1. Has your school ever used the School Health Index or other self-assessment tool to assess your school’s policies, activities, and programs in the following areas?




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ITEM RATIONALE

2012 SCHOOL HEALTH PROFILES

SCHOOL PRINCIPAL QUESTIONNAIRE



QUESTION:

1. Has your school ever used the School Health Index or other self-assessment tool to assess your school’s policies, activities, and programs in the following areas?



RATIONALE:


This question assesses whether the school has conducted an assessment or diagnosis as a critical first step in improving implementation of policies, programs, or environmental strategies to effect change or improvement in school health.1 Studies confirm that the School Health Index helps bring health issues to the school’s attention, builds school commitment, identifies changes that do not require resources, encourages development of policy and action, raises awareness of federal policies, and helps schools set policies and standards that meet national health objectives.2-6


REFERENCES:


1. Goodman R, Steckler A, Kegler MC. Mobilizing organizations for health enhancement. In: Glantz K, Lewis FM, Rimer B. eds. Health Behavior and Health Education. San Francisco, CA: Jossey Bass Publishers, 1997, pp. 287-312.


2. Pearlman DN, Dowling E, Bayuk C, Cullinen K, Thacher AK. From concept to practice: using the School Health Index to create healthy school environments in Rhode Island elementary schools. Preventing Chronic Disease [serial online] 2005;2(Special Issue):A09.


3. Staten LK, Teufel-Shone NI, Steinfelt VE, et al. The School Health Index as an impetus for change. Preventing Chronic Disease [serial online] 2005;2(1):A19.


4. Austin SB, Fung T, Cohen-Bearak A, Wardle K, Cheung LWY. Facilitating change in school health: a qualitative study of schools’ experiences using the School Health Index. Preventing Chronic Disease [serial online] 2006;3(2):A35.


5. Sherwood-Puzzello CM, Miller M, Lohrmann D, Gregory P. Implementation of CDC's School Health Index in 3 midwest middle schools: motivation for change. Journal of School Health 2007;77:285-293.


6. Geiger BF, Petri CJ, Barber C. A university-school system partnership to assess the middle school health program. American Journal of Health Studies 2004;19(3):158-163.


QUESTION:


2. The Elementary and Secondary Education Act requires certain schools to have a written School Improvement Plan (SIP). Many states and school districts also require schools to have a written SIP. Does your school’s written SIP include objectives on any of the following topics?


3. As part of your school’s improvement planning process during the past year, did you review health and safety data such as Youth Risk Behavior Survey data or fitness data?


RATIONALE:


These questions address the relationship between school improvement planning and student health. Education reform efforts are linked to student health; healthy students are present in school and ready to learn, while poor health is a barrier to learning and a frequent cause of underachievement.1 In turn, academic success is an indicator of overall student well-being and a strong predictor of adult health outcomes.2-4 A number of national education organizations recognize the close relationship between health and education and the need to embed health into the educational environment for all students.5


REFERENCES:


1. McKenzie FD, Richmond JB. Linking Health and Learning: An Overview of Coordinated School Health Programs. In: Marx E, Wooley S, eds. Health Is Academic: A Guide to Coordinated School Health Programs. New York: Teachers College Press, 1998, pp. 1-14.


2. Grossman M, Kaestner R. Effects of education on health. In: Behrman JR, Stacey N, eds. The Social Benefits of Education. Ann Arbor: University of Michigan Press, 1997.


3. Harper S, Lynch J. Trends in socioeconomic inequalities in adult health behaviors among U.S. states, 1990–2004. Public Health Reports 2007;122(2):177–189.


4. Vernez G, Krop RA, Rydell CP. The public benefits of education. In: Closing the Education Gap: Benefits and Costs. Santa Monica, CA: RAND Corporation, 1999, pp.13–32.


5. Association for Supervision and Curriculum Development. The whole child and health and learning. ASCD Adopted Positions. 2004. Available at: www.ascd.org/news_media/ASCD_Policy_Positions/All_Adopted_Positions.aspx#whole_child. Accessed June 10, 2009.


QUESTION:


4. Currently, does someone at your school oversee or coordinate school health and safety programs and activities?


RATIONALE:


This question assesses whether the school has identified a person responsible for coordinating a school’s health program. It is critical to have one person appointed to oversee the school health program.1 This individual coordinates school health activities, leads a school health committee or team, and integrates community-based programs with school-based programs.2,3 Administration and management of school health programs requires devoted time, attention, training, and expertise.4,5


REFERENCES:


1. Institute of Medicine. Schools and Health: Our Nation’s Investment. Washington, DC: National Academy Press, 1997.


2. Fetro JV. Implementing Coordinated School Health Programs in Local Schools. In: Marx E, Wooley S, eds. Health Is Academic: A Guide to Coordinated School Health Programs. New York: Teachers College Press, 1998.


3. American Cancer Society. School Health Program Elements of Excellence: Helping Children to Grow Up Healthy and Able to Learn. Atlanta, GA: American Cancer Society, 2000.


4. National Association of State Boards of Education. Fit, Healthy, and Ready to Learn: A School Health Policy Guide. Washington, DC: NASBE, 2000.


5. American Cancer Society. Improving School Health: A Guide to the Role of School Health Coordinator. Atlanta, GA: American Cancer Society, 1999.


QUESTIONS:


5. Is there one or more than one group (e.g., a school health council, committee, or team) at your school that offers guidance on the development of policies or coordinates activities on health topics?


6. Are each of the following groups represented on any school health council, committee, or team?


RATIONALE:


These questions assess whether the school has a health committee or team and the composition of that team. The school health committee or team should represent a coalition of representatives from within and outside of the school community interested in improving the health of youth in schools.1,2 Participation on such committees or teams can empower others through increased awareness and knowledge of the school health program, increase the chance of ownership and commitment, activate channels of communication, and increase involvement in decision making.1-6 This includes parents and community members. Parent leaders help other parents understand and contribute ideas to issues and policies that affect the design and quality of school programs and opportunities for all children.5


REFERENCES:


1. National Association of State Boards of Education. Fit, Healthy, and Ready to Learn: A School Health Policy Guide. National Association of State Boards of Education. Washington, DC: NASBE, 2000.


2. Shirer K. Promoting Healthy Youth, Schools and Communities: A Guide to Community-School Health Councils. Atlanta, GA: American Cancer Society, 2003.


3. Fetro JV. Implementing Coordinated School Health Programs in Local Schools. In: Marx E, Wooley S, eds. Health Is Academic: A Guide to Coordinated School Health Programs. New York: Teachers College Press, 1998, pp. 15-42.


4. Green, LW, Kreuter MW. Health Promotion and Planning: An Education and Environmental Approach. California: Mayfield Publishing Company, 1991, pp. 271-274.


5. Redding S, Langdon J, Meyer J, Sheley P. The Effects of Comprehensive Parent Engagement on Student Learning Outcomes. Presentation at the Annual Convention of American Educational Research Association, San Diego, 2004.


6. Epstein LS. School, Family, and Community Partnerships: Preparing Educators and Improving Schools. Boulder, CO: Westview Press, 2001.


QUESTION:


7. During the past year, has any school health council, committee, or team at your school done any of the following activities?...Identified student health needs based on a review

of relevant data?... Recommended new or revised health and safety policies and activities to school administrators or the school improvement team?...Sought funding or leveraged resources to support health and safety priorities for students and staff?... Communicated the importance of health and safety policies and activities to district administrators, school administrators, parent-teacher groups, or community members?...Reviewed health-related curricula or instructional materials?


RATIONALE:


This question assesses the major responsibilities of a school health committee or team. A school health council, committee, or team should regularly assess progress of school health activities and assist school leaders with oversight, planning, evaluation, and periodic revision of school health efforts.1-4 Such a team can address major health issues facing students, coordinate activities and resources, coordinate funding, support school health staff, and seek active involvement of students, families and the community in designing and implementing strategies to improve school health.2-6


REFERENCES:


1. National Association of State Boards of Education. Fit, Healthy, and Ready to Learn: A School Health Policy Guide. National Association of State Boards of Education. Washington, DC: NASBE, 2000.


2. Shirer, K. Promoting Healthy Youth, Schools, and Communities: A Guide to Community-School Health Councils. Atlanta, GA: American Cancer Society, 2003.


3. Taras H, Duncan P, Luckenbill D, Robinson J, Wheeler L, Wooley S. Health, Mental Health and Safety Guidelines for Schools, 2004. Available at: www.schoolhealth.org. Accessed June 23, 2011.


4. Fetro JV. Implementing Coordinated School health Programs in Local Schools. In: Marx E, Wooley S, editors. Health Is Academic: A Guide to Coordinated School Health Programs. New York: Teachers College Press; 1998:15-43.


5. Institute of Medicine. Schools and Health: Our Nation’s Investment. Washington, DC: National Academy Press, 1997.


6. Olsen L, Allensworth D. Health Education, School. Encyclopedia of Education. 2002. Available at: www.encyclopedia.com/doc/1G2-3403200284.html. Accessed June 23, 2011.


7. North Carolina Department of Public Instruction. Effective School Health Advisory Councils: Moving from Policy to Action. Raleigh, NC: North Carolina Department of Public Instruction, 2003.


QUESTION:


8. Has your school adopted a policy that addresses each of the following issues on human immunodeficiency virus (HIV) infection or AIDS?


RATIONALE:


This question assesses important components of school policies in place to address students and staff infected with HIV or AIDS. Students and staff infected with HIV or AIDS need policies protecting their rights.1


REFERENCE:


1. National Association of State Boards of Education. Someone at school has AIDS: a complete guide to education policies concerning HIV infection. Alexandria, VA: National Association of State Boards of Education, 2001. Available at: www.nasbe.org/index.php/component/content/article/78-model-policies/120-policies-concerning-students-and-staff-with-hiv-infection. Accessed June 11, 2009.


QUESTION:


9. Are any school staff required to receive professional development (e.g., workshops, conferences, continuing education, or any other kind of in-service) on HIV, STD, or pregnancy prevention issues and resources for the following groups?


RATIONALE:


This question assesses professional development requirements for school staff on HIV, STD, and pregnancy prevention, specifically for youth at high risk. Professional development has been described as a key component of effective prevention, since it creates opportunities for educators to learn about new developments in the field and innovative teaching techniques and to exchange ideas with colleagues.1-2 Providing proper training and materials help ensure that effective programs also achieve the desired outcome.3 In addition, when educators are trained to implement materials with fidelity to the original model, it is more likely that results can be replicated as well.4


Other components of effective programs include appropriateness for the age, sexual experience, gender, and culture of the youth.4 High risk youth include racial/ethnic minorities and those who participate in drop-out prevention, alternative education, or GED programs. Studies show that racial/ethnic minority students are more likely than white students to engage in sexual risk behaviors that can lead to HIV, STDs, and unintended pregnancy. For example, black and Hispanic/Latino students are more likely than white counterparts to have ever had sexual intercourse, to have had sexual intercourse before age 13 years, and to have had sexual intercourse with 4 or more persons during their life. Black students are also more likely to be currently sexually active (i.e., had sexual intercourse with 1 or more persons during the 3 months preceding the survey) than white or Hispanic students.5 Other studies have shown that American Indians are at increased risk as well.6 The prevalence of these same sexual risk behaviors is higher among alternative high school students than among all high school students nationally, based on comparable estimates from the 1998 national Alternative High School Youth Risk Behavior Survey (ALT-YRBS) and 1997 Youth Risk Behavior Survey (YRBS).7


REFERENCES:


1. Nation M, Crusto C, Wandersman A, et al. What works in prevention: principles of effective prevention programs. American Psychologist 2003;58(6-7):449-456.


2. Institute of Medicine. Schools and Health: Our Nation’s Investment. Washington, DC: National Academy Press, 1997.


3. National Campaign to Prevent Teen and Unplanned Pregnancy. Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases. 2007. Available at: www.thenationalcampaign.org/EA2007/

EA2007_full.pdf. Accessed June 1, 2011


4. Kirby D, Laris BA, Rolleri L. Sex and HIV education programs for youth: Their impact and important characteristics. Washington DC: Family Health International, 2006.


5. Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2009. MMWR 2010;59(SS-5):1–148.


6. Rutman S, Park A, Castor M, Taualii M, Forquera R. Urban American Indian and Alaska Native Youth: Youth Risk Behavior Survey 1997-2003. Maternal and Child Health Journal. 2008;12:S76-S81.


7. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance – National Alternative High School Youth Risk Behavior Survey, United States, 1998. MMWR 1999;48(SS-7):1-44.


QUESTION:


10. Does your school have a student-led club that aims to create a safe, welcoming, and accepting school environment for all youth, regardless of sexual orientation or gender identity? These clubs are sometimes called gay/straight alliances.


11. Does your school engage in each of the following practices related to lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth?


RATIONALE:


These questions assess whether the school implements activities and policies that are designed to create a safe and supportive school environment for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Research shows that sexual minority youth are more likely than their heterosexual peers to be threatened or injured with a weapon on school property and to skip school because they felt unsafe.1 In 2009, almost 85% of LGBT students reported that they were verbally harassed at school during the past year because of their sexual orientation, while 40% were physically harassed at school, and 19% were physically assaulted at school.2 Sexual minority youth who experience victimization at school are at a greater risk of attempting suicide than those who do not.1 Gay/straight alliances or similar clubs are associated with greater safety for sexual minority youth. Sexual minority youth who attend schools with such a club are less likely than sexual minority youth who attend other schools to report dating violence, being threatened or injured with a weapon on school property, and skipping school because they felt unsafe.1 In addition, sexual minority youth who attend schools with gay/straight alliances or similar clubs, those who attend schools with an anti-bullying policy, and those who feel that there is a school staff member who could be approached about a problem have a lower risk of suicidality than those who attend schools without these respective supports available.1 The importance of improving the health, safety, and well-being of LGBT youth is underscored by the addition of goals related to LGBT health in Healthy People 2020,3 such as increasing access to supportive health and social services for LGBT youth and increasing the proportion of middle and high schools that prohibit harassment based on a student’s sexual orientation or gender identity.

REFERENCES

  1. Goodenow C, Szalacha L, Westheimer K. School support groups, other school factors, and the safety of sexual minority adolescents. Psychology in the Schools 2006;45(3):573-589.



  1. Kosciw JG, Greytak EA, Diaz EM, Bartkiewicz MJ. The 2009 National School Climate Survey: The Experiences of Lesbian, Gay, Bisexual and Transgender Youth in Our Nation’s Schools. New York: Gay, Lesbian Straight Education Network; 2010. Available at: www.glsen.org/binary-data/GLSEN_ATTACHMENTS/file/000/001/1675-5.PDF. Accessed February 18, 2011.



  1. U.S. Department of Health and Human Services. Healthy People 2020. Washington, DC: U.S. Department of Health and Human Services, 2010. Available at: www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25. Accessed February 18, 2011.



QUESTIONS:


12. Is physical education required for students in any of grades 6 through 12 in your school?


13. Is a required physical education course taught in each of the following grades in your school?


RATIONALE:


These questions measure the extent to which physical education is required for students in grades 6 through 12. Physical education provides students with the knowledge, attitudes, skills, behaviors, and confidence to adopt and maintain physically active lifestyles.1-3 The importance of physical education in promoting the health of young people is supported by Healthy People 2020 Objectives PA-4 and PA-5.4


REFERENCES:


1. National Association for Sport and Physical Education. Moving into the Future: National standards for physical education. 2nd ed. Reston, VA: National Association for Sport and Physical Education, 2004.


2. Lee SM, Burgeson CR, Fulton JE, Spain CG. Physical education and activity: results from the School Health Policies and Programs Study 2006. Journal of School Health 2007;77(8):435-463.


3. National Association for Sport and Physical Education. Physical education is critical to a complete education. Reston, VA: National Association for Sport and Physical Education, 2001.


4. U.S. Department of Health and Human Services. Healthy People 2020. Washington, DC: U.S. Department of Health and Human Services, 2010. Available at: www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=33. Accessed June 22, 2011.


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