Coordinated School Health Model Research Articles

Addressing the Whole Child: The Power of Data and Teams.

As 21st-century school nurses, we address students holistically to meet their needs. The ASCD and the Centers for Disease Control and Prevention's coordinated school health model "Whole School, Whole Child, Whole Community" resonates with many school nurses. However, implementing the model can be challenging. This article explains how the school district of St. Johnsbury, Vermont, uses data to leverage their whole child team to meet their school district's needs.

Analysis of the Partnership for Health Promotion at School in Bulgaria

According to the concept of health promotion, health is a shared responsibility of individuals, the community, the state, and non-governmental organizations. Partnership offers great potential for addressing problems and achieving goals, but it is also associated with certain difficulties. Establishing a successful partnership requires common purpose, shared responsibilities, complementary competencies, collaboration, and mutual respect. The aim of this paper is to analyze whether partnership as a main principle of health promotion has been put into practice in the observed school community. A comprehensive medico-social survey on school health promotion was conducted from September 2012 to May 2013 over a representative sample of schools in the Pleven region of Bulgaria. Data were collected through a self-administered questionnaire among 1,280 members of the school community, interviews with school principals, and a review of the documents. Questions are directed toward the elements of the coordinated school health model. Data analysis of the presented part of the study, which examined the partnership for health promotion at school, was consistent with the methodology of the partnerships analysis tool using a specially designed checklist for evaluation. Over 90% of the investigated subjects and organizations realize the necessity of partnership. They have a clear goal to improve the well-being of the school community and a shared understanding that the benefits from partnership outweigh the exertions and costs. On the other hand, not all potential partners are included in the process of planning priorities for action. Almost half do not always have a clear idea about their responsibilities for fulfilling the goals. Both the positive and weak points of the partnership were able to be considered. The necessity for partnerships in promoting school health is recognized but difficult to transform into real action due to limited competencies and collaborations.

Increasing Immunization Compliance by Reducing Provisional Admittance.

Students in Vermont with incomplete or undocumented immunization status are provisionally admitted to schools and historically had a calendar year to resolve their immunization status. The process of resolving these students' immunization status was challenging for school nurses. We conducted a school-based quality improvement effort to increase student compliance with Vermont immunization regulations using a collaborative learning approach with public health school liaisons and school nurses from public schools to reduce provisional admittance in 2011-2012. Strategies included using a tracking system, accessing the immunization registry, promoting immunization importance, tracking immunization plans, and working with medical homes to update records. Participating school nurses observed decreases in the number of provisionally admitted students, although this reduction was not significantly different than matched comparison schools. We also found the number of provisionally admitted students fluctuated throughout the year and resolving the immunization status of New Americans and exchange students required special attention. Our approach supports the coordinated school health model and demonstrates the critical role school nurses play in improving population health outcomes.

Whole School, Whole Community, Whole Child-Calling School Nurses to Action.

The Whole School, Whole Community, Whole Child model released in 2015 as a collaboration between associations focuses renewed attention on the importance of improved physical, emotional, and social health to student learning. The model replaces and expands upon the Coordinated School Health Model that has been widely implemented in schools since the late 1980s. NASN celebrates this new model and calls school nurses to action in advocating for the implementation of this model in their communities. This article not only introduces this new model to school nurses but shares examples of school nurse advocacy initiatives.

A Healthy School Environment as a Precondition for the Welfare of Students and Staff

A healthy school environment is an important element of the Coordinated School Health model, which periodically focuses on the quality of a school’s physical and esthetic surroundings as well as its psychosocial climate, safety, and culture. According to previous studies, the characteristics of a school environment are statistically related to the students’ health and academic achievement. Therefore, the purpose of this paper is to examine various aspects of a school environment, their influences on the well-being of the school community, and the need for improvements. A comprehensive study on school health promotion was conducted with a representative sample of schools in the region of Pleven, Bulgaria. Data were collected by means of a self-administered questionnaire among students, parents, and staff as well as through interviews with school principals. In the region of Pleven, there are a total of 118 schools, which were built between 1912 and 1998. The majority of the buildings have been renovated, and the school surroundings are generally well-maintained. However, approximately 60% of the buildings have no easy access for disabled persons, and according to the school documents, any deviations from the standards of temperature, lighting, and ventilation in the classrooms have not been registered. In addition, approximately 40% of the respondents felt that improvements in human relationships and job satisfaction would create a healthier school community. Based on the findings, the influence of a healthy school environment on the welfare and academic performance of students and staff is confirmed and such an environment should be a precondition for the welfare of other school communities.

The Whole School, Whole Community, Whole Child model: a new approach for improving educational attainment and healthy development for students.

BACKGROUNDThe Whole Child approach and the coordinated school health (CSH) approach both address the physical and emotional needs of students. However, a unified approach acceptable to both the health and education communities is needed to assure that students are healthy and ready to learn.METHODSDuring spring 2013, the ASCD (formerly known as the Association for Supervision and Curriculum Development) and the US Centers for Disease Control and Prevention (CDC) convened experts from the field of education and health to discuss lessons learned from implementation of the CSH and Whole Child approaches and to explore the development of a new model that would incorporate the knowledge gained through implementation to date.RESULTSAs a result of multiple discussions and review, the Whole School, Whole Community, Whole Child (WSCC) approach was developed. The WSCC approach builds upon the traditional CSH model and ASCD's Whole Child approach to learning and promotes greater alignment between health and educational outcomes.CONCLUSIONBy focusing on children and youth as students, addressing critical education and health outcomes, organizing collaborative actions and initiatives that support students, and strongly engaging community resources, the WSCC approach offers important opportunities that will improve educational attainment and healthy development for students.

Fifteen Years of Promise in School-Based Physical Activity Interventions: A Meta-Analysis

Increasing physical activity among children and adolescents continues to be a public health priority (Glickman et al., 2012), with a focus on evidence-based physical activity in school settings. While individual studies report benefits from school-based physical activity interventions, no data-based analysis of these interventions has been published. This meta-analysis examined the outcomes of 12 school-based interventions that reported data from both treatment and intervention groups. The design of each study was unique; including one or more of 19 dependent variables representing physical activity, knowledge, body composition, and cardiovascular measures, and one or more component of the Coordinated School Health Model (CSHM). Generally the benefits from the intervention were small and not significant; health knowledge was the exception. Interventions including more components of the CSHM and interventions of greater duration (e.g., more minutes) were associated with enhanced outcomes and explained 89% of the variance. Weaknesses in the design and analysis of some interventions were inappropriate experimental unit (individual rather than school), multiple analyses on the same data without correction (e.g., Bonferroni), multiple publications of the same data, and the inclusion of all students regardless of whether the student needed to increase physical activity/ftness or reduce body mass/fat.

The Winning With Wellness Pilot Project

School-based efforts to promote physical activity and healthier eating are a potentially effective approach to decreasing child obesity in rural populations. This article describes follow-up data on student activity and eating behaviors 4 years after implementation of the Winning with Wellness obesity prevention initiative. This project was based on the Centers for Disease Control and Prevention's coordinated school health model and used a community-based participatory research approach to address health behaviors in rural Appalachian elementary students. Results suggest significant increases in daily pedometer steps and healthier food selections by students as well as teacher support for continued health promotion efforts.

Variation in School Health Policies and Programs by Demographic Characteristics of US Schools, 2006

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. 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 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. 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.

Developing a coordinated school health approach to child obesity prevention in rural Appalachia: results of focus groups with teachers, parents, and students

High prevalence rates of obesity, particularly among those residing in US rural areas, and associated physical and psychosocial health consequences, direct attention to the need for effective prevention programs. The current study describes an initial step in developing a school-based obesity prevention program in rural Appalachia, USA. The program, modeled on the Centers for Disease Control and Prevention Coordinated School Health (CSH) Program, includes a community-based participatory research approach to addressing the health needs specific to this region. Focus groups with teachers, parents, and 4th grade students were used to understand perceptions and school policy related to nutrition, physical activity, and the role of the school in obesity prevention. Results revealed that these community stakeholders were concerned about the problem of child obesity and supported the idea of their school doing more to improve the diet and physical activity of its students. Specifically, all groups thought that foods and drinks consumed by students at school should be healthier and that they should have more opportunities for physical activity. However, they cited limitations of the school environment, academic pressures, and lack of parental support as potential barriers to making such changes. Parents were most concerned that their children were not getting enough to eat and they and the teachers were not in favor of BMI screening at the school. Parents were in favor of increasing physical activity during school and thought that parent volunteers should help students select foods in the cafeteria. Students cited examples of how diet and physical activity affect their health and school performance, and thought that they should have more physical education time and recess. The data collected in the current study contributed to the limited knowledge base regarding rural populations as well as identified strengths and potential barriers to assist with the development of a pilot program based on the CSH model, Winning with Wellness.

A Coordinated School Health Approach to Obesity Prevention Among Appalachian Youth

Childhood obesity has been an increasing problem in the United States, especially in rural areas. Effective prevention approaches are needed. This article describes the development, implementation, effectiveness, feasibility, and sustainability of a school-based obesity prevention pilot project, Winning with Wellness. The program was based on the coordinated school health model and included a community-based participatory research approach aimed at promoting healthy eating and physical activity in a rural Appalachian elementary school. Findings from this preliminary project revealed improvements in nutrition offerings and increased physical activity during the school day. In addition, the program was found to be acceptable to teachers, successfully implemented utilizing both existing and newly developed resources, and sustainable as evidenced in continued practice and expansion to other area schools.

Improving Access to School-Based Nutrition Services for Children with Special Health Care Needs

Schools are recognized as a key setting to address the increase in overweight among youth. As part of the coordinated school health model, nutrition services can positively impact the eating habits of America’s school children and play a role in reversing this trend. The requirement for school districts participating in the US Department of Agriculture’s child nutrition programs to implement local wellness policies in the 2006-2007 school year presents opportunities for registered dietitians (RDs) to be directly involved in helping schools create more healthful environments.

Bridging the Gap between Community Health and K-12 Schools

The topic of this article is program planning for K-12 school health programs collaborating with community agencies, businesses, colleges, and organizations. Community involvement was listed as one of the weakest areas of school health efforts in a national coordinated school health study [1]. This article presents the 5-year results demonstrating the outcomes of K-12 schools program planning aimed at community involvement in the coordinated school health model. Directors of the Departments of Education and Health in South Dakota initiated training for school personnel in the coordinated school health model through development of councils in the schools starting in 2000. The expectations of the councils were to design a program plan to support the health of students and staff in their school. The short-term results of a 5-year evaluation indicated the greatest area of gain was in community health involvement to improve student and staff health.

"Razoo Health": a community-based nursing education initiative.

When statistics depicted a health crisis for people of all ages living in Louisiana, and New Orleans in particular, school of nursing faculty designed and instituted a neighborhood-based initiative to "Razoo Health." This initiative facilitated a paradigm shift from exclusively illness management to include health promotion and disease prevention. "Razoo," a local colloquialism used to claim an opponent's marble during game play, means to snatch or claim. Appropriately, Razoo Health refers to the intent of Louisiana citizens to reclaim and take back the health of the people in the cities' neighborhoods. Working with four inner-city parochial schools and churches as hubs, nursing faculty and students mobilize neighborhood assets, talents, and capacities to form partnerships for healthy change. The Centers for Disease Control and Prevention Coordinated School Health Model is employed within each neighborhood school to provide health care access, decrease absenteeism, raise test scores, and deliver worksite health programming to faculty and staff and to neighbors and parishioners. Nursing students work with citizens and students of other health care professions to learn community assessment skills and deliver primary, secondary, and tertiary services to individuals, families, and the community. Citizens wear crowns of empowered sovereignty as they take back, or razoo, what is rightfully theirs--health.