School Health Policies And Programs Study Research Articles

Establishing a Baseline Measure of School Wellness-Related Policies Implemented in a Nationally Representative Sample of School Districts

The Child Nutrition and WIC Reauthorization Act of 2004 required school districts to establish a local school wellness policy by the first day of the 2006-2007 school year. To provide a baseline measure of the extent to which wellness-related policies were implemented in school districts nationwide in 2006, this study analyzed data from the 2006 School Health Policies and Programs Study (SHPPS). SHPPS used a cross-sectional design to measure policies and practices among a nationally representative sample of 538 public school districts. The authors applied a standardized wellness policy coding system to the data by matching each element to relevant questions from SHPPS and calculated the percentage of school districts meeting each element in the coding system. Statistical analyses included calculation of 95% confidence intervals for percentages and mean number of elements met in each area. In 2006, none of the districts met all elements included in the coding system for local wellness policies. In addition, the percentage of districts meeting each element varied widely. On average, districts met the greatest number of elements in the area of nutrition education and the least number of elements in the area of physical activity. By applying a coding system for district policies to an existing dataset, this study used a novel approach to determine areas of strength and weakness in the implementation of local school wellness-related policies in 2006.

Applying the School Health Index to a Nationally Representative Sample of Schools: Update for 2006

The School Health Index (SHI) is a tool designed to help schools assess the extent to which they are implementing practices included in the research-based guidelines and strategies for school health and safety programs developed by the Centers for Disease Control and Prevention (CDC). CDC previously analyzed data from the 2000 School Health Policies and Programs Study (SHPPS) to determine the percentage of US schools meeting the recommendations in the SHI. A new edition of the SHI (2005) and the availability of 2006 SHPPS data made it necessary to update and repeat the analysis. SHPPS 2006 data were collected through computer-assisted personal interviews with faculty and staff in a nationally representative sample of schools. The data were then matched to SHI items to calculate the percentage of schools meeting the recommendations in 4 areas: school health and safety policies and environment, health education, physical education and other physical activity programs, and nutrition services. In accordance with the earlier findings, the present analysis indicated that schools nationwide were focusing their efforts on a few policies and programs rather than addressing the entire set of recommendations in the SHI. The percentage of items related to nutrition that schools met remained high, and an increase occurred in the percentage of items that schools met related to school health and safety policies and environment. More work needs to be done to assist schools in implementing school health policies and practices; this analysis helps identify specific areas where improvement is needed.

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.

A Comparison of Mail and Telephone Administration of District-Level Questionnaires for the School Health Policies and Programs Study (SHPPS) 2006: Effects on Estimates and Data Quality

The School Health Policies and Programs Study (SHPPS) is a national study periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. For SHPPS 2006, district-level questionnaires were designed for telephone administration, but mixed-mode data collection that also used paper-and-pencil mail questionnaires was required to obtain an acceptable response rate. Because most mode effect research has involved person-level rather than institution-level data, little is known about the effects of mixed-mode data collection on data quality and prevalence estimates obtained through surveys of school personnel. SHPPS 2006 used 1-stage stratified cluster sampling to select a nationally representative sample of public school districts. Personnel in about half of the 538 responding districts completed paper questionnaires and returned them via mail. Analyses were performed comparing data quality and prevalence estimates for mail and telephone administration. Prevalence estimates for only 7.0% (39) of 554 questions tested across the 7 questionnaires differed significantly by response mode at the p < .01 level. Regarding data quality, use of the "don't know" response was higher for telephone administration. The results of this study demonstrate that SHPPS 2006 successfully used a mixed-mode approach, allowing the data to be used without concern about the mixed-mode administration. The results may also be useful to other researchers interested in using surveys to collect data on schools or school districts or other data that is not person level.

National Study of Changes in Community Access to School Physical Activity Facilities: The School Health Policies and Programs Study

A Healthy People 2010 developmental objective (22-12) was set to increase the proportion of the nation's public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. The purpose of this study was to describe the prevalence of indoor and outdoor facilities at schools and the availability of those facilities to the public in 2000 and 2006. In 2000 and 2006, the School Health Policies and Programs Study (SHPPS) was conducted in each state and in randomly selected districts, schools, and classrooms. This analysis focused on the school level questionnaire from a nationally representative sample of public and nonpublic elementary, middle, and high schools (n = 921 in 2000 and n = 984 in 2006). No meaningful changes in the prevalence of access to school physical activity facilities were found from 2000 to 2006, for youth or adult community sports teams, classes, or open gym. These national data indicate a lack of progress from 2000 and 2006 toward increasing the proportion of the nation's public and private schools that provide access to their physical activity facilities for all persons outside of normal school hours.

State School Nutrition and Physical Activity Policy Environments and Youth Obesity

With the epidemic of childhood obesity, there is national interest in state-level school policies related to nutrition and physical activity, policies adopted by states, and relationships to youth obesity. This study develops a comprehensive state-level approach to characterize the overall obesity prevention policy environment for schools and links the policy environments to youth obesity for each state. Using 2006 School Health Policies and Programs Study (SHPPS) state data, qualitative and quantitative methods were used (2008-2009) to construct domains of state-level school obesity prevention policies and practices, establish the validity and reliability of the domain scales, and examine their associations with state-level obesity prevalence among youth aged 10-17 years from the 2003 National Survey of Children's Health. Nearly 250 state-level obesity prevention-policy questions were identified from the SHPPS. Three broad policy topic areas containing 100 food service and nutrition (FSN) questionnaire items; 146 physical activity and education (PAE) items; and two weight assessment (WA) items were selected. Principal components analysis and content validity assessment were used to further categorize the items into six FSN, ten PAE, and one WA domain. Using a proportional scaled score to summarize the number of policies adopted by states, it was found that on average states adopted about half of the FSN (49%), 38% of the PAE, and 17% of the WA policies examined. After adjusting for state-level measures of ethnicity and income, the average proportion of FSN policies adopted by states was correlated with the prevalence of youth obesity at r =0.35 (p=0.01). However, no correlation was found between either PAE or WA policies and youth obesity (PAE policies at r =0.02 [p=0.53] and WA policies at r =0.16 [p=0.40]). States appear to be doing a better job adopting FSN policies than PA or WA policies, and adoption of policies is correlated with youth obesity. Continued monitoring of these policies seems to be warranted.

Overview and Summary: School Health Policies and Programs Study 2006

The School Health Policies and Programs Study (SHPPS) 2006 is the largest, most comprehensive assessment of school health programs in the United States ever conducted. The Centers for Disease Control and Prevention conducts SHPPS 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=538). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=1103) 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) and teachers of required physical education classes and courses (n=1194). SHPPS 2006 describes key school health policies and programs across all 8 school health program components: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community involvement. SHPPS 2006 also provides data to monitor 6 Healthy People 2010 objectives. SHPPS 2006 is a new and important resource for school and public health practitioners, scientists, advocates, policymakers, and all those who care about the health and safety of youth and their ability to succeed academically and socially.

Methods: School Health Policies and Programs Study 2006

The School Health Policies and Programs Study (SHPPS) 2006 examined 8 components of school health programs: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community involvement. All 8 components were assessed at the state, district, and school levels. Two components, health education and physical education and activity, also were assessed at the classroom level. 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=538). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=1103), with a nationally representative sample of teachers of required health education classes or courses (n=912), and with a nationally representative sample of teachers of required physical education classes or courses (n=1194). This article provides a detailed description of the development of the questionnaires; sampling; data collection; and data cleaning, weighting, and analysis. SHPPS 2006 is the largest and most comprehensive study of school health programs ever conducted. Fielding a study of this magnitude provides many challenges, and several recommendations for future studies emerged from the experience.

Healthy and Safe School Environment, Part II, Physical School Environment: Results From the School Health Policies and Programs Study 2006

As society continues to focus on the importance of academic achievement, the physical environment of schools should be addressed as 1 of the critical factors that influence academic outcomes. The School Health Policies and Programs Study (SHPPS) 2006 provides, for the first time, a comprehensive look at the extent to which schools have health-promoting physical school environment policies and programs. The Centers for Disease Control and Prevention conducts the SHPPS 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 and the District of Columbia and among a nationally representative sample of school districts (n=424). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=992). One third (35.4%) of districts and 51.4% of schools had an indoor air quality management program; 35.3% of districts had a school bus engine-idling reduction program; most districts and schools had a policy or plan for how to use, label, store, dispose of, and reduce the use of hazardous materials; 24.5% of states required districts or schools to follow an integrated pest management program; and 13.4% of districts had a policy to include green design when building new school buildings or renovating existing buildings. SHPPS 2006 results can guide education and health agency actions in developing and implementing evidence-based tools, policies, programs, and interventions to ensure a safe and healthy physical school environment.

Mental Health and Social Services: Results From the School Health Policies and Programs Study 2006

Schools are in a unique position not only to identify mental health problems among children and adolescents but also to provide links to appropriate services. This article describes the characteristics of school mental health and social services in the United States, including state- and district-level policies and school practices. The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study (SHPPS) 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 and the District of Columbia and among a nationally representative sample of school districts (n=445). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=873). Although states and districts generally had not adopted policies stating that schools will have mental health and social services staff, 77.9% of schools had at least a part-time counselor who provided services to students. Fewer schools had school psychologists or social workers. Consequently, counseling services were more common in schools than were psychological or social services. Few schools delivered mental health and social services through school-based health centers. Arrangements with providers not located on school property were more common. SHPPS 2006 reveals that linkages with the community need to continue and grow to meet the mental health needs of students. Efforts must be made to build systematic state agendas for school-based mental health, emphasizing a shared responsibility among families, schools, and other community systems.

Health Services: Results From the School Health Policies and Programs Study 2006

The specific health services provided to students at school and the model for delivering these services vary across districts and schools. This article describes the characteristics of school health services in the United States, including state- and district-level policies and school practices. The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study (SHPPS) 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=449). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=1029). Most US schools provided basic health services to students, but relatively few provided prevention services or more specialized health services. Although state- and district-level policies requiring school nurses or specifying maximum nurse-to-student ratios were relatively rare, 86.3% of schools had at least a part-time school nurse, and 52.4% of these schools, or 45.1% of all schools, had a nurse-to-student ratio of at least 1:750. SHPPS 2006 suggests that the breadth of school health services can and should be improved, but school districts need policy, legislative, and fiscal support to make this happen. Increasing the percentage of schools with sufficient school nurses is a critical step toward enabling schools to provide more services, but schools also need to enhance collaboration and linkages with community resources if schools are to be able to meet both the health and academic needs of students.

Applying the School Health Index to a Nationally Representative Sample of Schools

The School Health Index (SHI) is a self-assessment and planning tool that helps individual schools identify the strengths and weaknesses of their health policies and programs. To determine the percentage of US schools meeting the recommendations in the SHI, the present study analyzed data from the School Health Policies and Programs Study (SHPPS) 2000. The SHPPS 2000 data were collected through computer-assisted personal interviews with faculty and staff in a nationally representative sample of schools. The SHPPS 2000 questions were then matched to SHI items to calculate the percentage of schools meeting the recommendations in 4 areas: school health and safety policies and environment, health education, physical education and other physical activity programs, and nutrition services. Although schools nationwide are meeting a few SHI items in each of these areas, few schools are addressing the entire breadth of items. A more coordinated approach to school health would help schools reinforce health messages.

School-based opportunities for physical activity in West Virginia public schools

Background. Schools have the unique potential to provide numerous opportunities for promoting physical activity. This article describes findings from a statewide survey of opportunities for physical activity in West Virginia (WV) schools. The purpose was to provide baseline data for two of the WV Healthy People 2010 objectives related to schools and youth to identify priorities for action. Method. Survey questions were adapted from the 2000 School Health Policies and Programs Study (SHPPS), conducted by CDC. Random stratified sampling across school level and size resulted in a final sample of 296 elementary schools, 146 middle and junior high schools, and 124 high schools (total = 566). The overall response rate was 73%. Results. Eleven percent of elementary, 2% of middle or junior high, and 31% of senior high schools met the SHPP's criterion of providing daily physical education. Ninety-four percent of elementary schools reported offering daily recess. Overall, 42.3% of schools provided student and community access to indoor facilities outside of normal school hours, while 80.7% of schools provided access to outdoor facilities beyond normal school hours. Conclusions. Survey results are being used to target increased physical education in elementary schools and increased opportunities beyond physical education at all school levels.

The relationship between school health councils and school health policies and programs in US schools.

This study analyzed data from the School Health Policies and Programs Study (SHPPS) 2000 to examine the relationship between school health councils and selected school health policies and programs. SHPPS 2000 collected data from faculty and staff in a nationally representative sample of schools. About two-thirds (65.7%) of US schools have school health councils. Schools with councils were significantly more likely than schools without councils to report policies and programs related to health services, mental health and social services, faculty and staff health promotion, and family and community involvement. Schools with councils were as likely as schools without councils to report policies and programs related to health education, physical education, and food service. Although school health councils are associated with the presence of some key school health policies and programs, a council does not guarantee a school will have all important school health policies and programs in place.

Reliability and validity of the School Health Policies and Programs Study 2000 questionnaires.

To help assess the quality of the questionnaires developed for the School Health Policies and Programs Study (SHPPS) 2000, the Centers for Disease Control and Prevention (CDC) conducted a data quality substudy in conjunction with SHPPS 2000. The substudy assessed validity of the state- and district-level questionnaires through telephone interviews with a subsample of the original state- and district-level respondents, and the test-retest reliability of the school- and classroom-level questionnaires through computer-assisted repeat interviews with a subsample of the school- and classroom-level respondents. Results indicated that although a few threats to the validity of responses to the state- and district-level questionnaires were identified, the questionnaires generally produced valid data. Among the school- and classroom-level questionnaires, some questions demonstrated poor reliability, but most exhibited moderate or substantial reliability, and some exhibited almost perfect reliability. CDC will use these results to revise the SHPPS 2000 questionnaires and will consider alternative methods of data collection to improve the quality of data collected in future versions of SHPPS.

Voices from the field--a qualitative analysis of classroom, school, district, and state health education policies and programs.

This study provides a qualitative analysis of responses from classroom-, school-, district-, and state-level educators and administrators to open-ended questions about school health education. These questions were posed as part of the School Health Policies and Programs Study (SHPPS), conducted by the Centers for Disease Control and Prevention in 1994, and elicited a range of responses about the status of school health education programs and factors that facilitated and hindered the delivery of such programs. To improve school health education in the United States, respondents cited the need to increase the value and priority of health education in the school curriculum and advocated for 1) professional preparation in health education for persons teaching health-related courses, 2) health education course curricula to address important and timely issues, 3) student testing in health education, 4) improved resources and support for health education, and 5) increased communication and collaboration within their schools and communities related to health education.

The Florida School Violence Policies and Programs Study.

The Florida School Violence Policies and Programs Study (FSVPPS) assessed characteristics of violence prevention and control policies and education programs in Florida's 67 public school districts. Data were collected using the Florida School Violence Policies and Programs Questionnaire (FSVPPQ). Instruments used in the national School Health Policies and Programs Study (SHPPS) served as the framework for item development. A questionnaire designed to solicit information about violence policies and education programs was mailed to all 67 school districts in Florida during spring 1996. Sixty-seven key informants were selected by asking district office personnel to identify the person with primary responsibility for violence prevention activities in their district. Fifty-five school districts returned completed questionnaires, yielding a usable response rate of 82%. Respondents included personnel of superintendent rank, district administrators and directors, instructional specialists, principals, and "Safe & Drug Free Schools" coordinators. Participating school districts were evenly distributed geographically across Florida. The FSVPPS data reported in this paper include administrative and programmatic information about violence prevention education.

The School Health Policies and Programs Study (SHPPS): Rationale for a Nationwide Status Report on School Health Programs

The School Health Policies and Programs Study (SHPPS): Rationale for a Nationwide Status Report on School Health Programs

The School Health Policies and Programs Study (SHPPS): Context, Methods, General Findings, and Future Efforts

The School Health Policies and Programs Study (SHPPS): Context, Methods, General Findings, and Future Efforts