Antony Card, Ed.D., Associate Director,

1
School Health Coordinators in Newfoundland
Labrador Initial Reflections

• Antony Card, Ed.D., Associate Director,
• School of Human Kinetics and Recreation
• Memorial University of Newfoundland
• 1-709-737-8667 antonyc_at_mun.ca

2
SHPLCs Study

• The aim of this study is to assess the effects of
  introducing school / community health
  coordinators, to facilitate education-health
  cooperation in promoting the health of children
  and learning at the school board/health
  authority/community level.

3
Other Research

• Warwick et al. (2004), have provided an extensive
  evaluation of school health coordinators in
  England. The results were promising and funding
  has continued as part of the National Health
  Service (NHS) reforms. The coordinators
• Develop support networks
• Share best practice
• Contribute to school accreditation
• Develop local and strategic links
• Provide a coherent and coordinated to student
  well-being

4
Background

• What lead to the positions?
• Provincial Wellness Council established
• Other initiatives underway SFGs, Smoke Free
  Grounds, Physical Education funding, Active
  Schools.
• Provincial Healthy Schools Summit was held and
  from this Healthy Students Healthy Schools was
  created and the SHPLCs were hired.

5

• Health Students Healthy Schools (HSHS)
  Initiative
• joint initiative of the Department of Health
  and Community Services and Education.
• - supports positive changes to school aged
  children
• - creates school environments that support
  healthy living for children
• - the SHPLCs are one key element of the HSHS
  initiative.

www.livinghealthyschools.com
6
The SHPLCs
7
Background

• The SHPLCs work out of the school board but are
  on the regional health payroll.
• Consultants report to both Education and Health.
• First position began November 2005.

8
Background

• Funding for the positions is provided by both the
  Department of Health and Community Services (and
  regional health authorities) and the Department
  of Education (and school boards).
• salary- regional health authorities
• travel- department of education
• office space supplies- school boards
• provincial meetings- department of education

9
Methodology

• The research design involves two phases
• The first involves an analysis of the documents
  pertaining to the role of the SHPLCs.
• The second phase involves a process of
  semi-structured interviews and focus groups with
  key informants.

10
Methodology

• Documents reviewed
• minutes from meetings
• annual workplans
• results from surveys
• district improvement plans
• reports prepared by the SHPLCs
• results of evaluations on the programs/activities
  conducted by the SHPLCs
• costs associated with the positions, newsletters,
  and feedback from teachers/principals.

11
Interviews

• Interviews (n40) were conducted with the
  following people from each district level
• SHPLC
• Parent child health coordinator
• Principals
• Program specialist responsible for the SHPLC
• Regional nutritionist
• Assistant director of programs (school board)
• Director of wellness and health promotion.

12
Findings

• Emerging Themes
• Positions viewed as helpful
• Effective Changes
• Barriers/Challenges
• Evaluation of the positions
• Response from parents
• Response from students
• Ideas for the future

13
Findings - Are the positions helpful?

• Yes, definitely!
• We have seen massive gains in that area and
  normally it takes a long time for change to occur
  so I dont credit all the success just because we
  had health consultants, like I said the ducks
  were all sort of in line for a positive change to
  happen, but with that being said without those
  people focused to drive to continue the messages
  to continue to come up with things we wouldnt be
  nearly as along as we are and we still have a
  long ways to go (school board official)
• Yes, as a champion
• - Positions viewed as a needed champion for
  school health.

14
Findings - Are these positions helpful?

• Yes, positive short term effect
• Yes I believe theyre already having a
  difference, but having said that, you cannot fix
  the problems associated with childhood obesity,
  and the problems associated with the lack of
  physical activity and all of those areas in a day
  or a month or a year (government official)
• Too early to tell
• Thats a good question, I mean, I dont know,
  time will tell, I think its probably too early
  to tell yet

15
Findings- Effective Changes

• Communication between Health Education
• Most referenced when asked about effective
  changes
• We dont do a good job with communication,
  sometimes we tend to be doing our own thing and
  they are doing their own thing and if you find a
  person that can go across both organizations or
  three or four organizations and being able to do
  that very successfully then thats a big strength
  of the position. (school board official).

16
Findings - Effective Changes

• Implementation of Provincial School Food
  Guidelines
• School Caterers In-Services
• Student Poster Contest
• New Cafeteria Equipment
• In the last provincial budget there was
  800,000 targeted towards that so (the SHPLC) has
  met with the caterers and talked to them about
  their needs and talked to the principals about
  that and certainly (the SHPLC) knows where our
  greatest priorities are. (health official)
• Active Schools
• Smoke-Free School Grounds

17
Findings - Effective Changes

• Funding Opportunities
• Living Healthy Teams
• Weve set up a healthy living team which are
  very active in the school in terms of creating
  more of an awareness of healthy living, healthy
  eating and active living. (principal)
• Teacher In-Services
• Principals Meetings

18
Findings - Effective Changes

• Living Healthy Commotions

19
Findings Barriers/Challenges

• Geographical distance
• I think I referred to the challenges for them
  is going to be geography, its going to be size,
  the number of schools you can get to the number
  of teachers you can contact relationships you can
  build with people, the support you can provide to
  teachers. (school board official)
• Status (non permanent).
• - Commented on most when asked about
  barriers and challenges.
• More information/education for parents
  guardians
• Children/youth bringing drugs into the schools or
  using drugs on school property.

20
Findings - Barriers/Changes

• Culture change
• Understanding the difference in roles/positions.
• Some children still leaving school property to
  purchase food
• A lot of people go to the store and they (the
  stores) do really well but were (the school
  cafeteria) okay (principal)
• Parents bringing in foods to students that do not
  meet the School Food Guidelines (SFGs).
• But we really do need to do a lot more, and
  thats something that weve been talking about
  over the past year, how do we get parents more
  involved, and thats why were not, like the full
  implementation is the full two years, cause we
  know we have all these different pieces we have
  to look at. (health official)

21
Findings - Barriers/Challenges

• Communication
• Funding
• More consultants needed
• The challenges to the successes right now in
  our district (are associated with) the time for
  one person to attack this issue (school board
  official)

22
Findings - Barriers/Challenges

• Teachers not complying with School Food
  Guidelines
• Time constraints
• Um, I guess one would be with all our positions
  is just the time restraints (health official)
• Rural vs Urban

23
Findings - Evaluation of Positions

• Consultant Backgrounds
• - Teacher, principal, dietician, social worker.
• Communication
• And I think the other thing thats really
  helped with the success is what theyve learned
  from each other, what weve all learned from each
  other, the building on ideas, and all the
  sharing, the development of policies, thats been
  another success, where we came up with the school
  food guidelines, each of the school districts had
  to come up with their own healthy eating or
  nutrition policies, and we all worked on those
  together, and I think thats made them very
  successful. (health official)

24
Findings - Evaluation of the Positions

• Liaison
• Resource
• Its good to have somebody like that as a
  resource person, the SHPLC came in and spoke to
  our student council and gave a powerpoint
  presentation to them on the new guidelines and
  where things were going and some educational
  pieces. It is good to have people like that, if
  that 10 people on the council go out and talk to
  their friends about it, it spreads the word.
  (principal)

25
Responses - Parents

• Responses from parents have been optimistic
  towards the changes with regards to the SFG,
  active schools and the smoke free grounds policy.
• Some principals suggested that there will always
  be parents that you struggle to reach but the
  majority of parents are very supportive.
• There is still a need for further information to
  be available to parents.

26
Response - Students

• Students responses have been encouraging towards
  the School Food Guidelines (SFG), active schools
  and smoke free grounds.
• Like the parents, some students were initially
  reluctant to change.
• Principals commented that students response to
  the commotions, or any physical activity days are
  always overwhelmingly positive.
• Yeah, I think overwhelmingly positive, because,
  you know, I guess the change in the menu, I mean
  the children are still accessing it, in terms of
  the foods that we provide, and theres still
  quite a bit of variety there that still allows
  them to balance out the type of foods that
  theyre eating. (principal)

27
Findings - Ideas for the Future

• Active Schools
• Another big focus on the physical activity, I
  would really like to next year have pilot schools
  and the following year look into having double or
  triple that, ultimately with the goal in mind to
  have all the schools with the Quality Daily
  Physical Activity (QDPA) focus. (principal)
• Additional Positions
• - School board officials suggested having
  additional positions
• - Another position to divide the district would
  be great (shplc)

28
Findings - Ideas for the Future

• Continued Positions
• We need to recognize that this is a permanent
  position in the school district office because
  you do need a champion it needs to be sustained
  to move onto the next stage
• (school board official)
• Living Healthy Teams
• You know I think that the best thing that the
  consultant can do is to ensure that schools have
  functioning healthy living or nutrition or
  whatever you want to call them committees.
  (principal)

29
Findings - Ideas for the Future

• More Caterers Sessions
• Food safety would be another issue, perhaps
  different recipes and menus, there is all kinds
  of things that could be done at that in-service
  if we could get the funding (shplc)
• More focus on High School
• - It was suggested by participants (principals)
  that there has been a lot of focus from the SHPLC
  on primary/elementary school-aged children and
  there needs to be a greater focus on high school
  students.
• - Often change is easier and more welcomed with
  the primary/ elementary schools.

30
Findings - Ideas for the Future

• More Physical Activity
• - Principals suggested a greater focus on
  physical activity
• Other Areas
• - Other areas of focus for the future that were
  suggested were
• - drug use
• - body image
• - more physical activity
• - violence in schools
• - bullying

31
Current SHPLCs work

• Active Schools
• Changes to Canteen/Cafeteria Equipment
• Professional Development Days
• Hand washing Pilot Project
• Training Preschool Staff
• Pedometer Challenge

32
SHPLCs future work

• After the full implementation of the School Food
  Guidelines, Physical Activity Smoke Free
  Grounds, the next focus areas for the consultants
  (based on the provincial wellness plan) will be
• Immunizations
• Social behaviors
• Vulnerable populations
• Injury prevention

33
(No Transcript)
34
Conclusion

• The findings have demonstrated the value of these
  positions and the need for them to continue.
• These positions have built a great rapport
  between health and education and have been
  successful in their role as a liaison between the
  two.
• The SHPLCs other health officials needs to be
  aware of their roles, responsibilities
  boundaries.
• The consultants have made significant changes
  (physical activity, school nutrition, smoke free
  schools) in a short period of time.