School Health Promotion

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School Health Promotion

• The Evidence, Issues and the Future
• Professor Lawrence St.Leger
• Vilnius June 2009

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What really works
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Sources of evidence
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Prerequisites for Health

• Shelter
• Education
• Food
• Income
• Stable ecosystem
• Peace
• Sustainable resources
• Social justice
• Equity

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Determinants of Health

• Biological
• Behavioural
• Environmental
• Social

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The Purpose of School Health?

• Education outcomes?
• Health behaviours?

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School Health Dilemmas

• External pressures
• Ideologies eg behaviourists
• A fun add on
• BUTHealth underpins learning

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What works

• Empowerment
• in action
• realistic
• Gale et al (2008)

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Bjarne Bruun Jensens Concepts

• Empowerment
• Four types of knowledge
• Genuine participation
• Action competence

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Major findings from the evidence

• Education sector
• good teaching
• quality
  schools
• leadership
• Health Sector
• whole school
  approach (HPS/CSH)
• dose of the
  initiative

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Learning outcomes for students improve if they

• Are happy in their schoolwork
• Believe in themselves
• Like and respect teachers
• Attend a supportive school

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Promoting Health in Schools- from evidence to
action

• an international document containing an
  advocacy argument with supportive evidence
  primarily for the Education sector
• International testing and review in Canada,
  Europe, New Zealand, Singapore, Australia, USA.
• Sponsored by IUHPE with financial support from
  CDC
• Draft
  authors..Ian Young and Lawry StLeger

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Effective Schools

• utilise learning and teaching methods that are
  evidence based
• facilitatecooperationamongstudents
• provide prompt feedback to students
• invest in capacity building experiences for all
  staff

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Effective schools

• establish and promote high expectations
• respect diverse talents and ways of learning
  permit adequate time for learning tasks
• ensure there is consultation between parents,
  students and teachers in establishing the
  schools direction
• establish programmes and facilities for students
  with special needs and
• provide clear leadership from the
  Principal/Director in establishing a school
  climate of trust, respect, collaboration and
  openness

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Mental Health

• The number one health area for effective outcomes
• See Blum et al (2002), Browne, et al
  (2004),Green et al (2005), Stewart Browne
  (2006), Weare and Markham (2005), Wells et al
  (2003)

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Mental Health

• Successful initiatives .
• are well designed and grounded in tested theory
  and practice
• link the school, home and community
• address the school ecology and environment
• combine a consistency in behavioural change goals
  through connecting students, teachers, family and
  community

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Mental Health

• Successful initiatives
• foster respectful and supportive relationships
  among students, teachers and parents
• use interactive learning and teaching approaches
  and
• increase the connections for each student

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Healthy eating and nutrition

• Initiatives and programs that follow
  evidence-based teaching practices and a whole of
  school approach have been shown to regularly
  increase student knowledge about food and diet.
• However, changes in student eating behaviours
  have been less successful. Girls tend to benefit
  more than boys and some quality initiatives have
  reported a modest increase in vegetable
  consumption.

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Healthy eating and nutrition

• Those initiatives which did achieve some
  biological and behavioural changes had some or
  all of the following features
• a whole of school approach
• links with parents and food preparation at home
• consistency between the taught curriculum and
  food availability in the school
• program longevity (over three years) and regular
  inputs by staff and students in planning and
  implementing activities and
• on-going capacity building opportunities for
  staff.

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Physical activity

• The evidence suggests that
• physical activity initiatives in schools are most
  effective if they adopt a comprehensive approach
  e.g. the development of skills, establishing and
  maintaining suitable physical environments and
  resources, upholding supportive policies to
  enable all students to participate
• there is a strong direct correlation between
  being physically active at school and undertaking
  physical activity in adult hood
• students gain more benefit from physical activity
  if they have opportunities to be active at
  regular times during the school day

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Physical activity

• The evidence suggests that
• if students collaborate with school staff in
  deciding the type of physical activity to be
  undertaken, which could include other activities
  not viewed as sport, like dance, then they will
  be more committed to participation
• biological measures, e.g. BMI, blood pressure
  measures and VO2 max, have limitations and may
  be ineffective in assessing physical fitness
  levels of growing young people and other outcomes
  of school-based physical activity and
• programs that cater for student diversity in
  areas such as ethnicity, physical ability, gender
  and age are more effective in terms of student
  participation and engagement than those that
  dont.

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Benefits of physical activity at schools

• Taras (2005)
• Improved social skills
• Enhanced mental health
• Better concentration
• Associated with fewer risk taking behaviours
• But of low frequency and dosage
• No substantiation of improved academic achievement

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Substance use

• School-based drug reduction initiatives are
  effective if the programs
• are interactive rather than teacher-centred
• focus on life skills, e.g. refusal skills,
  assertiveness
• take a whole of school approach
• link with the family and local community and
• address the improvement of connections for
  students.

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Substance use

• The evidence also shows.
• effect sizes (at best) are modest, but compare
  well with results of clinical trials
• some successful gains may include a short term
  delay in use and or short term reduction in
  usage
• positive effects are more likely to occur
  influencing tobacco, than alcohol or illicit
  drugs
• specific programmes are more likely to have no
  effects or harmful effects on alcohol use and
• teaching staff, who understand mental health
  issues, achieve higher health and educational
  outcomes for the students than those staff who
  dont.

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Sleep and Student Performance

• Taras (April 06, 2006)
• of all the health issues investigated, poor
  sleep was among the most unexpected and
  definitive causes of poor academic achievement
• Adolescents and the starting time of schools

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Sexuality and Relationships

• Sexuality education programs, when conducted by
  empathic and trained staff
• increase sexual knowledge
• may increase safe sex practices
• may delay the time of first sexual intercourse
• result in young people reporting on better
  communication in their relationships.

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Sexuality and Relationships

• Sexuality education programs, when conducted by
  empathic and trained staff
• Evidence indicates such programs do not promote
  earlier or increased sexual activity in young
  people.
• Initiatives in schools that explicitly promote
  and build school connectedness for students are
  strongly associated with reduced sexual activity
  in adolescence.

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The Issues of School Health

• For
• teachers
• schools
• education sector
• health sector

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External (Educational ? ) Assumptions

• Telling Teaching
• Listening Learning

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Important for teachers

• Structure
• Resources
• Curriculum, guidelines, prescriptions

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Some issues for teachers

• Accountability
• Performance indicators
• Time demands
• etc

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Curriculum intentions

• Analyse
• Explore
• Recognise
• Apply
• Practise
• Promote

• Develop
• Determine
• Evaluate
• Compare
• Identify
• Describe
• Examine
• source Country and regional curriculum
  guidelines

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Curriculum in Action
Cognitive
Affective
Educational Outcomes
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External Assumptions of Curriculum
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External Shapers
Internal Shapers
Classroom management
Curriculum guidelines
Environmental factors
Resources
Time
HPS guidelines
School policies
Learning orientations
Accountability
Parental expectations
Government policies
Organisation planning
Standards measures
Knowledge Skills
HEALTH ISSUES
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Factors Influencing Students
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The Future?

• Disseminating evidence to policy makers
• Mediating and disseminating evidence to
  practitioners
• Working across the curriculum
• Using educational evidence e.g. effective
  schools, quality teaching practices, integrated
  curriculum, leadership, etc
• Professional development to professional learning

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Curriculum in Action
Cognitive
Affective
Educational and Health Outcomes
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Rethinking curriculum

• Action competencies for all students
• means..

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assets/attributes to.

• Understand, know, think ,reason, analyse,
  synthesise, evaluate, create, plan, advocate,
  negotiate, take action..
• Action competencies