Creating health-promoting schools in rural China: a project started from deworming

Intestinal helminth infection is highly endemic in rural areasof China. This project was implemented to determine if dewormingefforts through schools could reduce helminth infections andsuccessfully serve as an entry point for developing a more comprehensiveapproach to school health, i.e. the components of ‘health-promotingschools’. Six primary and junior secondary schools with6188 students were involved in the project. Major interventionsin four experiment schools included: examination and treatmentof helminth infections; health education; improvement of schoolphysical environment; establishment of relevant school policiesand regulations; and strengthening relationship between schooland community. The only intervention taken by the other twoschools as controls was deworming. After 1 year of implementation,helminth infection in students and environmental contaminationby helminth eggs in experiment schools decreased by ~80%, significantlyhigher than that in control schools. Remarkable improvementsin students' knowledge, behaviour and skills of health protection,in school physical facilities, in school/community relationship,and in relevant policies and practices, were also observed inthe experiment schools. The conclusions are that the conceptof the health-promoting school has been well accepted by thestudents, teachers, parents and local government officers, andthat helminth reduction is an effective and feasible entry pointfor establishing health-promoting schools in rural areas wherehelminth infection has been an important public health problem.     

Healthy and safe school environment, Part II, Physical school environment: results from the School Health Policies and Programs Study 2006

BACKGROUND: As society continues to focus on the importance of academic achievement, the physical environment of schools should be addressed as 1 of the critical factors that influence academic outcomes. The School Health Policies and Programs Study (SHPPS) 2006 provides, for the first time, a comprehensive look at the extent to which schools have health-promoting physical school environment policies and programs. METHODS: The Centers for Disease Control and Prevention conducts the SHPPS every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states and the District of Columbia and among a nationally representative sample of school districts (n=424). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=992). RESULTS: One third (35.4%) of districts and 51.4% of schools had an indoor air quality management program; 35.3% of districts had a school bus engine-idling reduction program; most districts and schools had a policy or plan for how to use, label, store, dispose of, and reduce the use of hazardous materials; 24.5% of states required districts or schools to follow an integrated pest management program; and 13.4% of districts had a policy to include green design when building new school buildings or renovating existing buildings. CONCLUSIONS: SHPPS 2006 results can guide education and health agency actions in developing and implementing evidence-based tools, policies, programs, and interventions to ensure a safe and healthy physical school environment.     

湖南省中小学校卫生保健能力现状及改善策略

目的 为分析湖南省中小学校卫生保健能力配置现状,改善中小学卫生保健能力提供依据。 方法 开展学校卫生保健能力建设问卷调查,利用学校卫生工作体系和能力建设调查工作数据采集平台直报数据,对湖南省中小学校卫生保健机构设立以及卫生保健人员配备现状进行分析。 结果 湖南省12 614所中小学校中,3 599所寄宿制学校和1 704所600人以上非寄宿制学校,至少需配备专职校医9 967名,实际仅898名,7 311所不足600人非寄宿制学校,专职保健老师仅197名;调查学校中7.3%设置了卫生室,29.6%设置了保健室;7.5%配备了校医,5.3%配备了专职校医,专职校医配备合格率为1.3%;45.6%配备了保健老师,6.6%配备了专职保健老师;90.0%开展了卫生健康相关课程;5.7%的校医和26.5%的保健老师参加过卫生专业技术培训;设置卫生室或保健室、配备(专职)保健老师、配备(专职)校医、开展卫生健康教育、保健老师或校医参加过学校卫生专业知识培训的学校比例,随学龄阶段的上升、经济水平的提高、学校规模的变大,呈逐渐增加趋势(均P<0.001)。 结论 湖南省中小学校卫生保健机构以及卫生保健人员缺口较大,小于600人的小学卫生保健力量需重视;保健老师和校医学校卫生专业知识培训不足;经济水平仍是影响学校卫生保健机构以及人员配置的关键因素之一。建议通过增加学校卫生工作经费投入,不断完善学校卫生保健机构建立,合理增配学校卫生保健人员,并通过卫生保健人员专业技术培训来提升中小学校卫生保健工作能力。     

Applying the School Health Index to a nationally representative sample of schools: update for 2006

BACKGROUND: The School Health Index (SHI) is a tool designed to help schools assess the extent to which they are implementing practices included in the research‐based guidelines and strategies for school health and safety programs developed by the Centers for Disease Control and Prevention (CDC). CDC previously analyzed data from the 2000 School Health Policies and Programs Study (SHPPS) to determine the percentage of US schools meeting the recommendations in the SHI. A new edition of the SHI (2005) and the availability of 2006 SHPPS data made it necessary to update and repeat the analysis. METHODS: SHPPS 2006 data were collected through computer‐assisted personal interviews with faculty and staff in a nationally representative sample of schools. The data were then matched to SHI items to calculate the percentage of schools meeting the recommendations in 4 areas: school health and safety policies and environment, health education, physical education and other physical activity programs, and nutrition services. RESULTS: In accordance with the earlier findings, the present analysis indicated that schools nationwide were focusing their efforts on a few policies and programs rather than addressing the entire set of recommendations in the SHI. The percentage of items related to nutrition that schools met remained high, and an increase occurred in the percentage of items that schools met related to school health and safety policies and environment. CONCLUSIONS: More work needs to be done to assist schools in implementing school health policies and practices; this analysis helps identify specific areas where improvement is needed.     

Parliamentary Inquiry Into Health Promoting Schools in Victoria: Analysis of Stakeholder Views

BACKGROUND: In 2009, the Victorian Parliament Legislative Assembly of Australia commissioned a Parliamentary Inquiry into the opportunities for schools to become a focus for promoting healthy community living. Submissions to the Inquiry varied widely in their positions about school health promotion. The aim of this review is to analyze the submissions to identify core themes in the debates about school health promotion and how stakeholders saw schools becoming a focus for promoting healthy communities. METHODS: Submissions (N = 159) were downloaded from the Inquiry website. Open coding was used to code the data. The codes were then refined into conceptual categories to create themes. The Inquiry's terms of reference were used as an organizing framework. RESULTS: Emergent themes included barriers and enablers to school health promotion including the need for stronger leadership from the Departments of Health (DoH) and Education and Early Childhood Development (DEECD). CONCLUSION: Rather than supporting the idea that schools could have a wider role in communities, submissions pointed to the acute need for increased resource allocation to support health promotion in schools, and for coordinated approaches with stronger leadership from the health and education sectors. Without these structures, schools can only address health in an ad hoc manner with limited resources, capacity, and outcomes.     

Mental health screening in schools

BACKGROUND: This article discusses the importance of screening students in schools for emotional/behavioral problems. METHODS: Elements relevant to planning and implementing effective mental health screening in schools are considered. Screening in schools is linked to a broader national agenda to improve the mental health of children and adolescents. Strategies for systematic planning for mental health screening in schools are presented. RESULTS: Mental health screening in schools is a very important, yet sensitive, agenda that is in its very early stages. Careful planning and implementation of mental health screening in schools offers a number of benefits including enhancing outreach and help to youth in need, and mobilizing school and community efforts to promote student mental health while reducing barriers to their learning. CONCLUSIONS: When implemented with appropriate family, school, and community involvement, mental health screening in schools has the potential to be a cornerstone of a transformed mental health system. Screening, as part of a coordinated and comprehensive school mental health program, complements the mission of schools, identifies youth in need, links them to effective services, and contributes to positive educational outcomes valued by families, schools, and communities.     

Schools, health literacy and public health: possibilities and challenges

Health literacy is a concept that can be widely embraced by schools. Schools throughout the world contribute to the achievement of public health goals in conjunction with their educational commitments. In this paper, the interface between a school's core business of education and public health goals is identified, and examples provided in the area of nutrition demonstrating how these links can operate at school level. The structure and function of the health promoting school is described and the author proposes that there is a very close connection between the health promoting school and the enabling factors necessary in achieving health literacy. Major findings in the literature that provide evidence of good practices in school health education and promotion initiatives are described. Also, those factors that make schools effective and which facilitate learning for students are identified. There is a substantial overlap between the successful components of a health promoting school and effective schools. This enables schools to potentially achieve all three levels of health literacy, including level 3-critical health literacy. However, there are three challenges that must be addressed to enable schools to achieve this level: the traditional structure and function of schools, teachers practices and skills, and time and resources. Strategies are proposed to address all three areas and to reduce the impediments to achieving the goals of health literacy and public health using the school as a setting.     

The status of health-promoting schools in Hong Kong and implications for further development

An evaluation framework, called the Hong Kong Healthy Schools Award, has been developed to enable comprehensive collection and analysis of data reflecting the status of health-promoting schools (HPS) in Hong Kong. The key findings revealed a high prevalence of emotional problems, unhealthy eating habits, physical inactivity and risk-taking behaviours, leading to both intentional and unintentional injuries among students with higher prevalence among secondary school students. The results indicated a substantial lack of health policies in schools; it also indicated health services in schools not readily accessible to students and staff, and insufficient staff training in health promotion and education. However, most schools have made initiatives in environmental protection, established safety guidelines and strategies for managing students with emotional problems. The success of HPS depends largely on teachers' understanding of its building blocks. Evidence from the comprehensive mapping of the status of HPS in Hong Kong and from student surveys does show encouraging outcomes as well as identifying priority issues to be addressed in the next 5 years.     

Influence of Funding Cuts on Texas School Tobacco Programs*

BACKGROUND: Following the Master Settlement Agreement, state tobacco prevention spending peaked in 2002, but has subsequently been diminishing annually. This study compared the influence of 2004 Texas tobacco program budget cuts on school practices a year after funding loss. METHODS: Three school groups were compared: continuously funded for a 2‐year minimum (n = 109), funded but discontinued (n = 123), and never funded (n = 70). Among the 123 schools with discontinued funding, differences were examined based on funding cut decision level (state or local). Written responses to surveys based on the Centers for Disease Control and Prevention (CDC) School Health Education Profile Tobacco Module were received from 49% of health coordinators and 58% of principals. RESULTS: Principals and health coordinators from continuously funded schools reported more 1) tobacco instrunctional activities; 2) teacher training; 3) student cessation support; 4) program leadership; 5) a district advocate; 6) interest in tobacco use prevention education; 7) use of evidence‐based programs and CDC‐recommended teaching methods; 8) involvement of school staff; 9) student tobacco cessation programs at school and community; 10) family involvement; and 11) staff development funding. Previously funded schools approached profiles of those never funded. Few differences were noted among schools with funding loss due to state or local decisions. CONCLUSION: The continuously funded schools consistently were better positioned to positively reach their students with effective tobacco programs. Funding reductions were associated with rapid reductions in programming. Results emphasize the need for early programmatic initiation of capacity building skill development to ensure implementation and retention of health programs during fiscally challenging circumstances.     

Health education: results from the School Health Policies and Programs Study 2006

BACKGROUND: School health education can effectively help reduce the prevalence of health-risk behaviors among students and have a positive influence on students' academic performance. This article describes the characteristics of school health education policies and programs in the United States at the state, district, school, and classroom levels. METHODS: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n=459). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=920) and with a nationally representative sample of teachers of classes covering required health instruction in elementary schools and required health education courses in middle and high schools (n=912). RESULTS: Most states and districts had adopted a policy stating that schools will teach at least 1 of the 14 health topics, and nearly all schools required students to receive instruction on at least 1 of these topics. However, only 6.4% of elementary schools, 20.6% of middle schools, and 35.8% of high schools required instruction on all 14 topics. In support of schools, most states and districts offered staff development for those who teach health education, although the percentage of teachers of required health instruction receiving staff development was low. CONCLUSIONS: Health education has the potential to help students maintain and improve their health, prevent disease, and reduce health-related risk behaviors. However, despite signs of progress, this potential is not being fully realized, particularly at the school level.     

Variation in school health policies and programs by demographic characteristics of US schools, 2006

BACKGROUND: To identify whether school health policies and programs vary by demographic characteristics of schools, using data from the School Health Policies and Programs Study (SHPPS) 2006. This study updates a similar study conducted with SHPPS 2000 data and assesses several additional policies and programs measured for the first time in SHPPS 2006. METHODS: SHPPS 2006 assessed the status of 8 components of the coordinated school health model using a nationally representative sample of public, Catholic, and private schools at the elementary, middle, and high school levels. Data were collected from school faculty and staff using computer-assisted personal interviews and then linked with extant data on school characteristics. RESULTS: Results from a series of regression analyses indicated that a number of school policies and programs varied by school type (public, Catholic, or private), urbanicity, school size, discretionary dollars per pupil, percentage of white students, percentage of students qualifying for free lunch funds, and, among high schools, percentage of college-bound students. Catholic and private schools, smaller schools, and those with low discretionary dollars per pupil did not have as many key school health policies and programs as did schools that were public, larger, and had higher discretionary dollars per pupil. However, no single type of school had all key components of a coordinated school health program in place. CONCLUSIONS: Although some categories of schools had fewer policies and programs in place, all had both strengths and weaknesses. Regardless of school characteristics, all schools have the potential to implement a quality school health program.     

Promoting health literacy through the health education assessment project

BACKGROUND: The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is to describe the extensive ongoing development of the SCASS-HEAP and its benefits for important stakeholders in health and education. METHODS: A review of the products from the first decade of the SCASS-HEAP was undertaken. RESULTS: The SCASS-HEAP supports a comprehensive systems approach to helping educators focus effectively on the most important skills and issues in child and adolescent health and gives health education a place at the school reform table, providing visibility and credibility and promoting the essential links between health and learning. CONCLUSION: State education agencies and school districts can use SCASS-HEAP materials for assessment and, perhaps more importantly, to help teachers modify and improve instruction at the classroom level for increased student learning.     

School Nurses' Perceptions and Practices of Assisting Students in Obtaining Public Health Insurance

BACKGROUND: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses. METHODS: This study assessed public school nurses' knowledge and beliefs of the impact of health insurance on students' health and academic success. The study also determined whether public school nurses or their schools were involved in helping students obtain public health insurance, and if so, how they did so. Additionally, the study assessed the public school nurses' perceived benefits of and barriers to helping students obtain public health insurance. A paper-and-pencil survey was sent to a national random sample of 750 public school nurses. The response rate was 56%. RESULTS: Nearly 60% of respondents had helped students enroll in public health insurance. The majority perceived that helping students obtain public health insurance would reduce school absenteeism (90%), improve attention during school (84%), reduce the number of students held back (80%), reduce school dropouts (72%), and increase academic test scores (69%). Although the majority (53%) of nurses thought schools should assist students' parents with filling out public health insurance enrollment forms, some expressed reservations about the process. CONCLUSION: School nurses indicated health insurance is important for the health and academic success of students. These beliefs are congruent with state Child Health Insurance Program (CHIP) directors' perceptions, yet few schools have taken on the role of facilitating student enrollment in public health insurance programs.     

Elementary school parents'/guardians' perceptions of school health service personnel and the services they provide

BACKGROUND: The school nurse, the school social worker, and the school counselor play an important role in promoting the health of children. Health services in the school setting provide opportunities to appraise, protect, and promote student health. The purpose of this study was to identify parents' or caregivers' perceptions and beliefs regarding the importance of schools providing various health services to their elementary school-aged children. In addition, the study examined the levels of parental support for, perceptions of, and contact with school health service personnel. METHODS: In 2005, a nationally representative random sample of 369 (51% return rate) parents of elementary school-aged children completed the questionnaire developed for this study. RESULTS: A majority of parents/caregivers reported that their child's school had a school nurse (78.8%) and counselor (60.5%), but only 22.6% reported their school had a social worker. A majority of parents/caregivers perceived full-time school nurses (86.3%), school counselors (78.6%), and school social workers (56.3%) as important or extremely important and that schools should be held responsible for having each in their child's elementary school. A majority of parents/caregivers were willing to pay an increase in yearly tax dollars to have full-time school health personnel. CONCLUSIONS: This study established a level of parental support for, perceptions of, and contact with school health service personnel. Parents were most supportive of school nurses and should be perceived as allies in ensuring job security.     

连云港市赣榆区某农村学校2019年小学生健康体检结果分析

目的了解2019年连云港市赣榆区某农村学校小学生身体健康状况及常见病检出情况,对该校学生生长发育情况和健康状况进行客观评价,为今后开展学校健康教育、健康促进和政府健康扶贫、精准扶贫工作提供切实可行的参考依据。方法根据学生体检标准及其操作规程要求,对该校356名小学生体检情况进行统计分析。结果该农村学校小学生总患病率为90.4%,患病率较高的是视力低下(49.7%)和龋齿(46.6%),身高发育处于中等以下占35.4%,肥胖及超重检出率为27.9%,营养不良率为18.5%。经χ2检验,不同性别学生和各年龄组学生的身高、体重发育情况差异均有统计学意义。结论该农村学校的小学生健康状况应引起重视,应加强学校、家庭和社会的联动作用,制订健康干预方案,切实降低小学生常见病校发生率,提高农村小学生的健康水平;政府应加强对贫困地区农村学校的经费投入,重视贫困地区农村学校的硬件设施改善和学生营养改善计划投入,充分发挥政府、学校和社会等多方力量,共同保障农村未成年人的健康成长。     

Building bridges between school-based health clinics and schools

BACKGROUND: The 2 institutions that hold great promise in mitigating the negative cyclical relationship between poor health and educational readiness are schools and school-based health care facilities (SBHCs). In partnership with schools, SBHCs could have a profound effect on learning outcomes, which include, but are not limited to, poor concentration in school, attendance, and disturbances of normal sequential development. This article provides an overview of the role of federal, state, and local governmental agencies in the development and implementation of public educational policy and funding in an effort to provide SBHCs the foundation for building a bridge between the health and the educational lexicon. METHODS: This article reviews literature from a wide variety of sources to develop a better understanding of the complexities associated with public K-12 education and provides suggestions for initiating meaningful interactions between SBHC supporters and educational decision makers. RESULTS: Strategic reasoning between supporters of SBHCs and educational policy makers is critical because of the limitations of time and money for those delivering educational services. Additional projects (eg, SBHCs) no matter how well conceived will be difficult to promote unless officials can be convinced that collaboration in school-based health care actually enhances compliance with the No Child Left Behind Act. CONCLUSIONS: Though SBHCs and schools are both committed to enhancing the lives of children, these institutions speak different languages and are accountable to very different types of public and private bodies.     

2015—2018年佛山市三水区疑似预防接种异常反应监测分析

目的分析2015-2018年佛山市三水区疑似预防接种异常反应(AEFI)监测数据,为加强免疫规划管理提供依据。方法采用Excel和SPSS软件,对监测数据进行描述性统计分析。结果2015-2018年三水区共报告AEFI病例377例,4年总体报告率为28.30/10万剂次,多数发生在1岁以下年龄组,8~<18岁组最低。在153例1岁以下报告AEFI中,8月龄儿童占比最高,达22.88%,其次为6月龄儿童,占11.76%。AEFI病例局部反应占49.86%,局部红肿和结节各分别占34.21%和15.65%。全身反应以发热为主,占56.76%;涉及各种过敏反应占16.71%;有哭闹、皮疹和瘙痒等其他全身症状者占18.30%。属于一般反应者占75.07%,属于异常反应者占18.04%,偶合症占6.63%。有7例属于严重反应。根据AEFI产生各种症状数量对疫苗进行了排序。结论三水区AEFI监测结果在一定程度上反映疫苗的安全风险,尤其关注产生多种AEFI反应和严重反应的疫苗,有必要持续加强AEFI监测,及时发现潜在存在疫苗安全问题。     

Overheard in the halls: what adolescents are saying, and what teachers are hearing, about health issues

BACKGROUND: Schools have long been recognized as an excellent place to offer health education and supportive services. Teachers are among the most important influences in the lives of school-aged children and can provide valuable insight into the health issues important to adolescents. The purpose of this study was to examine the potential role general academic teachers may play in facilitating adolescent health promotion efforts. METHODS: To determine what teachers think about the role of health promotion in schools and what tools and topics they would find most helpful as critical advisers to students, we administered a 28-question survey at staff development meetings in 4 New York City schools. RESULTS: Teachers agreed that schools were an important venue for discussing and providing health messages. More than half of those surveyed reported having overheard student discussions about health once a week or more, and 70% stated that they had been actively approached by students 1-3 or more times per semester with reports of personal problems or health issues. Teachers expressed concern about their ability to handle student mental, behavioral, and reproductive health problems and desired additional staff development workshops to address these needs. CONCLUSIONS: Teachers felt that schools were important places to promote dialogue about health and accept the importance of playing a broader role in the lives of youth beyond education. To enhance the prospect of health-promoting interactions between teachers and students, attention must be paid to developing the overall skill and comfort level of teachers with respect to adolescent health concerns.     

Health services: results from the School Health Policies and Programs Study 2006

Background: The specific health services provided to students at school and the model for delivering these services vary across districts and schools. This article describes the characteristics of school health services in the United States, including state‐ and district‐level policies and school practices. Methods: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study (SHPPS) every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n = 449). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 1029). Results: Most US schools provided basic health services to students, but relatively few provided prevention services or more specialized health services. Although state‐ and district‐level policies requiring school nurses or specifying maximum nurse‐to‐student ratios were relatively rare, 86.3% of schools had at least a part‐time school nurse, and 52.4% of these schools, or 45.1% of all schools, had a nurse‐to‐student ratio of at least 1:750. Conclusions: SHPPS 2006 suggests that the breadth of school health services can and should be improved, but school districts need policy, legislative, and fiscal support to make this happen. Increasing the percentage of schools with sufficient school nurses is a critical step toward enabling schools to provide more services, but schools also need to enhance collaboration and linkages with community resources if schools are to be able to meet both the health and academic needs of students.