This is an excerpt from Essentials of Coordinated School of Health by David A. BirchD & onna M. Videto.
Tips for Implementation at District Level
The Cortland City (New York) school district was highlighted on the CDC website of success stories (CDC, 2013c) for the work conducted at Cortland City Schools in the CSH component of nutrition services. District initiatives included limiting student access to competitive foods, adopting marketing techniques to promote healthful choices, setting nutrition policies and standards, establishing nutrition standards for competitive foods, and making more healthy foods and beverages available. Six factors were reported as keys to the success of Cortland City Schools. The first factor was having a vision of being committed to a Coordinated School Health program. The second factor was leadership as demonstrated by administrative support from the board of education, superintendent, and the principals from the schools in the district. The third factor, collaboration, was shown through partnerships that were established with community agencies, staff, parents, and students. Teamwork in each building as well as districtwide provided a demonstration of the fourth factor. The fifth factor, data driven, was demonstrated by collecting baseline data to demonstrate improvements after repeated assessments, which were then conducted every two to three years. Finally, the sixth factor recognized was the issue of financial support, which was apparent in the use of minigrants such as one through the Healthy Heart Coalition.
Jeannette Dippo, former Health Education and Wellness coordinator with Cortland City Schools, offered five suggestions for the implementation of CSH programs and policies:
- Districts need to get administrative support for the CSH activities and to send out consistent messages.
- Broad involvement is needed, including support from parents, school staff, and community members. This support is necessary for strong advocates to assist in getting the CSH vision and goals converted into actual programs and policy. Administrators may respond more positivity to general staff and parents than to the typical school health champion, who is generally the health educator or health coordinator.
- The most critical CSH priorities need to be converted into policy. Such a policy will help ensure that work or effort in that area will continue. A policy will help to establish the priority after the champions leave or have moved on to other initiatives because the policy will still exist.
- Each school needs to have a health coordinator to drive and pull the work of the team together. The schools and the district need someone with real passion for CSH. CSH functions best when someone with continuity who believes in what is being done is there to oversee the actions. A health coordinator is someone to help develop the structure for the work to happen.
- A healthy school team is needed for every school building, along with a separate district team. The accomplishments that were made in individual schools happened because each school building had its own team to work with, and someone to take the program or initiative and make it happen at the school level. It is critical that school principals be members of each school team. This network needs to be in place to share ideas and develop and implement districtwide policies.
Implement the Plan and Strategies
Putting the action plan into place consists of implementing the plan and strategies, which usually consists of adopting policies or programs. When implementing the plan, districts need to direct the focus of school health efforts on meeting the education and health needs of students (CDC, 2013b). In addition, providing opportunities for students to be meaningfully involved in the school and the community will help the team to focus on students. School health efforts in programming and policies should give youth the chance to develop and exercise leadership abilities, build skills, form positive relationships with caring adults, and contribute to their school and greater community (CDC, 2013a).
CDC suggests that students can promote a healthy and safe school and community through opportunities such as involvement in peer education, peer advocacy, or cross-age mentoring programs. Other opportunities include involving young people in service learning avenues and participation on school health teams’ advisory committees and boards that address health and wellness, education, and youth-related issues (CDC, 2013b).
Moving into the taking-action phase of program and policy implementation, CDC suggests that school districts implement multiple strategies through multiple components. To address one school health component, a variety of efforts are needed to have an effect in that area. Because the components are often overlapping and dependent on each other, addressing multiple if not all of the components is recommended for achieving the positive health and learning outcomes desired (CDC, 2013b). Many possibilities exist for advancing each of the WSCC components, and examples of possible policies and programming efforts can be discovered in any of the CSH assessment tools or criteria (see table 10.2 for possible strategies for improvement). Tools such as the CDC School Health Index, ASCD Healthy Schools Report Card, and ASCD School Improvement Tool are some of the more well-known and commonly used tools. Any strategies pursued by a school or district should be based on an assessment conducted at the school or district.
Schools should consider implementing policies and programs to help students avoid or reduce health-risk behaviors that contribute to the leading causes of death and disability among young people as well as among adults (CDC, 2014d). CDC has identified six categories of priority health-risk behaviors as being linked to the leading causes of death and disability in the United States:
- Behaviors that contribute to unintentional injuries and violence
- Tobacco use
- Alcohol and other drug use
- Sexual behaviors that contribute to unintended pregnancy and STDs, including HIV infection
- Unhealthy eating
- Physical inactivity (CDC, 2014d)
Schools can assess health-risk behaviors among young people in these six categories as well as in general health status, overweight, and asthma through formal surveys such as the Youth Risk Behavior Survey (YRBS) (CDC, 2014d). The YRBS, available through CDC, is a national school-based survey that can provide the school and district with behavioral data for 9th through 12th graders (CDC, 2014d). Data resulting from the survey can be used to track behavioral trends at the local level for establishing priorities and for monitoring program and policy success. In addition, the local data can be used to make comparisons to state, regional, and national levels with the data available on the CDC YRBS website. For example if a school district discovers that the proportion of students who participated in at least 60 minutes of physical activity per day was lower than the proportion for students in the state and nation, the district may decide that they need to address the issue. The action could mean changing the academic schedule and requirements to include daily physical education, training teachers to incorporate physical activity into the classroom, allowing fit breaks throughout the day, or instituting a walk-to-school program. This example demonstrates how data from the YRBS system can be used to inform programming and policies as a district tries to improve the health and well-being of students and staff.
After a health-risk behavior or behaviors have been identified as a priority, the school or district faces the challenge of identifying or developing relevant policies or programs. Research-based programming that can reduce risk behaviors has been identified, and information is available through Registries of Programs Effective in Reducing Youth Risk Behaviors on the CDC website as well as through other similar sites (CDC, 2013d).
Besides selecting programming options, districts need to work to bring faculty and staff onboard with WSCC efforts. Education is important to help faculty and staff see the value of a coordinated approach and the relationship between health and academics. With proper training, teachers and school leaders can become important health champions to support and reinforce efforts of the school health education coordinator or administrator (Healthy Schools Campaign, 2012). Education is also essential for teachers, administrators, and other school employees committed to improving the health, academic success, and well-being of students. CDC stated,
Professional development can provide opportunities for school employees to identify areas for improvement, learn about and use proven practices, solve problems, develop skills, and reflect on and practice new strategies. In order to promote a Coordinated School Health approach, professional development should focus on the development of skills such as leadership, communication, and collaboration. (CDC, 2013b, para. 8)
In the 2013 document A Framework for Safe and Successful Schools,the recommendation was provided to conduct professional development for school staff and community partners that would address school climate and safety; positive behavior; and crisis prevention, preparedness, and response (NASP, 2013). As part of the professional development training, teachers and school leaders need to be provided with the information and resources they need to address student health issues and support a healthy school environment (Healthy Schools Campaign, 2012). Training might involve helping teachers to become aware of state-level health education regulations and requirements for health instruction so that those issues can be addressed outside the health education classroom and integrated into other subjects as a way to reinforce health-promoting concepts (Healthy Schools Campaign, 2012). Having more teachers and school leaders take on the role of health champion and work to support health concepts and health policies facilitates moving the district toward a more unified WSCC effort. Table 10.3 provides examples of how all teachers, not just health and physical education teachers, and school leaders can support WSCC though examples in each of the 10 components.
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