Key System Capacities in School Health Promotion

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Key System Capacitiesin School Health Promotion

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Purposes

• This presentation will present
• an explanation of the evidence, capacity and
  coordinator concepts underlying the approach
  being used by the Joint School Health Consortium
  and being investigated by the School Health
  Research network
• These concepts include ecological and
  systems-based framework that builds on population
  health and comprehensive school health
  approaches.

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The Reality of the School Environment
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School Interventions The Promise

• Several reviews conclude that school health
  programs hold promise of impact
• School Health programs can save money
• We need longer, controlled and other types of
  studies but the evidence is promising

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School Health Programs The Promising Practices

• Almost all reviews and studies suggest
  comprehensive and holistic approaches
• Aimed at the whole child, using the whole school,
  linked with the home and the community linking
  the school with agencies, over several school
  years, include environmental changes (cafeterias,
  physical education classes, lunch and recess
  interventions etc)

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School Interventions The Limits

• First, schools are primarily educational, not
  health institutions
• Scant evidence on life-long impact of
  comprehensive school health interventions (the
  intervention and the research is expensive)
• Most initiatives are not sustained (single issue,
  single person/agency, crisis response etc)
• We dont know how to coordinate over the long
  term, only in a crisis or with external funding
• We expect system change to come from the bottom
  up or without sustained support

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A Systems Analysis Approach

• Recognize the layers (24 steps from national to
  school)
• Openness to other competing influences
• Loosely coupled systems are not managed well by
  directives, they require persuasion and there is
  little formal coupling between the systems
• Professional bureaucracies with middle managers
  protecting system boundaries
• With professionals who will not adopt change
  until it addresses their practical and personal
  concerns and until they truly share the vision
  gained the required specific knowledge and skills

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Build Capacity, Assign Coordinators

• WHO assessment tool, other research and analysis
  of national plans suggests these organizational
  capacities
• Coordinated policy/policy on coordination
• Assigned staff and infrastructure
• Formal and informal mechanisms for cooperation
• Knowledge transfer, translation, promising
  practices
• On-going work force development (pre and
  in-service)
• Strategic, coordinated issue management
• Ongoing surveys of health, periodic surveys of
  programs

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Concluding Thoughts

• Promising Evidence that Coordinated Interventions
  can address complex school environment
• Examples, studies from Canada and other
  countries, notably England, show that assigning
  coordinators can work and show results.