tell us what your role is at this school

Out of total time in which students are in school, what is the average percentage of time in which a nurse is present at this school?

Please enter a number from 0 to 100.

For example, if a nurse is at school for a half-day every day, you would indicate 50.

If a student with diabetes had a health concern at this school while a nurse was not present, who would be responsible for caring for the student?

Please share the name of this school, what school district it is in, and town/city where it is located.

Approximately how many students have insulin-dependent diabetes at your school?

1-3

4-6

7-9

10+

FIRST SCHOOL Please tell us about the first school you work with. (Select all that apply).

Pre-K

Elementary school

Middle school / Junior high

High school

Other

FIRST SCHOOL What is your role at this school? (Select all that apply).

Nurse

Teacher

Coach

Front desk/administrative

Counselor

Other

FIRST SCHOOL Please tell us what your role is at this school

FIRST SCHOOL Out of total time in which students are in school, what is the average percentage of time in which a nurse is present at this school?

Please enter a number from 0 to 100.

For example, if a nurse is at school for a half-day every day, you would indicate 50.

FIRST SCHOOL If a student with diabetes had a health concern at this school while a nurse was not present, who would be responsible for caring for the student?

FIRST SCHOOL Please share the name of this school, what school district it is in, and town/city where it is located.

SECOND SCHOOL Please tell us about the second school you work with? Select all that apply.

Pre-K

Elementary school

Middle school / Junior high

High school

Other

SECOND SCHOOL What is your role at this school? (Select all that apply).

Nurse

Teacher

Coach

Front desk/administrative

Counselor

Other

SECOND SCHOOL Please tell us what your role is at this school

SECOND SCHOOL Out of total time in which students are in school, what is the average percentage of time in which a nurse is present at this school?

Please enter a number from 0 to 100.

For example, if a nurse is at school for a half-day every day, you would indicate 50.

SECOND SCHOOL If a student with diabetes had a health concern at this school while a nurse was not present, who would be responsible for caring for the student?

SECOND SCHOOL Please share the name of this school, what school district it is in, and town/city where it is located.

THIRD SCHOOL Please tell us about the third school you work with. Select all that apply.

Pre-K

Elementary school

Middle school / Junior high

High school

Other

THIRD SCHOOL What is your role at this school? (Select all that apply).

Nurse

Teacher

Coach

Front desk/administrative

Counselor

Other

THIRD SCHOOL Please tell us what your role is at this school

THIRD SCHOOL Out of total time in which students are in school, what is the average percentage of time in which a nurse is present at this school?

Please enter a number from 0 to 100.

For example, if a nurse is at school for a half-day every day, you would indicate 50.

THIRD SCHOOL If a student with diabetes had a health concern at this school while a nurse was not present, who would be responsible for caring for the student?

THIRD SCHOOL Please share the name of this school, what school district it is in, and town/city where it is located.

FOURTH SCHOOL Please tell us about the fourth school you work with. Select all that apply.

Pre-K

Elementary school

Middle school / Junior high

High school

Other

FOURTH SCHOOL What is your role at this school? (Select all that apply).

Nurse

Teacher

Coach

Front desk/administrative

Counselor

Other

FOURTH SCHOOL Please tell us what your role is at this school

FOURTH SCHOOL Out of total time in which students are in school, what is the average percentage of time in which a nurse is present at this school?

Please enter a number from 0 to 100.

For example, if a nurse is at school for a half-day every day, you would indicate 50.

FOURTH SCHOOL If a student with diabetes had a health concern at this school while a nurse was not present, who would be responsible for caring for the student?

FOURTH SCHOOL Please share the name of this school, what school district it is in, and town/city where it is located.

Between all of the schools in which you work, approximately how many students have insulin-dependent diabetes?

1-3

4-6

7-9

10+

Is there anything else you'd like to share about the schools you work, the number of students with diabetes, or school health personnel at your school(s)?

How would you rate your comfort level with the following:

Knowing when and how to administer treatment for LOW blood sugar (hypoglycemia)?

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Knowing when and how to administer treatment for HIGH blood sugar (hyperglycemia)?

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Administering insulin by syringe/vial?

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Administering insulin by pen?

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Interpreting a continuous glucose monitor (CGM) and responding to concerns related to CGMs

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Responding to concerns related to an insulin pump

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Supporting the nutritional needs of children with diabetes

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Providing developmentally appropriate support (and autonomy) for children with diabetes

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Planning for and supporting participation of students with diabetes in after-school care

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Planning for and supporting participation of students with diabetes in sports

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Supporting mental health and responding to mental health concerns in children with diabetes

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Responding to a routine illness (such as a stomach bug or cold) in a child with diabetes

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Supporting a child in their first few months after a diabetes diagnosis

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

Connecting children and families to diabetes-related social support and resources

1 – not at all comfortable	2	3	4	5	6	7	8	9	10 – extremely comfortable

The DiSH-MT Program

Are there any other topics you are interested in or would like to learn more about that are not listed in the questions above?

Yes

What topic(s) are you interested in?

How did you hear about the DiSH-MT program?

Please use this free text box to provide any thoughts about how you feel students with diabetes in Montana can be best supported in school

CAPTCHA

2023/2024 DiSH-MT Participant Survey

DiSH-First-Time-Attendee 2023/2024

General Information

How would you rate your comfort level with the following:

The DiSH-MT Program

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