RESUMEN
Menstrual health and hygiene (MHH) inequities disproportionately impact communities who are marginalized. In 2018, Illinois passed the Learn with Dignity Act (LWDA) requiring schools to provide menstrual products in bathrooms, yet little is known about its impacts. This evaluation examined LWDA implementation across Chicago Public Schools (CPS) and identified barriers, facilitators, and lessons to inform future MHH policy implementations. A qualitative study was conducted by thematically analyzing interviews with CPS staff (n = 36) from October 2020 - September 2021 in partnership with CPS Office of Student Health and Wellness (OSHW). Staff reported inadequate LWDA and MHH education and inconsistent menstrual product availability. Structural, systemic, and cultural implementation barriers hindered student access to products and created inequities based on age, gender, and income. Staff investment and student education were implementation facilitators. Staff awareness of policy implementation protocol, student MHH education, and addressing access inequities are key factors for consideration in future policy implementations. Through the WSCC model, these findings demonstrated the importance of strengthening MHH policies and policy implementation to promote student health, well-being, and educational opportunities.
RESUMEN
BACKGROUND: Undergraduate majors in education, specifically in school health education (HE), have declined considerably in the United States. Reductions in state and federal funding for K-12 public education and increased demands on educators to prioritize standardized academic outcomes versus focusing on the whole child encompass many factors leading to fewer qualified teachers and reduced quality of HE delivery within schools. METHODS: A content analysis of over 300 HE teacher preparation programs throughout the United States was conducted from 2019 to 2020 to assess available and required curriculum for pre-service HE teachers. Seven curriculum areas were reviewed: nutrition, physical activity (PA) and physical education (PE), HE, chronic disease management (CDM), social emotional learning and mental health (SEL/MH), drug abuse and tobacco prevention (DA/TP), and a methods course in teaching HE. RESULTS: Findings indicated program type influenced course offerings, with stand-alone HE and joint HE/PE programs providing the most comprehensive curriculum. Most programs required courses in general HE, PA and PE, and nutrition. Programs were deficient in offering courses in CDM, DA/TP, and SEL/MH. CONCLUSION: This article contains recommendations to improve the quality of HE delivery in public schools, for example by ensuring that school health educators are trained in providing skills-based HE to youth, which can assist in addressing child and youth health outcomes (eg, CDM, mental health) for the nation.
Asunto(s)
Curriculum , Educación en Salud , Maestros , Humanos , Estados Unidos , Educación en Salud/organización & administración , Servicios de Salud Escolar/organización & administración , Formación del ProfesoradoRESUMEN
BACKGROUND: Given levels of sedentary behavior among youth, teachers have been called upon to increase physical activity (PA) by implementing classroom PA breaks. School-based interventions enacted in classroom settings have shown promise in increasing youth PA. Yet little is known about how teacher efficacy toward implementing classroom PA breaks may influence intervention effects. PURPOSE: Therefore, the purpose of this study was to examine how the Dearborn School Health through Integrated Nutrition and Exercise Strategies (D-SHINES) intervention, implemented across 8 schools, influenced classroom teacher's efficacy toward providing classroom PA breaks. METHODS: A mixed-methods design examined classroom teachers' efficacy toward implementing classroom PA breaks and used semi-structured interviews to better understand teachers' efficacy and implementation. RESULTS: Quantitative results indicated that teacher efficacy significantly increased over the intervention period and that general and institutional efficacy predicted higher amounts of PA breaks offered. Qualitative results suggested that to enhance teachers' facilitation of classroom PA breaks, one must tap into the institutional, student, and educational factors that constitute teacher efficacy. IMPLICATIONS FOR SCHOOL HEALTH: Designing interventions that focus on teacher efficacy toward classroom PA may be a viable way to increase PA breaks in schools. Implications for the whole school, whole community, whole child model are discussed.
Asunto(s)
Ejercicio Físico , Instituciones Académicas , Adolescente , Niño , Humanos , Estado Nutricional , Maestros , Conducta Sedentaria , EstudiantesRESUMEN
BACKGROUND: Improving the academic achievement of youth in the United States is an area of interest and a critical indicator of the future success of the youth. The purpose of this study was to examine the impact of a comprehensive school physical activity and healthy eating program on 5th-grade students' academic achievement, specifically reading and math. METHODS: Overall, 628 (intervention: 377, 54% girls; comparison: 251, 49% girls) 5th-grade children participated across the 6 schools in a year-long comprehensive health intervention, completing curriculum-based academic achievement measures at 2 time-points. RESULTS: Results showed that even after controlling for class clustering, age, sex, race, and T1 reading and math variables, students' T2 reading and math achievement were significantly higher in the intervention group than the comparison group. CONCLUSIONS: Comprehensive health programming can enhance the health and academic achievement of youth.
Asunto(s)
Éxito Académico , Logro , Adolescente , Niño , Escolaridad , Femenino , Humanos , Masculino , Instituciones Académicas , EstudiantesRESUMEN
BACKGROUND: Involving communities in school health has been purported as a practice integral to supporting a Whole School, Whole Community, Whole Child (WSCC) approach. Although community collaboration is often included in school-based health initiatives, there is little research considering methods for increasing community engagement. The purpose of this study was to identify effective school-based health interventions documenting changes in community engagement. METHODS: Academic experts and school stakeholders guided procedures for a systematic review of studies published from 1987-2017 and gray literature (ie, best practice documents; policy documents, etc.) on comprehensive school health interventions including community engagement as a targeted outcome. RESULTS: The search identified 9 studies addressing community as an outcome of school-based health interventions; types of partnership mechanisms and partners' roles were classified. CONCLUSIONS: Although involving communities is a WSCC component and commonly recommended as a strategy fundamental to school health, there is little empirical research examining effective strategies for engaging communities and engagement is often not measured as part of intervention studies. Further measurement and research in engaging communities in school health is warranted.
Asunto(s)
Evaluación de Resultado en la Atención de Salud , Servicios de Salud Escolar , Instituciones Académicas , Niño , HumanosRESUMEN
BACKGROUND: In this study, we explore how a health education course may play a role in pre-service teachers' perceptions in teaching and integrating health education activities to nurture K-8 students' health literacy. METHODS: We used mixed methods to examine the effect of a health education course in a teacher education program. Of 55 pre-service teachers, 41voluntarily participated in the study. Quantitative data were obtained through an online questionnaire administered to participants at the beginning and end of the course. We conducted 6 focus groups at the end of the course. RESULTS: The inferential analysis from a series of analysis of variance with repeated measures revealed significant differences in health knowledge (F = 113.39, p < .01, η2 = 0.74), preparedness (F = 104.74, p < .01, η2 = 0.73), attitudes (F = 15.02, p < .01, η2 = 0.28), and beliefs (F = 8.87, p < .01, η2 = 0.19) between time points. Qualitative data led to the conclusion that where one health education course is insufficient, such a course is the first step into future curriculum development and implementation. CONCLUSION: One health education course might be beneficial for general education teachers to increase their knowledge and preparation to teaching school health. On-going training is needed for program success.
Asunto(s)
Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Competencia Profesional , Maestros/psicología , Formación del Profesorado/métodos , Adolescente , Adulto , Femenino , Grupos Focales , Alfabetización en Salud , Humanos , Masculino , Michigan , Servicios de Salud Escolar , Instituciones Académicas , Adulto JovenRESUMEN
BACKGROUND: District wellness policies provide an avenue to advance the Whole School, Whole Community, Whole Child (WSCC) model. The extent to which wellness policies currently align with WSCC is unclear; to-date, tools have been unavailable to examine this issue. METHODS: We reviewed written health-focused policies among 37 school districts in Los Angeles County in 2017 utilizing a 54-item tool designed to examine the quality of policies in the 10 WSCC domains. Descriptive analyses explored overall and domain-specific comprehensiveness and strength; simple negative binomial regression models examined differences in the policy quality and structure by legislated status. RESULTS: Approximately half of expected policies were present in wellness policies (mean comprehensiveness score = 52.65, ±18.09), < 20% were strong (mean strength score = 16.97, ±8.05). Content in WSCC domains addressed by legislative mandates was significantly more comprehensive and stronger, and more frequently located within the wellness policies, relative to content in non-legislated domains. CONCLUSIONS: Opportunities exist for better alignment of wellness policies with WSCC. Education and health practitioners can utilize the tool developed for this study to identify priority areas where policy support is needed in their jurisdictions. Additional efforts are needed to help schools facilitate and document practice gains around WSCC-aligned policies.
Asunto(s)
Política de Salud , Promoción de la Salud , Instituciones Académicas , Niño , Estudios Transversales , Humanos , Los Angeles , Proyectos Piloto , Servicios de Salud EscolarRESUMEN
School nurses are in a unique position to monitor and influence not only the health of students but also the health of school employees. The National Association of School Nurses (NASN) provides support and evidence-based best practice guidelines for the specialty practice of school nursing. NASN's Framework for 21st Century School Nursing Practice™ provides a road map for a healthy and safe school environment. With a focus on student health and academic success, the framework also aligns with the whole school, whole community, whole child model to provide a collaborative structure to learning and health. Both models are student centered and include family, the school community, and school employees. A group of school nurses from the Alexandria City Public Schools (ACPS) in Alexandria, Virginia, attended the Johnson and Johnson School Health Leadership Program and were challenged to create sustainable change in their community. Their goal was to develop a plan for the school division that would affect employee wellness and ultimately improve student achievement and educational outcomes. This article will describe the current ACPS Employee Wellness Program, Finding Fit, and the strategies and tools used to develop the program.
Asunto(s)
Promoción de la Salud , Liderazgo , Servicios de Enfermería Escolar , Humanos , Modelos de Enfermería , Salud Laboral , Servicios de Salud Escolar , VirginiaRESUMEN
BACKGROUND: In recent decades, the alignment of health and education has been at the forefront of school reform. Whereas the establishment of national in-school physical activity (ISPA) recommendations and state-level mandates demonstrates success, there has been less achievement in areas that address health disparities. The purpose of this investigation was to explore barriers and facilitators to implementing state-mandated ISPA policies in the Mississippi Delta. METHODS: Focus groups or interviews were conducted with district administrators, school principals, teachers, and students. A total of 2 semistructured moderator guides were developed to focus on (1) student ISPA practices and preferences and (2) facilitators and barriers to implementing ISPA policies and practices. RESULTS: A total of 6 themes were developed. In that, 2 themes addressed participant-described barriers (primary challenges and interferences and excuses). Three themes highlighted participant-described facilitators (compromises, things that work, and being active at school). Finally, 1 theme encompassed the participant-described need to address educating the whole child. CONCLUSIONS: There is a critical need for meaningful and relevant solutions to circumvent challenges to implementing ISPA policies and practices in the Mississippi Delta. The Whole School, Whole Community, Whole Child model offers a broad means of visualizing rural, low-income, racially concentrated schools to circumvent challenges and foster ISPA policies and practices.
Asunto(s)
Ejercicio Físico , Adhesión a Directriz , Política de Salud/legislación & jurisprudencia , Disparidades en el Estado de Salud , Educación y Entrenamiento Físico/legislación & jurisprudencia , Instituciones Académicas/legislación & jurisprudencia , Personal Administrativo/psicología , Adulto , Actitud Frente a la Salud , Niño , Relaciones Comunidad-Institución , Ejercicio Físico/fisiología , Ejercicio Físico/psicología , Grupos Focales , Humanos , Entrevistas como Asunto , Programas Obligatorios , Grupos Minoritarios , Mississippi , Política Organizacional , Áreas de Pobreza , Investigación Cualitativa , Características de la Residencia/clasificación , Población Rural , Maestros/psicología , Instituciones Académicas/organización & administración , Estudiantes/psicología , Factores de TiempoRESUMEN
BACKGROUND: While it is a national priority to support the health and education of students, these sectors must better align, integrate, and collaborate to achieve this priority. This article summarizes the literature on the connection between health and academic achievement using the Whole School, Whole Community, and Whole Child (WSCC) framework as a way to address health-related barriers to learning. METHODS: A literature review was conducted on the association between student health and academic achievement. RESULTS: Most of the evidence examined the association between student health behaviors and academic achievement, with physical activity having the most published studies and consistent findings. The evidence supports the need for school health services by demonstrating the association between chronic conditions and decreased achievement. Safe and positive school environments were associated with improved health behaviors and achievement. Engaging families and community members in schools also had a positive effect on students' health and achievement. CONCLUSIONS: Schools can improve the health and learning of students by supporting opportunities to learn about and practice healthy behaviors, providing school health services, creating safe and positive school environments, and engaging families and community. This evidence supports WSCC as a potential framework for achieving national educational and health goals.
Asunto(s)
Escolaridad , Conductas Relacionadas con la Salud , Estado de Salud , Actividad Motora , Adolescente , Niño , Servicios de Alimentación , Educación en Salud , Humanos , Metaanálisis como Asunto , Ciencias de la Nutrición , Cultura Organizacional , Servicios de Salud Escolar , Instituciones Académicas , EstudiantesRESUMEN
BACKGROUND: The new Whole School, Whole Community, Whole Child (WSCC) model, designed to depict links between health and learning, is founded on concepts of coordinated school health (CSH) and a whole child approach to education. METHODS: The existing literature, including scientific articles and key publications from national agencies and organizations, was reviewed and synthesized to describe (1) the historical context for CSH and a whole child approach, and (2) lessons learned from the implementation and evaluation of these approaches. RESULTS: The literature revealed that interventions conducted in the context of CSH can improve health-related and academic outcomes, as well as policies, programs, or partnerships. Several structural elements and processes have proved useful for implementing CSH and a whole child approach in schools, including use of school health coordinators, school-level and district-level councils or teams; systematic assessment and planning; strong leadership and administrative support, particularly from school principals; integration of health-related goals into school improvement plans; and strong community collaborations. CONCLUSIONS: Lessons learned from years of experience with CSH and the whole child approaches have applicability for developing a better understanding of the WSCC model as well as maximizing and documenting its potential for impacting both health and education outcomes.
Asunto(s)
Relaciones Interprofesionales , Modelos Educacionales , Servicios de Salud Escolar/organización & administración , Centers for Disease Control and Prevention, U.S. , Conducta Cooperativa , Humanos , Relaciones Interinstitucionales , Liderazgo , Instituciones Académicas , Estados UnidosRESUMEN
BACKGROUND: Collaborative partnerships are an essential means to concomitantly improve both education outcomes and health outcomes among K-12 students. METHODS: We describe examples of contemporaneous, interactive, and evolving partnerships that have been implemented, respectively, by a national governmental health organization, national nongovernmental education and health organizations, a state governmental education organization, and a local nongovernmental health organization that serves partner schools. RESULTS: Each of these partnerships strategically built operational infrastructures that enabled partners to efficiently combine their resources to improve student education and health. CONCLUSIONS: To implement a Whole School, Whole Community, Whole Child Framework, we need to purposefully strengthen, expand, and interconnect national, state, and local collaborative partnerships and supporting infrastructures that concomitantly can improve both education and health.
Asunto(s)
Conducta Cooperativa , Relaciones Interinstitucionales , Relaciones Interprofesionales , Servicios de Salud Escolar/organización & administración , Adolescente , Centers for Disease Control and Prevention, U.S. , Niño , Escolaridad , Estado de Salud , Humanos , Sector Privado , Instituciones Académicas , Sociedades Científicas , Gobierno Estatal , Estudiantes , Estados UnidosRESUMEN
BACKGROUND: The Whole School, Whole Community, Whole Child (WSCC) model calls for greater collaboration across the community, school, and health sectors to meet the needs and support the full potential of each child. This article reports on how 3 states and 2 local school districts have implemented aspects of the WSCC model through collaboration, leadership and policy creation, alignment, and implementation. METHODS: We searched state health and education department websites, local school district websites, state legislative databases, and sources of peer-reviewed and gray literature to identify materials demonstrating adoption and implementation of coordinated school health, the WSCC model, and associated policies and practices in identified states and districts. We conducted informal interviews in each state and district to reinforce the document review. RESULTS: States and local school districts have been able to strategically increase collaboration, integration, and alignment of health and education through the adoption and implementation of policy and practice supporting the WSCC model. Successful utilization of the WSCC model has led to substantial positive changes in school health environments, policies, and practices. CONCLUSIONS: Collaboration among health and education sectors to integrate and align services may lead to improved efficiencies and better health and education outcomes for students.
Asunto(s)
Educación/organización & administración , Relaciones Interinstitucionales , Relaciones Interprofesionales , Administración en Salud Pública , Servicios de Salud Escolar/organización & administración , Relaciones Comunidad-Institución , Conducta Cooperativa , Política de Salud , Humanos , Entrevistas como Asunto , Gobierno Local , Modelos Educacionales , Características de la Residencia , Instituciones Académicas , Gobierno Estatal , Estados UnidosRESUMEN
BACKGROUND: Students are the heart of the Whole School, Whole Community, Whole Child (WSCC) model. Students are the recipients of programs and services to ensure that they are healthy, safe, engaged, supported, and challenged and also serve as partners in the implementation and dissemination of the WSCC model. METHODS: A review of the number of students nationwide enjoying the 5 Whole Child tenets reveals severe deficiencies while a review of student-centered approaches, including student engagement and student voice, appears to be one way to remedy these deficiencies. RESULTS: Research in both education and health reveals that giving students a voice and engaging students as partners benefits them by fostering development of skills, improvement in competence, and exertion of control over their lives while simultaneously improving outcomes for their peers and the entire school/organization. CONCLUSIONS: Creating meaningful roles for students as allies, decision makers, planners, and consumers shows a commitment to prepare them for the challenges of today and the possibilities of tomorrow.
Asunto(s)
Participación de la Comunidad/métodos , Conducta Cooperativa , Toma de Decisiones , Servicios de Salud Escolar , Estudiantes , Adolescente , Niño , Relaciones Comunidad-Institución , Humanos , Relaciones Interpersonales , Relaciones Interprofesionales , Modelos Educacionales , Instituciones Académicas , Apoyo Social , Estudiantes/psicología , Estados UnidosRESUMEN
BACKGROUND: The Whole School, Whole Community, Whole Child (WSCC) model provides a framework for promoting greater alignment, integration, and collaboration between health and education across the school setting and improving students' cognitive, physical, social, and emotional development. By providing a learning environment that ensures each student is emotionally and physically healthy, safe, actively engaged, supported, and challenged, the WSCC model presents a framework for school systems to evaluate, streamline, implement, and sustain policies, processes, and practices. METHODS: This article examines the essential roles of the school district and of schools in aligning, developing, and implementing policy, processes, and practices to create optimal learning environments that support the whole child. RESULTS: Three key factors advance efforts to align policies, processes, and practices. These include hiring a coordinator at the district and school levels, having collaborative teams address health and learning at the district and school levels, and using data to make decisions and build health outcomes into school and district accountability systems. CONCLUSIONS: These key factors provide a road map for successfully implementing WSCC. More research is needed to determine the extent that coordinators, collaborative teams, and the inclusion of health indicators in accountability systems impact student health and learning.
Asunto(s)
Conducta Cooperativa , Relaciones Interinstitucionales , Relaciones Interprofesionales , Servicios de Salud Escolar/organización & administración , Adolescente , Niño , Política de Salud , Humanos , Modelos Educacionales , Características de la Residencia , Instituciones Académicas , Estudiantes , Estados UnidosRESUMEN
BACKGROUND: The Whole School, Whole Community, Whole Child (WSCC) model shows the interrelationship between health and learning and the potential for improving educational outcomes by improving health outcomes. However, current descriptions do not explain how to implement the model. METHODS: The existing literature, including scientific articles, programmatic guidance, and publications by national agencies and organizations, was reviewed and synthesized to describe an overview of interrelatedness of learning and health and the 10 components of the WSCC model. RESULTS: The literature suggests potential benefits of applying the WSCC model at the district and school level. But, the model lacks specific guidance as to how this might be made actionable. A collaborative approach to health and learning is suggested, including a 10-step systematic process to help schools and districts develop an action plan for improving health and education outcomes. Essential preliminary actions are suggested to minimize the impact of the challenges that commonly derail systematic planning processes and program implementation, such as lack of readiness, personnel shortages, insufficient resources, and competing priorities. CONCLUSIONS: All new models require testing and evidence to confirm their value. District and schools will need to test this model and put plans into action to show that significant, substantial, and sustainable health and academic outcomes can be achieved.
Asunto(s)
Conducta Cooperativa , Política de Salud , Relaciones Interinstitucionales , Relaciones Interprofesionales , Servicios de Salud Escolar/organización & administración , Participación de la Comunidad , Humanos , Aprendizaje , Modelos Educacionales , Desarrollo de Programa , Instituciones Académicas , EstudiantesRESUMEN
BACKGROUND: Schools, school districts, and communities seeking to implement the Whole School, Whole Community, Whole Child (WSCC) model should carefully and deliberately select planning, implementation, and evaluation strategies. METHODS: In this article, we identify strategies, steps, and resources within each phase that can be integrated into existing processes that help improve health outcomes and academic achievement. Implementation practices may vary across districts depending upon available resources and time commitments. RESULTS: Obtaining and maintaining administrative support at the beginning of the planning phase is imperative for identifying and implementing strategies and sustaining efforts to improve student health and academic outcomes. Strategy selection hinges on priority needs, community assets, and resources identified through the planning process. Determining the results of implementing the WSCC is based upon a comprehensive evaluation that begins during the planning phase. Evaluation guides success in attaining goals and objectives, assesses strengths and weaknesses, provides direction for program adjustment, revision, and future planning, and informs stakeholders of the effect of WSCC, including the effect on academic indicators. CONCLUSIONS: With careful planning, implementation, and evaluation efforts, use of the WSCC model has the potential of focusing family, community, and school education and health resources to increase the likelihood of better health and academic success for students and improve school and community life in the present and in the future.