Title: Comprehensive School Health Model: An Integrated School Health Education and Physical Education Program
1Comprehensive School Health Model An Integrated
School Health Education and Physical Education
Program
- Jingzhen Yang, PhD, MPH
- College of Public Health
- The University of Iowa
- June 24, 2006
- jingzhen-yang_at_uiowa.edu
2Outline
- Trends, Challenges and Opportunities
- Behavior Factors and Behavior Relations
- Evolution of USA School Health Program
- Summary
3The University of Iowa
4The University of Iowa
- a major national research university
- composed of 11 colleges
- more than 29,000 students enroll each year.
(undergraduate 20,300 and graduate 5,412) - 1,700 faculty numbers and 13,000 staff
- Big Ten sports (12 varsity teams for women and 10
for men)
5Trends, Challenges and Opportunities
- Q What is the first
- thing that comes to
- mind when you
- hear words the
- Health Education?
6Goal of Health Education
- To provide the individual with the information,
skill, and motivation necessary to make
INTELLIGENT DECISIONS concerning lifestyle and
personal health behavior. - In any case, health education is working to
promote health, prevent disease, disability, and
premature death.
7Trends
- In the early 1900s
- The major causes of morbidity and mortality were
infectious diseases. - Many major health threats were diseases
associated with poor hygiene, poor sanitation,
poor nutrition, or poor maternal and infant
health (CDC, 1999). - Today
- The major health problems are caused, in large
part, by behaviors established during youth
(Kolbe, 1993).
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10Nine Leading Behavioral Causes of Death
- 1. Tobacco
- 2. Diet and activity patterns
- 3. Alcohol
- 4. Microbial agents
- 5. Toxic agents
- 6. Sexual behavior
- 7. Firearms
- 8. Motor vehicles
- 9. Drug use
- Source Adapted from McGinnis, J. M., and Foege,
W. H. (1993).
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12Obesity Trends Among U.S. AdultsBRFSS, 1991,
1996, 2004
(BMI ?30, or about 30 lbs overweight for 54
person)
1996
2004
No Data lt10 1014
1519 2024 25
13Obesity Trends Among U.S. AdultsBRFSS, 2004
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
14Challenges
- Given that behaviors are often the actual causes
of death, a reduction in the number of deaths
caused by many diseases lies not in finding cures
for them but in changing the behaviors that lead
to them in the first place.
15An ounce of prevention is worth a pound of cure
- Prevention is more important than treatment in
general. - A lot of people often neglect to maintain their
health when they are young. Consequently, many
preventable health problems are not prevented. - This is especially true with most chronic
diseases that have been traced as a result of
various unhealthy behaviors.
16Prevention is a cost effective strategy
- As many as 50 to 80 of deaths caused by
cardiovascular disease, strokes, and cancer could
be avoided or delayed by preventive measures. - Eliminating smoking could prevent more than
300,000 deaths each year. - No amount of money could possibly compensate for
those lives, nor buy peoples health.
17Knowledge, attitudes and behaviors
- High-quality health knowledge could lead to
high-quality health decision-making. - Having knowledge about prevention does not
guarantee that a person will establish a positive
attitude toward disease prevention, or practice
healthy behaviors. - Altering one's attitude and behavior often
requires special efforts involving education,
manpower, sound strategies, and ultimately, time.
- Education that aims at one's behavior change
cannot be a onetime snapshot.
18Opportunity
- In the United States, every single school day,
about 52 million students attend more than
100,000 schools. - Schools have the potential to improve the health
of young people by providing instruction,
programs, and services that promote a healthy
lifestyle for students. - Schools are an efficient vehicle for providing
health instruction and programs because they
reach most children and adolescents. - (Hales, 1999)
19The good news for school health education is
- Health education is now recognized as being
important as it is one of few curriculum areas
that emphasize the individual instead of the
subject matter or academic skills. - The health information and skills students learn
are not prerequisites for another course, but are
immediately applicable to life. - (Lohrmann, Gold, Jubb, 1987).
20Health education in today's schools
- has many advantages it never had before.
- no longer just a classroom lecture or physical
education. - more informative, student centered, demonstrative
in scope, sequence, progression and continuity. - designed to develop students critical thinking
and individual responsibility for ones health. - (Collins et al., 1995)
21Dimensions of Health
- Physical Health
- Psychological Health
- Social Health
- Spiritual Health
- Environmental Health
22Determinants of individual health
23BEHAVIOR FACTORS AND BEHAVIOR RELATIONS
- Q List the external
- factors that can and
- often affect peoples
- lives
24BEHAVIOR FACTORS AND BEHAVIOR RELATIONS
- Q List the Behaviors
- that can and often
- affect peoples
- health
25Factors that shape positive behaviors
- Predisposing factors - knowledge, attitudes,
beliefs, values, and perceptions. - Enabling factors - skills, resources, accessible
facilities, and physical and mental capacities. - Reinforcing factors - praise from family and
friends, rewards from teachers or parents, or
encouragement and recognition for meeting a goal.
26- One positive action taken would likely lead to
another positive action and the next negative
health related action would beget a negative
action. - The gateway drug effect
27Distribution of Students by Sports Participation
and Cigarette Smoking
Do you take part in any varsity sports? Do you take part in any varsity sports? Do you take part in any varsity sports?
Do you smoke cigarettes? Yes No
Do you smoke cigarettes? Yes 253 1,035
Do you smoke cigarettes? No 2,234 4,497
Chi-square444.9 (plt.01
28Smoking Habits and Health Practices
Health Practice Never () Former () Current ()
Never eats breakfast 18.3 19.0 37.6
Heavy drinker 7.2 11.9 20.1
Sleep 6 hours or less 20.9 20.0 25.3
Less physically active 17.3 18.1 21.8
29EVOLUTION OF SCHOOL HEALTH PROGRAM
30History of school health education
- 1850-1880, period of recognition--people start to
recognize that school could be used to
educate/screen for disease and solve health
problems. - 1880-1920, period of exploration--childrens
health problems were emphasized and funded
studies were done to document these health
problems. - In 1910, the American Physical Education was
renamed American School Hygiene and Physical
Education. - In 1927, the American School Health Association
was founded. - Since the 1980s, more sophisticated school health
education programs were developed, which offers
students not only the opportunity for improved
health status, but also to achieve a life-style
that would lead to a satisfying and productive
life. - (Porter, 1987)
31Historical School Health Model
- From the late 1880s until the late 1990s, school
health programs were conceived as having three
components health education, health services,
and healthy school environment (Figure 3), which
still serve as a base for the school health
education program today.
32Historical School Health Model
33Comprehensive School Health Program (CSHP)
- In 1987, Allensworth and Kolbe (1987) proposed a
model, the Comprehensive School Health Program
(CSHP), which extended the classic triad of
health education, health services, and healthy
school environment to include physical education,
counseling and psychological services, nutrition
services, health promotion for staff, and
parent/community involvement interactive
components (Figure 4). Which is broadly adopted
in the United States and internationally.
34Comprehensive School Health Program (CSHP)
35Comprehensive School Health Program (CSHP)
- The CSHP model requires systematic coordination
among eight components to magnify the benefits
available in each component. - Collaborative efforts among families, health care
workers, the media, religious organizations, and
community organizations must be involved to
maintain the well being of young people. - The glue that could cement each component is
health education, for it is the major source of
the one element common to all components---health
knowledge.
36School Health Coordinator (SHC)
- In 1996, Resnicow and Allensworth proposed a
model--the School Health Coordinator (SHC, see
Figure 5), which is revised from CSHP. The main
feature of SHC is that it set up the school
health coordinator component, an essential and
unifying element, into the model. The major
function of the SHC component is the
coordination.
37School Health Coordinator (SHC)
38Health Education
- School health education is a planned, and
sequential health instruction for grades 1
through 12, which addresses the physical, mental,
emotional, social, spiritual, and environmental
dimensions of health. - It integrates education as a range of categorical
health problems and issues at developmentally
appropriate ages. - The school health education curriculum should
focus on not only improving students knowledge,
but also emphasizing the development of
appropriate skills and positive attitudes toward
health and healthy lifestyles (Koble, Kann
Collins, 1995).
39The school health education curriculum
- Personal hygiene
- Prevention and control of diseases (infectious
and chronic) - Injury prevention and safety
- Nutrition
- Tobacco prevention
- Relationships, sexuality and family planning
- Physically active lifestyles
- Mental and emotional health
- Environmental health
- Positive attitudes toward meaningful life and
living
40The school health education curriculum
- The school health education curriculum should
have the flexibility to incorporate local or
regional health problems as needed. - Health instruction should be implemented by
qualified, academically trained teachers and
certified health educators. - To have a dynamic curriculum, it is important to
have the programs evaluated by regional
government and school administrators so that it
could be routinely revised and improved.
41Physical Education
- School physical education is a planned,
sequential grades 1 through 12 curriculum which
provides cognitive content and learning
experiences in a variety of activity areas such
as basic movement skills, physical fitness,
rhythms and dance, games, team, dual, and
individual sports, tumbling and gymnastics, and
aquatics. - School physical education should also promote
enjoyable, lifelong physical activity and improve
the physical and social environments that
encourage and enable physical activity. - (Pate et al., 1995 CDC, 1997).
42Nutrition Services
- Cooperating with health educators, the nutrition
staff serving the school should take the
opportunity to promote a healthy diet among
students. - The ultimate purpose of nutrition services is to
promote health by emphasizing a balanced and
adequate eating habit. - Nutrition services should provide student access
to a variety of nutritious and appealing meals
that accommodate the health and nutrition needs
of all students.
43School health services
- School health services should be staffed by
qualified professionals including physicians,
nurses, dentists, health educators and
pharmacists. - These health professionals should have experience
and expertise in the areas of school health and
school aged children. - These services should ensure access and /or
referral to health care services. It should also
focus on prevention and controlling communicable
diseases as well as emergency care for illness or
injury.
44Healthy School Environment
- A healthy school environment includes the
physical surroundings, psychosocial climate, and
culture of the school. - Schools should provide a physical environment
free from biological or chemical agents that are
detrimental to health. - School administrators should provide and promote
a positive and healthy environment where students
feel safe and happy. - Schools should encourage school staff to pursue a
healthy lifestyle that contributes to the
school's overall coordinated health programs and
create positive role modeling for students.
45Parent/Community/Staff Involvement
- Parents, community leaders and teachers often can
and do serve as role models for students. - Students serve as a linkage with school and
family while parents can and should cooperate
with schools to help their children. - The school health program could impact parents
knowledge, attitudes and practice regarding
healthy lifestyles. - Through newsletters, correspondences, meetings
and volunteering, schools and parents
cooperatively, and collaboratively can and should
significantly impact the health and well being of
students.
46SUMMARY
- Unhealthy behaviors of adults are usually sewn
during their childhood. - There is no place better than schools to provide
health knowledge and skills. - School health education has been a major part of
the educational force in promoting healthy
lifestyles. - School health education has advanced from
providing pure classroom lectures of anatomy and
physiology to implementing comprehensive school
health programs. - The most effective school health education
programs are those following comprehensive school
health program models, theory informed,
sequentially designed from k to 12th grade, and
with family and community involvement.
47SUMMARY
- The successful development and implementation of
comprehensive school health programs and health
education theories and models in the USA provide
a sample profile for health education in China. - The experiences that American health educators
have accumulated over time, as well as the
lessons they learned from their practices and
research, could be an invaluable resource to
Chinese health educators.
48Thank You!
Questions?Comments?