School Health Education in the European Community

ABSTRACT: The School Health Education Commission of the European Community is making efforts to improve school health education in the European Community countries. While past efforts have involved single issue causes, current activities emphasize a holistic perception of school health education. Radical education reforms throughout the European Community advocate improved health education. The movement toward quality health education in the European Community countries uses a model called the Health Promoting School, a cooperative effort involving schools, families, and communities. The model is being promoted through three stages: 1) national conferences held in each European Community country, 2) summer schools to provide teacher training, and 3) national projects, supported by the World Health Organization, agreement conducted to determine the efficacy of the Health Promoting School Model.     

Cambio En Las Escuelas: Mexican-American Parent Attitudes Toward School Health Education

The purpose of this study was to determine the attitudes of Mexican-American (MA) parents of children toward school health education programs in South Texas. The Parent Attitude Scale (PAS) was developed and validated by American Cancer Society (ACS) staff and volunteer health educators. The validated survey was used to question randomly selected parents in the McAllen, Texas, school district regarding their attitudes toward school health education. Of 253 parents contacted, 235 (92.9%) parents were interviewed. Mann-Whitney U-Tests indicated that Mexican-American (MA) parents consider school health education to be more important than non-Mexican-American parents do. MA parents, overall, felt that it was more important that their child has good health habits and more important that their child's teacher provide support to them by teaching good health habits than non-MA parents. MA parents also felt that health was more important relative to other subjects at school than non-MA parents. The data indicate strong support for school health education efforts among MA parents in southern Texas. Such support may grow stronger with appropriate parent-recruitment efforts, including those by the ACS. Mexican-American parents may also represent an untapped resource for social and political support for school health programming.     

Using the Whole School,Whole Community,Whole Child Model to Support Mental Health in Schools

The COVID-19 pandemic increased already high rates of student mental health concerns and further underscored inequities and disparities in access to services and care. As schools continue to address the effects of the pandemic, they must prioritize student mental health and well-being. In this commentary, using feedback from the Maryland School Health Council, we present the connection between mental health in school and the Whole School, Whole Community, Whole Child (WSCC) model, a school health model commonly employed by schools and school districts. In doing so, we aim to highlight how school districts can use this model to address child mental health needs across a multi-tiered system of support.     

Health education in Nigerian secondary schools

A survey of 600 secondary school teachers and 120 secondary school administrators was conducted in Oyo State, Nigeria, to identify their attitudes and practices regarding school health education. Nearly all teachers and administrators felt that health education is important and should be an integral part of the curriculum. None-theless, there were few resources and little curriculum time devoted to health education. Since many of the health problems of developing countries can be addressed by enhancing the health knowledge of the populace, health education in the schools of such countries deserves more emphasis.Amos K. Fabiyi, MPH, PhD is Lecturer and Consultant (Health Education), Department of Community Health and Nutrition, Faculty of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria.Daniel S. Blumenthal, MD, MPH is Professor and Chairman, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Dr., Atlanta GA 30310.     

HIV prevention education and HIV-related policies in secondary schools--selected sites, United States, 2006

Persons who engage in sexual risk behaviors are at increased risk for human immunodeficiency virus (HIV) infection. School health education can help reduce the prevalence of sexual risk behaviors among students. In addition, school health policies can help protect the rights and health of HIV-infected students and staff members and reduce the likelihood of transmitting HIV infection to others. To determine the prevalence and extent of HIV prevention education and the prevalence of HIV infection policies among public secondary schools, CDC analyzed data from the 2006 School Health Profiles for schools in 36 states and 13 large urban school districts. The results of that analysis indicated that, in 2006, the majority of secondary schools included HIV prevention in a required health education course (state median: 84.2%; district median: 57.2%); however, few secondary schools (state median: 21.1%; district median: 28.5%) taught all 11 topics listed in the questionnaire related to HIV prevention. Approximately half of schools (state median: 51.6%; district median: 48.3%) had a policy regarding students or staff members with HIV infection or acquired immunodeficiency syndrome (AIDS). To help reduce HIV-related risk behavior and protect the rights and health of HIV-infected students and staff members, schools should increase efforts to teach all HIV prevention topics and implement policies regarding students or staff members with HIV infection.     

Development of a collaborative model to improve school health promotion in The Netherlands

In recent decades, school health promotion programs have been developing into whole-school health approaches. This has been accompanied by a greater understanding among health promoters of the core-business of schools, namely education, and how health promotion objectives can be integrated into this task. Evidence of the positive impact of school health promotion on health risk behavior of students is increasing. This article focuses on the processes and initial results of developing a collaborative model tailored for whole-school health in the Netherlands, named schoolBeat. The Dutch situation is characterized by fragmentation, a variety of health and welfare groups supporting schools, and a lack of sound integrated youth policies. A literature review, observations, and stakeholder consultation provided a clear picture of the current situation in school health promotion, and factors limiting a comprehensive and needs-based approach to school health. This revealed that a health promotion team within a school is fundamental to an effective approach to tailored school health promotion. A respected member of school staff should chair this team. To strengthen the link with the school care team, the school care coordinator should be a member of both teams. To provide coordinated support to all schools in a region, participating organizations decided to share advisory tasks. These tasks are included in the regular health promotion work of their staff. This means working with one advisor representing all school-health organizations per school, and using a comprehensive overview of possible support and projects promoting health. Empowering schools in needs assessments and comprehensive school health promotion is an important element of the developed approach. This article concludes with an examination of emerging issues in evaluating collaborative school health support during the first 18 months of development, and implementation and future perspectives regarding sustainable collaboration and quality improvement.     

A survey of health promotion at international schools

This study investigated health promotion efforts at international schools serving the education needs of expatriate communities abroad. Factors supporting the implementation of whole-school approaches to health promotion also were examined. Self-completed questionnaires were distributed by a combination of electronic and conventional mail. International school staff in 93 countries (n = 205) completed an adapted version of an instrument used for evaluating the Western Australian School Health Project (WASHP). This survey demonstrated usefulness of the WASHP instrument cross-culturally in a variety of school settings. The level of whole-school approaches to health promotion in the participating international schools varied but tended to be low. Demographic characteristics of schools were not associated with differences in the level of health promotion, with the exception school size. School organizational factors support implementation of health promotion programs.     

Secondary school health education related to nutrition and physical activity--selected sites, United States, 2004

Eating a healthful diet and engaging in physical activity have important health benefits for youths, such as reducing overweight, a condition that affected 17% of those aged 12-19 years during 2003-2004. School health education that includes information about nutrition and physical activity is an important component of a comprehensive approach to improving dietary behavior, reducing sedentary behavior, and increasing physical activity among youths. A previous study suggested that professional development for health education teachers helps ensure the quality of health education instruction. To identify which nutrition and physical activity topics are being taught in school health education courses and what percentage of lead health education teachers have received professional development on nutrition and physical activity, CDC analyzed data from the 2004 School Health Profiles for public secondary schools (i.e., middle, junior high, and senior high schools) serving students in grades 6-12 in 25 states and 10 large urban school districts. This report summarizes the results of that analysis, which indicated that in 2004, approximately one half to three fourths of schools in the participating states and school districts taught all 15 nutrition and dietary behavior topics listed in the School Health Profiles questionnaire in a required health education course, and approximately one third to two thirds taught all 12 physical activity and fitness topics. State and local education agencies should continue to encourage schools to provide education on nutrition and physical activity as part of a coordinated school health program and promote staff development for health education teachers.     

Meeting the social and behavioral health needs of students: rethinking the relationship between teachers and school social workers

BACKGROUND: While school‐based mental health professionals obviously must provide mental health services to students directly, the literature is increasingly identifying an empowerment role for these professionals, whereby they support teachers as primary service providers. The purpose of this study was to identify subtypes of school social workers within the context of collaborative practice, and to identify individual and contextual factors associated with these classifications as well as overall levels of collaboration. METHODS: Latent class analysis, conducted using data collected as part of the National School Social Work Survey 2008 (N = 1639), was employed to examine underlying subtypes of school social work practitioners in relation to collaborative practices and to examine predictors of collaborative practice. RESULTS: Four broad categories of school social workers were identified, including (1) noncollaborators, (2) system‐level specialists, (3) consultants, and (4) well‐balanced collaborators. These classes were associated with the number of schools served, grade level, education, and clinical licensure status; level of administrative responsibility was not associated with class membership. CONCLUSION: While school social workers varied in collaborative practices, opportunities exist to enhance their role in educating and supporting teachers to serve as primary providers to students with social, mental health, and behavioral needs. The implications for school‐based mental health providers, teachers, administrators, policymakers, and researchers are discussed.     

Competitive foods and beverages available for purchase in secondary schools--selected sites, United States, 2004

School Health Profiles is conducted biennially to assess characteristics of school health programs. State and local departments of education and health select either all public secondary schools within their jurisdictions or a systematic, equal-probability sample of public secondary schools to participate in School Health Profiles. At each school, the principal and lead health education teacher were sent questionnaires to be self-administered and returned to the state or local agency conducting the survey. In 2004, a total of 27 states and 11 large urban school districts obtained weighted data from their survey of principals. The findings in this report indicate that the majority of secondary schools in 27 states and 11 large urban school districts allow students to purchase snack foods or beverages from vending machines or at the school store, canteen, or snack bar. The types of competitive foods and beverages available for purchase varied across states and large urban school districts. Overall, fruits or vegetables were less likely to be available for purchase than the other types of foods or beverages. Bottled water and soft drinks, sports drinks, or fruit drinks that are not 100% juice were most likely to be available for purchase.     

Health for the school aged: a fledgeling concern

Despite acknowledging India's crucial need for health education for school aged children, government institutions have failed to provide the necessary support. Past experience has shown that while the government has drafted policy statements concerning school health, scant action has followed. What little has been done consists primarily of perfunctory medical check-ups of school children, a service mostly limited to urban centers. Evident from the current status of health education for the school aged, several changes must take place: 1) Government institutions must reach a consensus regarding the content of school health services. Since school health is intended to improve both children's health status and cognitive capability, such a service demands a comprehensive program that includes regular and complete health surveillance. And it also means that the schools themselves must be healthy environments, and that teachers must serve as role models of good health. 2) School health efforts must involve and be supported by the parents and the community. 3) Government policies must take into account children who are not attending school. This means both a long-term policy to solve the problem of drop-outs and a short-term policy of providing non formal education -- including health education -- for these children. 4) Of critical importance, the health and education sectors need to work together; they must have "joint responsibility." 5) A related issue is that both the health and education sectors accord a low priority to the issue of school health -- something that needs to change. 6) Finally, the government must change its generally weak commitment to providing school health services.     

Family and community involvement in schools: results from the School Health Policies and Programs Study 2006

BACKGROUND: Family and community involvement in schools is linked strongly to improvements in the academic achievement of students, better school attendance, and improved school programs and quality. 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 school districts (n=461). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=1029) and with a nationally representative sample of teachers of required health education classes and courses (n=912) and required physical education classes and courses (n=1194). RESULTS: Although family and community involvement in states, districts, and schools was limited, many states, districts, and schools collaborated with community groups and agencies to promote and support school health programs. More than half of districts and schools communicated information to families on school health program components. Teachers in 55.5% of required health education classes and courses and 30.8% of required physical education classes and courses gave students homework or projects that involved family members. CONCLUSIONS: Although family and community involvement occurred at all levels, many schools are not doing some of the fundamental things schools could do to increase family involvement. Improvements in family and community involvement can support school health programs in states, districts, schools, and classrooms nationwide.     

The School Health Innovative Programs: Integrating School Health and Managed Care in San Diego

ABSTRACT: Managed care organizations (MCOs) are being recruited to support school health services delivered in school clinics. Schools without clinics already provide numerous health services and could provide more if they had support from managed care organizations. This article describes the first two years of a San Diego-based collaborative consisting of MCOs, school districts, and other health care agencies. By establishing trust, developing overriding principles, and creating an interagency communication infrastructure, this collaborative has encouraged shared management of many student health issues. Because the agreements apply to all schools, programs can reduce high rates of absenteeism district-wide and avoid unnecessary doctor appointments for common health problems. These collaborative agreements are designed to be financially self-sustaining. However, data collection, the logistics of obtaining parental consent, and getting health professionals to communicate with each other in new ways remain to be significant challenges.     

Health programmes for school employees: improving quality of life, health and productivity

School health programmes in the 21st century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st century: school administrators, employees, and policymakers must be informed about the need and the means to do so; school employee health programmes must become part of the culture of education and the expectation of educators; and colleges that prepare school administrators and other school employees must provide the pre-service and in-service training, research, development, and leadership to make it happen. This article outlines ten actions that can be taken by school districts to build or improve school employee health programmes, and a list of websites that provides more detailed information about such programmes.     

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.     

Students with chronic illnesses: guidance for families,schools, and students

ABSTRACT: Developed by a work group representing several nonprofit and federal health and education organizations, Students with Chronic Illnesses: Guidance for Families, Schools, and Students provides cross-cutting action steps to facilitate full participation in learning and other school activities by students with chronic diseases. Between 10% and 15% of children in the United States are affected by at least one chronic disease. This guide offers practical tips to help ensure that schools are responsive to the health needs of children with chronic illnesses.
Children with chronic health conditions are more likely to miss days from school, need specialized health care, and require special education services or homebound teaching. School health advocates agree that meeting the needs of these children requires collaboration among the students, their families, school personnel, and community health care providers. Such efforts can help students establish better attendance, improve their alertness and physical stamina, and face fewer restrictions on physical activity at school and fewer medical emergencies.
The guide addresses issues such as routine and urgent care needs of students, medication access and administration, and school personnel training to ensure compliance with applicable local, state, and federal regulations. While emphasizing the value of adopting general policies for supporting students with chronic conditions, the guide also encourages schools to develop and implement condition-specific and individualized protocols. The responsibilities of family members, school district officials, teachers and school administrators, and students are outlined to help each constituent fulfill these objectives.
The guide is available online at http: www.nhlbi.nih.gov health public lung asthma guidfam.htm .     

Association of the presence of state and district health education policies with school tobacco prevention program practices

BACKGROUND: Texas does not require health education or tobacco use prevention education (TUPE) in its middle schools. During planning for the Texas Tobacco Prevention Initiative, this baseline research was conducted to (1) describe tobacco prevention and control practices in middle schools prior to the pilot, (2) analyze implementation of a state law prohibiting tobacco use on campuses and at school events, and (3) identify how schools are influenced by district policies requiring health education. METHODS: Written surveys derived from the 2000 School Health Education Profile Tobacco Module developed by the Centers for Disease Control and Prevention were completed by principals and health coordinators at schools in districts requiring health education (n = 31) and schools without district requirements (n = 32). RESULTS: School tobacco policy familiarity and enforcement were consistently reported in response to a state law with rigorous recommendations prohibiting tobacco use. Significantly more activity in numerous components of TUPE was reported in schools in districts with a health education requirement. CONCLUSIONS: Results have implications for intervention programs planned in schools located in states seeking to develop or strengthen state laws, or in states without health education or specific health content requirements.     

School superintendents' perceptions of schools assisting students in obtaining public health insurance

Background: Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between health and learning, and specific school system practices for assisting students were also examined. Methods: A 4‐page questionnaire was sent to a national random sample of public school superintendents using a 4‐wave postal mailing. Results: Only 19% of school districts assessed the health insurance status of students. School districts' assistance in helping enroll students in health insurance was assessed using Stages of Change theory; 36% of superintendents' school districts were in the action or maintenance stages. The schools most often made health insurance materials available to parents (53%). The perceived benefits identified by more than 80% of superintendents were to keep students healthier, reduce the number of students with untreated health problems, reduce school absenteeism, and improvement of students' attention/concentration during school. The 2 most common perceived barriers identified by at least 50% of superintendents were not having enough staff or financial resources. Conclusions: Most superintendents believed schools should play a role in helping students obtain health insurance, but the specific role was unclear. Three fourths of superintendents indicated overwhelmingly positive beliefs regarding the effects of health insurance status on students' health and academic outcomes. School personnel and public policy makers can use the results to support collaboration in getting students enrolled in health insurance.     

Comprehensive School Health Programs in Texas Public Schools

One goal of the Texas Comprehensive School Health Initiative (TCSHI) involves assessing the status of comprehensive school health (CSH) programs in Texas public schools. This project used a case study approach to establish baseline information regarding CSH programs in selected school districts across the state. Eight researchers were trained to use a case study instrument and procedures for conducting interviews. Seven school districts participated in the survey during fall 1990. Results indicated considerable concern and support for CSH programs but little coordination of programs was evident. Six districts were not organized to address health comprehensively. Generally, school districts were overwhelmed with other responsibilities, so CSH programming was not a priority. Results will be used to revise the survey instrument and further expand the data base.