Committment to School Health

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Committment to School Health

• Why Coordinated School Health
• What is Coordinated School Health
• Two-Pronged Approach How
• Health Is Academic Initiatives and Successes
• Research MS Center for Health Policy
• Policy Development
• Media Plan

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Coordinated School Health

• WHY

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Trends in Overweight Prevalence
Source Centers for Disease Control. National
Center for Health Statistics. Prevalence of
Overweight among Children and Adolescents United
States, 2003-2004.
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Why Be Concerned about Overweight Children?

• Overweight children are at risk for early
  development of chronic disease, leading to
  disability and premature death.
• Overweight children miss more school days and
  demonstrate lower academic performance.
• Parents of overweight children often do not
  recognize that their child is overweight.

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Overweight Children Often Become Overweight Adults

• Childhood obesity is a significant predictor of
  coronary heart disease in adulthood.
• Overweight adolescents have a 70 chance of
  becoming overweight or obese adults.
• Overweight and obese individuals are at increased
  risk for type 2 diabetes, heart disease,
  hypertension, osteoarthritis, sleep apnea,
  gallbladder disease, respiratory problems,
  stroke, endometrial cancer, breast cancer, colon
  cancer, prostate cancer, depression, and other
  conditions.
• Obesity accounts for a substantial part of
  increased disability in adults and is expected to
  result in an increase of 10 25 in the nursing
  home population by 2020.

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Mississippis Problem is Worse

• Mississippi has high rates of disease,
  disability, and death
• Premature death
• SSI beneficiaries, overall disability
• Heart disease, diabetes, hypertension, stroke
• Mississippi has the highest rate of adult
  obesity.

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Percentage of Obesity (BMI gt 30) in U.S. Adults
Source Centers for Disease Control. Behavioral
Risk Factor Surveillance System (BRFSS).
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
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Percentage of Obesity (BMI gt 30) in U.S. Adults
Source Centers for Disease Control. Behavioral
Risk Factor Surveillance System (BRFSS).
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Obesity Affects the Bottom Line

• Obesity accounts for approximately 9.1 of total
  annual medical expenditures.
• The estimated annual health care cost attributed
  to adult obesity (in 2003 dollars) in Mississippi
  is 757 million, of which 223 million is cost to
  Medicare and 221 million is cost to Medicaid.
• Approximately 8 of private employer medical
  claims are due to overweight and obesity.
• About 27 of the increase in medical costs from
  1987 to 2001 was due to obesity.

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Its Worse Than We Thought

• The percentage of children found to be overweight
  is higher when data are collected through
  measured heights and weights than through
  self-reports.

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Self-Report vs. Measurement
Source Kolbo JR, Penman AD, Meyer MK, Speed NM,
Molaison EF, Zhang L. Prevalence of overweight
among elementary and middle school students in
Mississippi compared with prevalence data from
the Youth Risk Behavior Surveillance System.
Prevention of Chronic Disease
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Why?

• If schools do not deal
• with childrens health
• by design, they deal
• with it by default.
• Health is Academic, 1997

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Coordinated School Health

• WHAT

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Strategic Initiatives to Address Childhood Obesity

• Two-pronged approach
• Infrastructure
• State level
• Local level
• Policy
• Legislative branch
• Executive branch

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CDC Fundamental Principles(aka why schools?)

• Establishing healthy behaviors during childhood
  is easier and more effective than trying to
  change unhealthy behaviors in adults.
• Schools have a critical role to play in promoting
  the health and safety of young people.
• Schools are an opportunity to reach children.
• Schools provide an opportunity to practice
  healthy behaviors such as healthy eating and
  physical activity.
• Studies have shown that school health program can
  reduce health risk behaviors among young people
  and positively impact on students academic
  performance.

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Coordinated School Health Program
Physical Education
Health Education
Family and Community Involvement
Health Services
Health Promotion for Staff
Nutrition Services
Healthy School Environment
Counseling, Psychological Services
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Health Education

• Reading and math scores of third and fourth
  grade students who received comprehensive health
  education were significantly higher than those
  who did not receive comprehensive health
  education
• Schoener, Guerrero, and Whitney, 1988

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Physical Education

• Intensive physical activity programs for
  students led to an improvement in students
  scores in mathematics, reading, and writing and
  to a reduction in disruptive behaviors in the
  classroom. Sallis,
  1999

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Fitness and Academic Performance
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Fitness and Academic Performance
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Fitness and Academic Performance
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Health Services

• Early childhood and school aged intervention
  programs that provide parental support and health
  services are associated with improved school
  performance and academic achievement.
• Early intervention may also improve high school
  completion rates and lower juvenile crime.
• Reynolds, Temple, Robertson, and Mann, 2001

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Healthy School Environment

• The physical condition of a school is
  statistically related to student academic
  achievement.
• An improvement in the schools condition by one
  category, say from poor to fair, is associated
  with a 5.5 point improvement in average
  achievement scores.
• Berner, 1993

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Health Promotion for Staff

• Teachers who participated in a health promotion
  program focusing on exercise, stress management,
  and nutrition reported
• Increased participation in exercise and lower
  weight
• Better ability to handle job stress
• A higher level of general well-being
• Blair, Collingwood, Reynolds,
• Smith, Hagan and Sterling, 1984

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Family/Community Involvement

• Community activities that link to the
  classroom
• Positively impact academic achievement
• Reduce school suspension rates
• Improve school-related behaviors
• Nettles, 1991
• Allen, Philliber, Herring,
• and Kupermine, 1997

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MONEY MONEY MONEY(2004-2005)

• Statewide Enrollment 494,590
• ADA Statewide 472,577
• Statewide Attendance 95
• 4,193 per student based on fully funded MAEP
  (2004-2005)
• Statewide schools leaving 92,300,509 on table
  (not taking into consideration local
  contribution)

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Measurable Cost to Schools(Example)

• School District 3,000 Students
• Each 1 attendance improvement
• 125,790

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Maslows Hierarchy
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Coordinated School Health

• HOW

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Uncoordinated System
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MUST HAVE

• Commitment from leadership of the Department of
  Education
• Coordinated infrastructure/resources in the
  Department of Education

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Office of Healthy Schools
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School Health Nucleus
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Focused and Incremental Approach to Coordinated
School Health
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Strategic and Systematic Approach
Policy Level
Implementation Level
Grass Roots Level
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Office of Healthy Schools Process

• Lessons learned from funded CSHP states
• Assessed capacities of all offices in OHS
• SWOT Analysis
• Worked with CDC to develop SCHP Logic Model

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Office of Healthy Schools Process

• Stakeholders meeting Wellness Guide
• MS Dept of Health
• MS Dept of Human Services
• MS Dept of Finance and Administration
• MS Division of Medicaid
• Cancer Society
• American Lung Association
• MASS, MASA, MPE, MAE, MASB, MASBO
• UMC
• MSU Extension Service

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Office of Healthy Schools Process

• IHL
• School Food Nutrition Association
• MS School Nurses Association
• MS Nurses Association
• MAHPERD
• MASH
• Legislators
• MDE Board and Leadership Education

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Build Success and Momentum
Knowledge of School Health
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Initiatives
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Get the Word Out

• MS Association School Superintendents
• MS Dietetic Association
• School Psychologist
• MS Association of School Administrators
• Special Education Discipline Training
• Teacher Renewal Institute
• Effective Classroom Regional Training
• School Convocations

• MS Academy of Pediatrics
• MS Elementary Principals Association
• Video Streaming Educators Statewide
• MS Professional Educators Workshop
• MS Counseling Association
• Minority Administrators
• TRAIN

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Health is Academic2007 Presentations

• 130 venues (national, state and local
  conferences, training and school convocations)
• 9,165 teachers, students, principals,
  superintendents, parents, school nurses, federal
  and state agency staff
• 12 of 12 monthly MS Board of Education Meetings

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• Coming together is a beginning
  keeping together is progress
  working together is success.
• Henry Ford

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• School Success Stories

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Amory School District

• Amory Middle School adopted a policy that allows
  students to drink water in the classroom - so
  they are properly hydrated and ready to learn.

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Columbus School District

• All schools have completely removed
  deep fryers as part of
  their overall commitment toward healthier
  food preparation.

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Brookhaven School District

• Alexander Junior High offers intramural
  basketball and volleyball, as well as walking,
  aerobics, and dance activities before school
  each day.

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Grenada School District

• Grenada Middle School began a morning exercise
  routine via school-wide telecasting - with
  students standing beside their desks in
  classrooms.

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Gulfport School District

• Pass Road Elementary students have daily
  FANtastic Movement Moments - 5 minutes of
  physical activity to help them be more alert and
  able to focus in class.

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DeSoto County Schools

• Hernando Elementary introduced a snack program
  where apples, oranges, and bananas are
  sold to students for just 25 cents.

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DeSoto County Schools

• Shadow Oaks Elementary offers 30 minutes of
  physical activity for every student - with
  special recognition for those who walk with
  principal at recess.

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Petal School District

• W.L. Smith Elementary teachers worked with
  students to set personal goals for a healthier
  lifestyle - and helped them monitor their weekly
  progress.

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Clarksdale School District

• Schools now have Physical Education
  teachers to provide PE classes for all students.

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East Tallahatchie School District

• Charleston Elementary
• Fifteen minutes of Nutrition Education was
  devoted to the Monthly PTO meetings

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Jackson Public School District

• Van Winkle Elementary
• Students met with the Food Service Director to
  make suggestions on healthy choices for the
  school lunch program.

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Pearl Public School District

• Pearl Upper Elementary
• Student council members will be trained to teach
  peers the importance of breakfast and nutritious
  snack choices.

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MS School for the Blind

• Adjusted class schedules for students to
  participate in physical activity before lunch.
  Also implemented a water hydration policy.

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Ocean Springs School District

• N. E. Taconi Elem.
• The SHC purchased posters depicting a healthy
  lifestyle and proper nutrition. These were
  posted in the school cafeteria.

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• Never doubt that a small group of committed
  people can change the world. Indeed, it is the
  only thing that ever has.
• Margaret Mead

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It Keeps Getting Worse
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Source Kolbo JR, Penman AD, Meyer MK, Speed NM,
Molaison EF, Zhang L. Prevalence of overweight
among elementary and middle school students in
Mississippi compared with prevalence data from
the Youth Risk Behavior Surveillance System.
Prevention of Chronic Disease
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It Starts Early in Life
Source Jerome R. Kolbo, PhD, ACSW School of
Social Work, College of Health, University of
Southern Mississippi.
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Timely and Relevant Research
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Lessons from Research

• There is a direct relationship between
  consumption of sugar-sweetened beverages and
  junk foods and the body-mass index of
  adolescents.
• Regular physical activity in childhood and
  adolescence improves
• Strength and endurance
• Weight control
• Anxiety and stress
• Self-esteem
• Blood pressure and cholesterol
• Academic performance

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• School Health
• Policy
• Development

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Center for Mississippi Health Policy

• Independent funded by the Bower Foundation
• Non-profit
• Modeled after similar centers in Kansas, Ohio,
  Colorado, and Texas
• Emphasis on the translation and application of
  research to relevant health policy issues

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Communicating Research to Policymakers

• Information must be relevant to current policy
  debates.
• Policy makers have varying information needs.
• Information should be layered (e.g. issue brief
  accompanied by a full report).
• Trusted sources are independent and dont have a
  stake in the outcome.

Source Sorian, R. Baugh, T. Power of
information closing the gap between research and
policy. Health Affairs, March/April 2002, 21(2)
264-273.
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C4MHPs Role

• Summarize Research for Policymakers
• Data on childhood obesity
• Best practices
• Policies and programs in other states
• Legislation in other states
• Public opinion survey with local perspective
  What Do Mississippians Think About Childhood
  Obesity?

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C4MHP Role

• Build trust with key policymakers
• Best done through personal contact
• Attend committee meetings
• Respond to requests for information
• Maintain objectivity
• Identify significant persistent and emerging
  health policy issues
• Provide information and analysis needed to inform
  decision-making

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C4MHPs Role

• Communication
• Issue Brief What Do Mississippians Think About
  Childhood Obesity?
• Distributed to all legislators through a
  champion in each chamber
• Presentations
• Legislative committees and subcommittees
• State Board of Education
• School superintendents

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C4MHPs Role

• More communication
• Tracked legislation
• Maintained updates on web site (3rd most popular
  topic)
• Technical Assistance
• Provided legislative staff with statutes and
  policies from other states
• Responded to requests for information from
  legislators and state staff

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Kansas Health Institutes Illustration of
theProject Development Process
Answer important questions being
asked by policymakers now
Help policymakers ask better questions over time
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Example Childhood Obesity

• Policymakers demonstrated readiness
• The issue had local champions
• Other states had shown success
• The issue was gaining national attention
• Key questions being asked
• How is the issue affecting the state?
• What are other states doing?
• What can we do?

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SUCCESS Public School Accountability Standards

• Health and Physical Education required part of
  basic curriculum k-8
• School Health Councils required of all schools in
  state
• Wellness Policies required of all schools Nov.
  2006

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SUCCESS MDE Board Passes Vending Regulations
Oct. 20, 2006

• As of 2007-2008 all full caloried, sugar
  carbonated soft drinks can not be sold
• As of 2008-2009 bottled water, lowfat and nonfat
  milk, 100 juice, no/low calorie beverages and
  light juices or sports drinks may be sold
• Nutritional standards set for snack vending
• Requirements vary for grade level

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SUCCESS Legislation Passes

• MS Healthy Students Act
• Senate Bill 2369
• Mandates 2008 -2009 school year
• for grades k-8
• 150 min/week of PE
• 45 min/week of HE
• Requires MDE to regulate statewide improvements
  in school food programs

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2007-2008 Grants Built on New Legislation

• Five Star Foods
• Nutrition Integrity
• Web Based Lessons
• Committed To Move

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5 Star Food Grant
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5 Star Food

• Kitchen equipment
• Training from Chef on fruit and vegetable
  preparation and presentation
• 80 participating schools
• Partnering with MSU Extension

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Harrison County School District

• Office of Child Nutrition will remove all ice
  cream products for sale in the cafeteria except
  the reduced fat cups. Fresh fruit choices will
  always be readily available!

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Pearl Public School District

• Pearl Upper Elementary
• Student council members will be trained to
  teach peers the importance of breakfast and
  nutritious snack choices.

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Nutrition Integrity
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Nutrition Integrity

• Replace fryers with combi-ovens
• Onsite chef training
• 20 participating schools

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Starkville School District

• All schools
• have completely removed deep fryers as part of
  their overall commitment toward
  healthier food preparation.

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Rankin County School District

• Office of Child Nutrition has purchased
  Combi-Ovens for all schools in the district. No
  fried food is being prepared.

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Nutrition Integrity
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HEALTH IN ACTION

• Quality Health Education Programs
• Quality Physical Education Programs
• Easily accessible
• Based on state standards
• Supportive of other subject areas
• Inclusive of all students

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Health in Action

• Web based health and physical activity lesson
  plans
• Linked to core subjects
• Based on state standards
• All schools and teachers

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Grenada School District

• Grenada Middle School
• began a morning
• exercise routine via
• school wide telecasting
• with students standing
• beside their desks
• in classrooms.

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Corinth School District

• East Corinth Elementary
• Five minutes of healthy tips are presented by the
  principal each morning in the auditorium to all
  students and facts about the healthy tips are
  documented and highlighted in teacher's
• lesson plans.

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Committed to Move
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Committed to Move

• Physical Best training and material
• Fitnessgram software for fitness testing
• Physical Education equipment
• 25 participating schools

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Clarksdale School District

• Schools now have Physical Education teachers to
  provide PE classes for all students.

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MS School for the Blind

• Adjusted class
• schedules for students
• to participate in
• physical activity before
• lunch. Also
• implemented a water
• hydration policy.

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DeSoto County Schools

• Shadow Oaks Elementary offers 30 minutes of
  physical education for every student - with
  special recognition for those who walk with
  principal at recess.

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Fitnessgram

• Computerized tool that enables schools to perform
  quality fitness assessments and physical activity
  assessments
• Components
• Aerobic Capacity
• Body Composition
• Abdominal Strength
• Trunk Extensor strength
• Upper Body Strength
• Flexibility

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Committed to Move
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SUCCESS Legislation Passes

• School Nurse Program
• House Bill 1132
• Designates MDE as state agency for school nurse
  program
• Defines school nurse role
• Appropriated 2.5 M

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School Health Lessons for Success

• To reach schools and their students and staff one
  must work within hierarchical education system
• With support from the local district and school
  leaders project will likely succeed
• Start with some success or readiness
• Base payments on benchmark achievement

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FIT
HEALTHY
READY TO SUCCEED
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Strategic Initiatives to Address Childhood Obesity

• Two-pronged approach
• Infrastructure
• State level
• Local level
• Policy
• Legislative branch
• Executive branch

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MEDIA PLAN
3 Press releases MANY media contacts 1
Special event MEDIA SUCCESS
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STAY ON MESSAGE
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Overall Messages
1. Nutrition and physical activity at school help
Mississippi children be fit, healthy, and ready
to succeed. 2. When children are well-nourished
and physically fit, they do better in school. 3.
Our school is taking important steps to meet the
standards of Healthy Students Act passed by the
2007 Legislature.
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Press Release 1

• Commit to Move Grant awarded
• Our school received a grant from the Mississippi
  Department of Education, Office of Healthy
  Schools, to purchase PE equipment and learn about
  fitness testing.
• This grant, along with district matching funds,
  will help us improve our Physical Education
  program to comply with the 2007 Mississippi
  Healthy Students Act.
• The new Physical Education equipment and ongoing
  fitness assessments will help insure that the
  children in our school are fit, healthy, and
  ready to succeed.

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Press Release 1

• 5 FOOD Grant awarded
• Our school received a grant from the Mississippi
  Department of Education, Office of Healthy
  Schools, to purchase needed equipment for the
  school kitchen.
• The equipment, along with training for kitchen
  staff, will help improve our School Nutrition
  program to comply with the 2007 Mississippi
  Healthy Students Act.
• With the Five Star Food Grant, we can help make
  school breakfasts and lunches as healthy as
  possible so that children are fit, healthy, and
  ready to succeed.

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Press Release 2

• JANUARY
• Nutrition and activity help children get fit
• Linked to media focus on New Years Resolutions

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Press Release 3

• MARCH
• Food and fitness affect standardized testing
• Linked to administration of tests in classroom

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Press Release 4

• YOUR CHOICE
• Promote special event to showcase grant
• Linked to anything that is a good way to hook
  the audience

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Special Event
Goal To coordinate media coverage and share
your success with community leaders at the same
time.
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Special Event
Choose the right time. Invite the right
people. Make it fun.
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Press Release 1

• Grant(s) awarded
• Our school received a grant from the Mississippi
  Department of Education, Office of Healthy
  Schools, which allows us to install needed
  equipment in the school kitchen.
• The deep fat fryer will be removed and replaced
  with a combination oven steamer that uses
  super-heated steam to cook with less fat,
  saturated fat, and trans fats.
• With this new equipment, our goal is make our
  school breakfasts and lunches as healthy as
  possible so that children are fit, healthy, and
  ready to succeed.

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Press Release 2

• Update on Installation
• Our school has removed our deep fat fryer and
  replaced it with a state of the art oven with a
  grant from the Office of Healthy Schools and The
  Bower Foundation.
• Our baked foods are crisp on the outside and
  moist on the inside. Students and staff are
  enjoying them just as much as the fried versions.
• This new oven helps us prepare healthier school
  meals so that children are well-nourished, better
  able to pay attention in class, and more likely
  to do well on tests.

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Press Release 3

• Changes in foodservice
• The grant we received last fall from the Office
  of Healthy Schools and The Bower Foundation has
  helped our cafeteria serve healthier meals to
  students and staff.
• Since the installation of our new oven, our meals
  have been even tastier and better looking. When
  foods are crispy, crunchy, and colorful, children
  enjoy them more.
• Serving healthier school meals is just one of the
  many ways that our school is working to improve
  the health and performance of our students.
  Health is academic!

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GOAL
ACCURATE
POSITIVE

• Media Coverage
• Newspaper articles
• TV coverage
• Excellent
• Effective

CONSISTENT
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School Wellness SUCCESS
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Who benefits?

• Administrators
• Teachers
• Schools
• Families

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Who benefits?
STUDENTS
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• Unless someone like you cares a whole awful lot,
  nothing is going to get
  better. It's not.
• Dr. Seuss

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HEALTH SERVICES Hire RN Hire Certified
Nurse Assistant to work with RN Clinic
Equipment Clinic Supplies Clinic Space
FOOD SERVICE Buy fresh fruits and vegetables
Provide healthy snacks Hire Registered
Dietitian Purchase ovens to replace fryers

• STAFF WELLNESS
• Walking Track
• School RN Health Screening
• Staff Fitness Room
• After school health/fitness

• SOURCES
• Administrative Claiming
• Invest in School Health
• Improve Student Heath 
• Improve ADA
•  

PHYSICAL EDUCATION Hire PE Teacher Hire PE
Assistant Fitness Room Walking Track
Purchase curriculum
SAFE AND HEALTHY ENVIRONMENT Hire District
Safety Officer Random drug testing Security
cameras
COUNSELING Hire Mental Health Therapist Hire
Social Worker Hire Guidance Counselor
Depression Screening Tool
FAMILY AND COMMUNITY Health Fairs Parenting
Classes Faith Based Partnerships
HEALTH EDUCATION Hire Health Education
Teacher Purchase curriculum
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Coordinated School Health Programs An
Investment In Our Future

• Schools could do more than perhaps any other
  single institution in society to help young
  people, and the adults they will become, to live
  healthier, longer, more satisfying, and more
  productive lives.
• Carnegie Council on Adolescent Development

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