Appendix A: Sample Chart of Performance Measures and Case Variables

The chart below is an example of what this section of the application might look like. Applicants should feel free to present the required information in any clear and effective format.

Data Element
Source/Measure
Collection Frequency
Number of children identified as having been exposed to violence, and the number of families from which these children come.

Agency records

Other sources and measures

Quarterly
Number of children served, and the number of families from which these children come.

Agency records

Other sources and measures

Quarterly
Number of professionals and direct service workers trained on issues related to children’s exposure to violence, and the number of different agencies from which those trained come.

Attendance records and sign-in sheets from trainings

Other sources and measures

Quarterly
Number of policies developed, enhanced, or expanded to address the issue of children’s exposure to violence, and the number of agencies that these policy changes affect.

Phone interviews with collaborative partners

Other sources and measures

Quarterly
Type(s) of violence witnessed.

Intake forms in case files

Other sources and measures

Quarterly
Severity of violence witnessed.

Intake forms in case files

Other sources and measures

Quarterly
Child’s relationship to persons involved.

Intake forms in case files

Other sources and measures

Quarterly
How often has the index child witnessed violence?

Intake forms in case files

Other sources and measures

Quarterly
How many exposures has the child had?

Intake forms in case files

Other sources and measures

Quarterly
Was any intervention received for the first exposure to violence?

Intake forms in case files

Other sources and measures

Quarterly
Was any intervention received for subsequent exposures to violence?

Intake forms in case files

Other sources and measures

Quarterly
Age of child at exposure.

Intake forms in case files

Other sources and measures

Quarterly
Gender of child.

Intake forms in case files

Other sources and measures

Quarterly
Race/ethnicity of child.

Intake forms in case files

Other sources and measures

Quarterly
Length of time since index incident.

Intake forms in case files

Other sources and measures

Quarterly
Child’s proximity to the violent event witnessed (approximate linear distance).

Intake forms in case files

Other sources and measures

Quarterly
Is this the child’s first exposure to violence?

Intake forms in case files

Other sources and measures

Quarterly
At intake, has the child already received any intervention or treatment for this incidence of exposure?

Intake forms in case files

Other sources and measures

Quarterly
Does the child display any of the following sequelae at intake (preintervention)?

List validated instruments used to measure depression, developmental delay, school failure, antisocial/delinquent behavior, posttraumatic stress disorder, other

Parent/teacher interviews

Other sources and measures

At intake and then semiannually for 24 months
Does the child display any of the following sequelae at followup (postintervention)?

List validated instruments used to measure depression, developmental delay, school failure, antisocial/delinquent behavior, posttraumatic stress disorder, other Parent/teacher interviews

Other sources and measures

At intake and then semiannually for 24 months

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Safe Start: Promising Approaches for Children Exposed to Violence OJJDP, September 2004