School Interventions

1
School Interventions

• Public Policy Analysis Education Center for
  Middle Childhood, Adolescent Young Adult Health
  and
• National Adolescent Health Information Center,
• Department of Pediatrics Institute for Health
  Policy Studies, University of California, San
  Francisco

2
Presentation Overview

• Importance of schools
• Creating a healthy environment
• School connectedness
• What schools can do
• Responses
• Coordinated School Health Program
• School-based health centers
• Summary Resources

3
Importance of Schools

• Why are schools important settings for improving
  adolescent health?
• Place to reach young people, as well as their
  families.
• 48 million youth enrolled in elementary and
  secondary schools 17 million young
  people enrolled in colleges/universities.
• 98 of 7-13 year-olds, 96 of 14-17 year-olds,
  and 64 of 18-19 year-olds enrolled in school.
• Structure already exists to provide adolescents
  with health education, services, and referrals.

Sources CDC, 2005 NCES, 2006 CHHCS, 2006
4
Importance of Schools

• Schools are an appropriate setting to provide
• Environment that fosters healthy development
• Health education to reduce risky behaviors and
  promote healthy behaviors
• Links to health care services or referrals
• Training for school staff to aid in health
  education for adolescents and their families and
• Policies to help implement school health
  programs/guidelines.

Source CDC-HRSA-NAHIC, 2004
5
Creating a Healthy Environment

• Research has shown a strong association between
  adolescent connections to schools and the
  prevention of risky behavior.
• Higher school connectedness--the interaction of
  the student with the school environment--is
  linked to lower substance use, less emotional
  distress, less violent behavior and lower
  pregnancy rates.

Source Resnick, et al.,1997
6
Students who Feel Connected to School are Less
Likely to Use Substances
Level of Substance Use (SD Units)
Levels of Connectedness
Source Resnick, et al.,1997
7
Students who Feel Connected to School Experience
Less Emotional Distress
Level of Emotional Distress (SD Units)
Levels of Connectedness
Source Resnick, et al.,1997
8
Students who Feel Connected to School Engage In
Less Violent or Deviant Behavior
Level of Violence or Deviant Behavior (SD Units)
Levels of Connectedness
Source Resnick, et al.,1997
9
Students who Feel Connected to School are Less
Likely to Become Pregnant
Percent ever Pregnant
Levels of Connectedness
Source Resnick, et al.,1997
10
CDC Division of Adolescent School
HealthCoordinated School Health Program

• Rationale for school health programs
• Schools by themselves cannot, and should not be
  expected to, address the nations most serious
  health and social problems.
• Families, health care workers, the media,
  religious organizations, community organizations
  that serve youth, and young people themselves
  also must be systematically involved.
• However, schools could provide a critical
  facility in which many agencies might work
  together to maintain the well-being of young
  people.

Source CDC, 2005
11
CDC Division of Adolescent School
HealthCoordinated School Health Program
Source CDC, 2005
12
What Schools Can Do Example Suicide Prevention

• Schools are a good setting for suicide prevention
  efforts as they can provide
• Education for students to increase awareness and
  teach themselves/other peers how to get help
• Mental Health Screening to assess risk for
  suicide
• Gatekeeper training to teach school staff to
  identify students at risk for suicide and give
  appropriate referrals
• Support for adolescents and parents.

Source Weiss Cunningham, 2006
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What Schools Can Do Example Obesity Prevention

• Promotion of physical activity and nutrition can
  be incorporated at schools
• Physical Activity - provide high quality physical
  education classes and sports teams
• Nutrition - reduce access to non-nutritious foods
  and drinks (e.g., vending machines, fast-food in
  cafeteria)
• School Nurses can identify students at risk for
  being overweight and follow up with those not
  seeing a provider on a regular basis.

Sources Wechsler et al, 2004 CHHCS, 2006
14
School-Based Health Centers

• Health centers are located within or near a
  school and can provide a range of health care
  services for young people. Features often
  include
• Parents sign consents for their children to
  enroll
• Advisory board (parents, young people, community
  and family organizations) plans health center
  activities
• School health center staff often includes nurses,
  social workers, physicians and other health care
  professionals and
• School staff work cooperatively with health
  center staff to integrate the center into school
  life.

Source CHHCS, 2006
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School-Based Health Centers

• School-based health centers -- 1,500 nation-wide
  School nurses, 30,000 estimated School
  counselors, 81,000 School psychologists,
  20,000-22,000 School social workers, 12,000.
• Services may include
• immunizations,
• diagnosing and treating acute illness and injury,
• managing and monitoring chronic diseases,
• dispensing medications, and
• offering preventive and primary dental care.

Source CHHCS, 2006
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Evaluation CDC School Health Policies and
Programs Study

• National survey that assesses school health
  policies and programs at the state, district,
  school and classroom levels for elementary,
  middle and high schools.
• Reviews health program components health
  education services, physical activity, mental
  health social services, school policy
  environment, food service, faculty staff health
  promotion, and family community involvement.

Source CDC, 2006
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Evaluation CDC School Health Policies and
Programs Study

• Results show that many schools are addressing
  health issues for adolescents, thereby improving
  the health of this population
• Most schools (89) are required to teach health
  education
• Over three fourths (77) of schools have a school
  nurse to provide health services
• Almost all (99) of middle/high schools have
  interscholastic sports programs and half (49) of
  all schools have physical activity clubs or
  intramural activities
• A guidance counselor is available in 77 of
  schools and 63 of schools have a student
  assistance program and
• Over half of all schools (60) gave families of
  students information about the school health
  program.

Source CDC, 2006
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Summary

• Schools are valuable settings in which to address
  and improve the health of adolescents
• Can reach adolescents and their families to
  provide health education and services
• Can help identify and reduce health problems
  through different programs and
• Can provide a safe environment for healthy
  development.
• Multiple sectors (families, communities, etc.)
  are naturally integrated into school health
  programs.

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Resources

• For more information about the 21 Critical Health
  Objectives and the National Initiative to Improve
  Adolescent Young Adult Health, visit
  
• http//nahic.ucsf.edu/nationalinitiative/ or
  http//www.cdc.gov/HealthyYouth/AdolescentHealth/N
  ationalInitiative/
• For more information on School Interventions,
  visit
• Partner Resources Database http//nahic.ucsf.edu/i
  ndex.php/partner_resources/

20
References

• Centers for Disease Control and Prevention.
  (2005). Coordinated School Health Program.
  Available at http//www.cdc.gov/HealthyYouth/CSHP
  /
• Centers for Disease Control and Prevention.
  (2006). School Health Policies and Programs
  Study, 2006. Available at http//www.cdc.gov/Heal
  thyYouth/shpps/overview/index.htm
• Centers for Disease Control and Prevention,
  National Center for Chronic Disease Prevention
  and Health Promotion, Division of Adolescent and
  School Health Health Resources and Services
  Administration, Maternal and Child Health Bureau,
  Office of Adolescent Health National Adolescent
  Health Information Center, University of
  California, San Francisco. (2004). Improving the
  Health of Adolescents Young Adults A Guide for
  States and Communities. Atlanta, GA Authors.
  Available at http//nahic.ucsf.edu/2010guide/
• National Center for Education Statistics. (2006).
  Digest of Education Statistics Tables and
  Figures, 2005. Available at http//nces.ed.gov/pr
  ograms/digest/d05/lt1.asp1
• Resnick, M.D., Bearman, P.S., Blum, R.W., Bauman,
  K.E., Harris, K.M., Jones, J., et al. (1997).
  Protecting adolescents from harm Findings from
  the National Longitudinal Study on Adolescent
  Health. Journal of the American Medical
  Association, 278(10), 823-32.

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References

• The Center for Health and Health Care in Schools.
  (2005). Childhood Obesity What the Research
  Tells Us. Available at http//www.healthinschools
  .org/sh/obesityfacts.asp
• The Center for Health and Health Care in Schools.
  (2006). School-Based Health Centers A
  Background. Available at http//www.healthinschoo
  ls.org/sbhcs/sbhc.asp
• Wechsler, H., McKenna, M.L., Lee, S.M., Dietz,
  W.H. (2004). The Role of Schools in Preventing
  Childhood Obesity. Alexandria, VA The State
  Education Standard, National Association of State
  Boards of Education. Available at
  http//www.nasbe.org/Standard/17_Dec2004/Wechsler2
  .pdf
• Weiss, C.L.A., Cunningham, D.L. (2006). Suicide
  Prevention in the Schools. Baltimore, MD Center
  for School Mental Health Analysis and Action,
  Department of Psychiatry, University of Maryland
  School of Medicine. Available at
  http//csmha.umaryland.edu/resources.html/suicide
  20prevention20brief.pdf

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National Adolescent Health Information Center
and Public Policy Analysis Education Center
for Middle Childhood, Adolescent Young Adult
Health
WEB SITES http//nahic.ucsf.edu/ http//p
olicy.ucsf.edu/ EMAIL
nahic_at_ucsf.edu policycenter_at_ucsf.edu PHONE
[phone]