Index

A

Abortion counseling and birth control, 257, 398, 409-410.

See also Teen pregnancy prevention

Absenteeism and tardiness, 24, 35, 67, 73, 160, 174, 189, 193, 397-398

Academic performance

grade retention/repeated grades, 24

health services and, 193, 396-398

health status and, 19, 51

parental involvement and, 25

physical activity/education and, 68, 85, 90-91

poverty and, 24

psychosocial environment and, 65-66

Accelerated schools, 385

ACCESS model of CSHP, 56, 57

Access to health care

health insurance and, 27-28

professional training in adolescent health care and, 28

psychosocial interventions and, 67

school health services and, 7, 15, 158, 196, 217-218, 226, 298, 365 -366, 394

transportation, convenience, and cultural issues, 28

Adolescent and School Health Initiative, 242

Adolescent females, 434-435

Adolescent Parenting Program, 378

Advanced Nurse Education, 436-437

Advisory Committee on Immunization Practices, 427

Advocates for Youth, 190-191, 389-390

After-school programs, 37-38, 121

AIDS/HIV prevention, 16, 49, 69, 100, 106-107, 112-115, 119, 207, 242, 248, 403, 436-437, 458

AIDS Prevention Education Curricula, 106-107

Alcohol and drug abuse, 20, 21, 23, 72

Alcohol and drug abuse prevention, 16, 157

access to care for, 28

cost-effectiveness, 122

funding for, 250

health education and guidance, 46, 47, 69, 100, 101, 112-115, 122, 129, 130, 283-284, 314-317, 320-323, 422, 424

model programs, 378

outcomes of interventions, 103, 393-394

physical activity/education and, 68, 85

professional development/training, 118

Student Assistance Programs, 174, 372-373, 394

temperance movement and, 336-337

Alternative schools, 396

American Academy of Pediatrics, 59, 64 n.6, 154, 161-162 n.3, 163, 166, 216, 217 n.7, 219, 221, 241, 463-464, 469, 471



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School & Health: Our Nation's Investment Index A Abortion counseling and birth control, 257, 398, 409-410. See also Teen pregnancy prevention Absenteeism and tardiness, 24, 35, 67, 73, 160, 174, 189, 193, 397-398 Academic performance grade retention/repeated grades, 24 health services and, 193, 396-398 health status and, 19, 51 parental involvement and, 25 physical activity/education and, 68, 85, 90-91 poverty and, 24 psychosocial environment and, 65-66 Accelerated schools, 385 ACCESS model of CSHP, 56, 57 Access to health care health insurance and, 27-28 professional training in adolescent health care and, 28 psychosocial interventions and, 67 school health services and, 7, 15, 158, 196, 217-218, 226, 298, 365 -366, 394 transportation, convenience, and cultural issues, 28 Adolescent and School Health Initiative, 242 Adolescent females, 434-435 Adolescent Parenting Program, 378 Advanced Nurse Education, 436-437 Advisory Committee on Immunization Practices, 427 Advocates for Youth, 190-191, 389-390 After-school programs, 37-38, 121 AIDS/HIV prevention, 16, 49, 69, 100, 106-107, 112-115, 119, 207, 242, 248, 403, 436-437, 458 AIDS Prevention Education Curricula, 106-107 Alcohol and drug abuse, 20, 21, 23, 72 Alcohol and drug abuse prevention, 16, 157 access to care for, 28 cost-effectiveness, 122 funding for, 250 health education and guidance, 46, 47, 69, 100, 101, 112-115, 122, 129, 130, 283-284, 314-317, 320-323, 422, 424 model programs, 378 outcomes of interventions, 103, 393-394 physical activity/education and, 68, 85 professional development/training, 118 Student Assistance Programs, 174, 372-373, 394 temperance movement and, 336-337 Alternative schools, 396 American Academy of Pediatrics, 59, 64 n.6, 154, 161-162 n.3, 163, 166, 216, 217 n.7, 219, 221, 241, 463-464, 469, 471

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School & Health: Our Nation's Investment American Alliance for Health, Physical Education, Recreation and Dance, 59 n.5 American Association for the Advancement of Science, 70n.9, 129, 130-131 American Association of School Administrators, 40, 245 American Cancer Society, 124, 136, 207, 246 American Child Health Association, 43 American College Health Association, 59 n.5 American Dental Association, 241 American Heart Association, 86-87 American Medical Association, 18, 39, 44, 47, 222-223, 241, 245, 298 American Nurses Association, 44-45, 48, 163, 241 American Occupational Therapy Association, 168 American Physical Therapy Association, 168 American Public Health Association, 44-45, 48, 59 n.5 American Red Cross, 207 American School Counselor Association, 154, 162 n.3, 171 American School Food Service Association, 154, 162 n.3 American School Health Association, 44, 45, 48, 59 n.5, 63 n.6, 154 , 222-223 American Speech, Language, and Hearing Association, 168-169 Americans with Disabilities Act, 64 ASSIST grant program, 251 Association for the Advancement of Health Education, 44, 59, 108, 109 Association of State and Territorial Directors of Public Health Education , 59 n.5 Astoria Plan, 41, 43-44 Audiologists, 169 B Baltimore, Maryland, 43, 182-183, 191, 298, 386, 390, 394, 397 Beacons program, 185, 382 Behaviors, problem. See also Health behavior change and adolescent mortality and morbidity, 1, 4, 20-21, 22, 139 CDC priority areas, 20, 101, 132, 141 clusters of, 13, 21, 120, 286-287, 290, 310 and dropout rates, 21 environmental factors in, 5, 117, 120, 127, 140, 272, 279, 357 expectancy values and, 310 family structure and, 26-27 perceived norms and, 260, 310, 359-361 poverty and, 24 survey, 20-21 theory, 286-287, 290, 309-310 Beyond Rhetoric,46 Big Brother/Big Sister organization, 385 Blacks family structure, 26 poverty, 23 Boards of Cooperative Educational Services, 251-252 Boys Clubs of America, 184, 381 Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 18, 299-300 Brookline Project, 189 Brown University, 387 Bureau of Education, 38-39 Bureau of the Census, 20 C California, 398 comprehensive multicomponent programs, 383-384 Family Resource Centers, 185, 379, 405-406 full-service schools, 387 Healthy Start program, 193, 207, 298, 393-394, 395, 396, 397, 404 school-based health centers, 161, 191, 196, 242 n.3, 374, 400, 403 , 406 School-Community Health Project, 43 Cardinal Principles of Secondary Education, The, 39 Cardiopulmonary resuscitation, 112, 114, 118, 218-219 Cardiovascular Heart Healthy Eating and Exercise, 104-105 Carnegie Corporation, 47, 404 Carnegie Council on Adolescent Development, 67, 245 Carnegie Task Force on Meeting the Needs of Young Children, 23 Case management, 165, 174, 184, 380-381, 398 Cattaragus County Studies, 43 Causes of death, 22-23

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School & Health: Our Nation's Investment Center for Mental Health Services Research Project, 434 Center for Reproductive Health Policy Research, 395 Center for School Mental Health Assistance, 184 Centers for Disease Control and Prevention, 1 Chronic Disease and Health Promotion, 250 definition of health education, 99 Division of Adolescent and School Health, 46, 54, 64 n.6, 75 n.11, 103, 108, 155, 242, 244, 247-248, 251, 403, 456 funding for school health services, 207, 250 Guidelines for School and Community Health Programs to Promote Physical Activity Among Youth , 4, 64 n.6, 97-98, 139 health education evaluation guidelines, 280 physical education recommendations, 97-98 SHPPS study, 4, 5, 69, 71, 85, 92, 110-116, 132, 135, 138-139, 140 , 141, 153, 155, 163, 182, 297, 373 social morbidity findings, 20, 101, 139, 141 Youth Risk Behavior Survey, 20-21 Child abuse evaluations and follow-up, 155, 156, 378 Child/Adolescent Planning and System Development Program, 434-435 Child and Adolescent Health Policy Centers, 243 n.4 Child and Adolescent Trial for Cardiovascular Health (CATCH), 89, 179 Child Health Organization, 38 Child Nutrition Act, 45, 176 Children's Aid Society, 387, 397 Children's Defense Fund, 245 Children's Health Charter, 299, 300 Christmas Seal drive, 36 Cities in Schools, 184, 380-381 Claude Worthington Benedum Foundation, 458, 462 Clearinghouses, for family support programs, 380 Clinics, see School-based health centers Closer Look, A, 71, 155, 157, 163, 218 n.8 Coalition of Essential Schools, 386-387 Coalition of National Health Organizations, 59 Collaborative Study of Children with Special Needs, 187, 189 Colorado, 191-192, 243 n.4, 374, 391, 393 Comer School Development Program, 383, 404 Commission of the European Communities, 58 COMMIT trial, 324-325 Committee for Economic Development, 181 Committee on War Time Problems of Children, 38 Communicable disease control, 34, 35, 127 Communities in Schools, 195 Community definition, 313 health instruction, 112, 114, 118 programs, 14, 51, 316-318, 323-324 Community and Migrant Health Centers, 243, 434-435 Community Health Center Program, 45 Community participation in CSHPs components, 63, 313, 318-322, 324-326, 353-354 coordinating council, 10-11, 63, 165, 173-174, 240 effectiveness, 74, 121, 313, 318-322, 324-326, 328-329 extended services, 181, 184, 185, 225, 369 goals and objectives, 51, 63, 353 health education, 7, 51, 74, 75, 121, 137, 223-224, 306-311, 313, 316-326 health services, 165, 172, 173, 187, 217, 225-226, 464, 467 historical examples, 37-38, 40, 41, 42, 43 importance of, 41 infrastructure building, 252-253, 259-260, 264-265, 266, 461-462 issues, 326-328 mental health services, 71 mobilization of, 252, 259-260 models, 55-56, 307-308 physical education, 98 policy and administration, 63, 353 practical considerations, 308-309 rationale for, 308-311 research and evaluation, 63, 74, 329 school linkages for, 67, 165, 172, 173, 187, 217, 225-226, 464, 467

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School & Health: Our Nation's Investment strategic prevention concept, 311-313 theoretical considerations, 309-311 and turf wars, 259, 406-407 Community Partnership Demonstration Grant Program, 432-433 Competitive sports, 4, 88, 94, 139 Comprehensive School Health Program, 436-437 Comprehensive school health programs (CSHPs). See also individual components ACCESS model, 56, 57 Allensworth model, 56-57 charge to the committee, 2, 17 community participation in, 15, 55-56, 63, 74, 297-298 components, 14-15 DASH models, 46, 54, 247-248 deficiencies, 15, 297-298 definitions, 2, 28, 51-60, 301, 355 effects of, 121, 273, 281, 284-285 eight-component model, 3, 52-54, 64 n.6 family-school-community (Nader) model, 55-56 feasibility, 15, 280 full-service schools, 3, 59 goals and desired outcomes, 2, 16-17, 50-51, 242, 271, 338-339 governance, 405-406, 449 guidelines, 337-355 implementation, 17, 273-274 infrastructure, see Infrastructure building for CSHP integration of elements of, 60, 74-76, 165, 310-311 international models, 58-59 issues and questions, 29, 402-411 key elements, 2-3, 63-76, 446-447 models, 56, 58, 443-455 organization, 382-384 origin, 1-2, 16 principles, 445 rationale for, 271, 296-297, 308-311, 444-445 school-based versus community-based, 407-408 status, 14-15, 17, 297-298 three-component model, 3, 52, 53 types of services, 452 Conferences, 44-45, 47, 246, 261. See also specific conferences Confidentiality of student records, 8-9, 191, 204-206, 227, 256, 390, 419 Conflict resolution, nonviolent, 100, 112, 114, 118, 250, 378, 393 -394 Connecticut dental services, 375-376 Family Resource Centers, 185, 379 school-based health centers, 374, 407 School Development Plan, 386 school health services model, 199, 202-203, 463-473 vision screening, 35 Consumer health instruction, 112, 114, 118 Controversies birth control and abortion counseling, 257, 398, 409-410 funding, 207 in health education, 69, 257 historical, 49 management of, 11, 257-259, 409-411 in school health services, 7, 11, 158, 398, 409-410 Cooperative learning, 67 Coordinated Services Project, 242 Coordination of health programs. See also Community participation in CSHPs advisory and coordinating councils , 66, 138-139, 241, 252-254, 263 , 297-298, 386 family services, 73 federal interagency, 238-241, 242 funding for, 73 n.10, 374 historical efforts, 39 psychosocial environment, 67 research, 240 school-based health centers, 398 Cost-effectiveness health education, 5, 122-123, 140, 327 health services, 400 Council of Chief State School Officers, 47, 108, 240, 245 Council of Europe, 58 Council of Great City Schools, 241 Counseling. See also School guidance counselors; Vocational counseling mental health, 3, 49, 155, 156, 157, 169, 171-172, 184, 192, 391 nutrition, 155, 156, 158, 176 Creating an Agenda for School-Based Health Promotion: A Review of Selected Reports , 245 Crisis medical situations, 218-219

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School & Health: Our Nation's Investment Critical Populations Program, Adolescent Track, 432-433 Curriculum AIDS/HIV instruction, 49 ''back to the basics" movement, 46 crowding issue, 141 dissemination of effective programs, 103, 108, 242, 244 health education, 4, 40, 41, 45, 49, 52, 53, 58, 69, 72, 100-101, 103-108, 110-115, 132-133, 139, 258, 284, 288, 342 How to Live with 10-15 Year Olds, 462 implementation of effective programs, 132-133 nutrition, 72 physical education, 37, 52, 68, 84, 85, 88-92, 95, 98, 139, 347-348 social skills, 66, 122 substance abuse prevention, 101 D Dallas, Texas, 375, 383 Danforth Foundation, 382 Databases, 242, 243 n.4 Day care centers, 375, 385 Death and dying, instruction, 112, 114, 118 Definitions and terminology, 452-453 Committee's definition, 2, 60-62 community, 313 comprehensive school health program, 355 extended services, 181 health, 1 n.1, 354 health education, 99 need for definition, 51-52 previous definitions, 52-60 primary care and primary health care, 154 n.1 school-based health centers, 373 School Health Coordinating Council, 355 school health services, 153 Delaware, 191, 374, 390-391, 395 Delivery of health services funding for, 248 models/guidelines, 202-203, 417, 419, 447 primary care in schools, 45, 187 regional approaches, 186, 188 Dentists and dental services controversies, 49 demand for, 365-366 funding, 168, 376 health education, 112, 114, 118 history, 37, 42, 49 models, 376, 459, 467 poverty and, 24 in school-based health centers, 473 standards, 467 types of services, 71, 167-168, 375-376 Denver, Colorado, 191-192, 391, 393 Depression, 16, 28 Dietary behaviors, 112-115, 119 Dietary Guidelines for Americans, 177-178, 243, 460 Diffusion of innovation theory, 310 Disease prevention, 112, 114, 119 District school health advisory councils, 252-253, 297-296 Driver training, 41 Drop-Out Prevention Initiative, 195 Drug abuse, see Alcohol and drug abuse Dummer Grammar School, 33 E Eagle Forum, 409 Early and Periodic Screening, Diagnostic, and Treatment Program, 24, 207, 209, 219, 221, 243-244, 402-403, 432-433 Early Intervention Group, 378 Eat Smart School Nutrition Program, 179 Education. See also Health education; Physical education elements of, 3 importance of, 18-20 Education Audiology Association, 169 Education for All Handicapped Children Act, 45, 214 Education of the Handicapped Act, 168, 187 Educational Service Agencies, 188 Elementary and Secondary Education Act, 45, 48 n.4, 73 n.10, 170, 172, 173, 207, 241-242, 248, 250, 436-437 Elementary school dental services, 167, 376 extended services, 386 health education in, 5-6, 7, 110-112, 115, 140, 141-142 nutrition, 179 physical education, 93 professional development and qualifications, 141 pupil personnel teams, 371 Emergency Medical Services for Children, 218-219 Employee Assistance Programs, 174 Employment, see Youth employment Environment, see School environment

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School & Health: Our Nation's Investment Environmental health, 112, 114, 119 European Network of Health Promoting Schools, 58 Evaluation of programs, see Research and evaluation Even Start, 172, 380 Extended services. See also Dentists and dental services; School-based health centers basis for, 181 case management, 165, 174, 184, 380-381, 398 Cities in Schools, 184, 380-381 community role, 7, 181, 184, 185, 225, 369, 381 components, 367, 370 comprehensive multicomponent programs, 382-384 coordination of, 374 definition, 181 effectiveness, 366 Family Resource Centers, 185, 379-380, 398 full-service schools, 3, 59, 185-186, 204, 365, 380, 387-389 funding, 181, 185, 371, 378, 379, 380, 382, 389 goals, 367 issues, 225, 366 mental health centers, 184, 376-379, 391, 394, 395 models, 202-203, 464, 465-467 organization of, 366-389 parental permission for services, 465-467 personnel/staffing, 173-174, 367, 368, 370-372, 377-378, 465 pupil personnel teams, 173-174, 370-372 recommendations, 8, 227 regional approaches, 186, 188, 203 research and evaluation, 227 school reorganization, 66, 385-387 standards, 465-466 student assistance programs, 174, 372-373, 378, 394 success factors, 399-400 target groups, 367, 395 teen parent programs, 384-385 user characteristics, 365-366 youth service centers, school-based, 184-185, 382, 393, 395 Extracurricular activities, 98, 121 F Family and Community Endeavors, 382 Family Educational Rights and Privacy Act of 1974, 205 Family Planning Program (Title X), 183, 374, 432-433 Family Preservation Act, 48 n.4 Family Resource Centers, 185, 379-380, 388, 398, 403-404, 405 Family Resources Coalition, 380 Family services, elements of, 73-74 Family structure. See also Single-parent households and health and welfare of children, 18 and school health programs, 16, 25-27 traditional, 26 wages and earnings and, 26 Family support teams, 66-67, 386, 397 Federal Interagency Committee on School Health, 238-240 Federal programs, infrastructure building, 241-245 First aid, 71, 112, 114, 119, 155 Florida Family Resource Centers, 185, 379, 380 full-service schools, 207, 403-404 Funding for School Services Act, 199, 203-204, 251 school-based health centers, 242 n.3, 374, 391, 392-393, 397, 398-399, 403, 406, 408 School Enrollment-Based Health Insurance concept, 210-211, 298-299 Supplemental School Health Program, 371-372, 392-393 Focus on Youth, 194 Food Labeling Education Program, 436-437 Framingham, Massachusetts, 43 Full-service schools, 3, 59, 185-186, 204, 207, 380, 387-389, 403-404, 406, 407 Funding of school health services categorical, 203-204, 244-245, 264, 406 controversial, 207 coordination of, 10, 188, 239, 248-251 for coordination of services, 73 n.10 dental services, 168, 376 by excise taxes and penalties, 9, 216, 251 extended services, 181, 185, 203-204, 378-379, 380, 382, 389 federal, 179, 207, 213, 239, 430-442 Great Society and, 46 health care services, 168, 203-204 health education, 248, 250

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School & Health: Our Nation's Investment health insurance, school-based, 9, 210-212 infrastructure building, 241-245, 248-251, 262-264 Medicaid, 9, 208-209, 212, 213, 214, 219, 221, 402-403 mental health or pupil services, 169, 170, 173, 378, 379 multisource, 188 nonprofit intermediary for contracting services, 213-215 nutrition and foodservice, 175, 177, 179-180, 243 overview, 206-208 personnel/staffing, 248, 250 pooled-fund approach, 213, 263 private foundations, 208 recommendations, 9, 10, 227, 450 research and evaluation, 262-263 school-based health centers, 46, 183, 212-213, 243, 250, 374, 398, 402-405 screening, 209, 219, 221 sources, 9, 183, 207-208, 249, 250, 264, 298-299, 402-405 in standard benefit packages, 9, 216 state and local, 179-180, 207-208, 213, 239, 248, 249 surcharge on health care payers, 215 training and professional development, 248, 250 G Gallup Organization, 124 Girls Clubs of America, 381 Go for Health, 104-105 Goals 2000: Educate America Act, 48 n.4, 73 n.10, 238 Golden Anniversary Conference on Children and Youth, 44 Great Society programs, 45, 46 Growing Healthy, 104-105, 132 Guidelines health education, 64 n.6 mental health center, 377 nutrition, 64 n.6 physical activity, 4, 64 n.6, 97 professional training and education, 44-45 tobacco prevention programs, 64 n.6 Guidelines for Adolescent Preventive Services (GAPS) abuse (emotional, physical, sexual), 426 alcohol and drug abuse, 422, 424 barriers to implementation, 222 clinical applications, 47, 428 confidentiality of adolescent care, 419 delivery of health services, 417, 419 depression/suicide risk, 426 frequency of preventive services, 417-419 health guidance, 47, 417, 418, 419-422 immunizations, 417, 418, 427-428 injury prevention, 421 learning or school problems, 427 nutrition/diet-related, 421, 422-424 overview, 416-419 parental involvement, 419, 420 physical activity, 421 physical assessment, 418, 423-424 primary care providers, 222-223, 298 recommendations, 222 screening, 417, 418, 422-427 sexual behavior and responsibility, 421-422, 424-426 sociocultural sensitivity, 419 tests, 418 tobacco use, 424 topics/health conditions addressed by, 417 traditional approaches contrasted with, 428-429 Guidelines for Comprehensive School Health Programs, 63-64 n.6 Guidelines for Developing and Implementing School-Based Early Periodic Screening, Detection and Treatment Services , 458-459 Guidelines for Health Supervision, 469 Guidelines for School and Community Health Programs to Promote Physical Activity Among Youth , 4, 64 n.6, 97, 139 Guidelines for School Settings, 464 H Head Start, 45, 48 n.4, 170, 175, 380 Health aides, 163 centers, see School-based health centers defined, 1 n.1, 16 n.1, 45, 354 examination surveys, 167-168 guidance, 419-422 information, access to, 16 insurance, 27-28, 67, 160, 161, 165, 210-211, 214, 216, 241, 247, 298, 365 literacy, 4, 102, 137, 138, 139-140 records and medical information, 155, 156 services, see School health services Health Appraisal of School Children, 40

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School & Health: Our Nation's Investment Health behavior change. See also Social learning theory expectations and, 359-361, 362-363 goals and, 361-363 health education and, 5, 103-107, 109-110, 116, 117, 120-121, 122-123, 140, 281, 313-322, 341-342, 356-363 hours of instruction and, 103, 109-110, 115, 135, 140 individual characteristics and, 117, 120 measuring, 271-272 models used in health education programs, 356-363 as outcome measure, 278-279 parental involvement and, 120 peer involvement in prevention and, 120 relapse prevention, 117, 120 school-based health centers and, 7, 190, 191-192, 226, 366, 390-391 self-efficacy and, 120, 357-359, 362-363 skils and, 13, 117, 120, 362-363 social support and, 117, 120 teacher/professional qualifications and, 103, 118-119, 140 Health Care Financing Administration, 208 Health care services, see Access to Health care; Extended services; School-based health centers; School health services Health education alternative approaches, 6, 103, 110, 141 barriers to, 309 and behavior change, 5, 103-107, 109-110, 116, 117, 120-121, 122-123 , 140, 281, 283-284, 286-287, 341-342, 356-363 booster sessions, 103, 110, 141, 283-284, 285, 287, 309 cardiovascular, 316-317, 320-321 community role, 121, 137, 223-224, 306-311, 313, 316-326 controversies, 69 cost-effectiveness, 5, 122-123, 140, 327 current practice, 110-116, 140, 141 curriculum, 4, 40, 41, 45, 49, 52, 53, 58, 69, 72, 99, 100-101, 103 -108, 110-115, 132-133, 139, 258, 284, 288, 309, 342 effectiveness, 116-124, 136, 140, 284-285, 316-323 environment for, 135 exemptions from, 112 funding for, 248 GAPS recommendations, 47, 417, 418, 419-422 goals and objectives, 3, 4, 39-40, 47, 52, 69, 81, 99-100, 101-110 , 112, 136, 140, 341 grade level and, 5-6, 7, 110-112, 115-116, 140-141 health services and, 166, 182, 215, 218-219, 223-224, 373, 417, 418 , 419-422 hours of instruction, 103, 109-110, 115, 140, 141, 281-282, 283-284 infrastructure, 457-458 infusion/integration approach, 13, 40, 68, 69-70, 74-75, 98, 111, 112-116, 125-131, 136-137, 138, 176, 180-181 instructional elements, 45, 46, 99, 100-101, 117, 120, 121-122, 126 , 127, 132-133, 141, 285-286, 342 interagency collaboration, 247 issues, 326-328 legislation, 41 literature review, 306 local education agency role, 137 media role, 121, 309, 318-323, 325 models, 307-308 national action plan, 135, 136, 140 national organizations' role, 138 National Science Education Standards and, 129-130 needs, 132-135 outcomes, 103, 116-117, 287-288, 341-342 parental involvement, 101, 117, 120, 318-323, 325, 420 peer-based, 286 performance assessment, 102-103, 108, 141, 240 physical fitness, 98, 112-115, 125, 126, 128, 134, 320-321, 421 policy and administrative support, 135, 239-240, 325, 341 priorities, 4, 101, 138, 139, 140, 141 professional development and qualifications, 5, 6-7, 103, 108-109, 115-116, 117, 118-119, 121, 133-134, 137, 138, 140, 141-142, 343, 457-458 public perceptions of, 123-124, 140 recommendations, 5-7, 135-142 requirements for graduation, 5, 6, 110-112, 140, 141 research and evaluation, 5, 103-107, 116-124, 132, 135, 280-288, 312

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School & Health: Our Nation's Investment risk-factor specific vs. problem behavior intervention, 286-287 role in CSHPs, 99-139 in school-based health centers, 182, 373, 470, 472-473 Science for All Americans standards, 130-131 sexuality and reproductive, 49, 69, 100, 112-115, 119, 130, 166, 286, 314-315, 318-319, 421 SHPPS findings and recommendations, 110-116, 135, 138-139, 140, 141 sociocultural issues, 117, 121 standards, 4, 5-6, 48, 101-103, 108, 109, 129-131, 132, 135, 136-138 , 139-140, 141, 238-239, 466-467 state education and health agencies, 137 strategic prevention concept, 311-313 teaching/learning materials, 342-343 theoretical framework, 116, 117, 120, 309-310, 356-363 trends, 104-107, 117, 121 Health Insurance Association of America, 67-68 Health promotion effectiveness of programs, 314-315, 320-321 objectives, 46-47 movement, 38, 117, 121 for staff, 3, 53, 67-68, 352-353, 461 Health status and academic achievement, 19, 51 nutrition and, 72-73 physical education and, 4, 68-69, 81-82, 83, 84, 139 school-based health centers and, 7 Health Supervision and Medical Inspection of Schools, 39 Health: You've Got to Be Taught, 123 Healthy Caring, 183, 258-259 Healthy Kids Corporation, 299 Healthy Kids: Nutrition Objectives for School Meals, 175 Healthy People 2000 initiative, 22, 39-40, 46-47, 67-68, 83-84, 85 , 99, 102, 112-115, 177-178, 215 n.6, 271 Healthy Schools, Healthy Communities, 48, 243, 280, 434-435 Healthy Start program, 193, 207, 298, 393-394, 395, 396, 397 Hearty Heart, 104-105 High Risk Youth Demonstration Grant Program, 432-433 High schools, see Secondary schools Hillsdale County Elementary Success Program, 195 Hispanics family structure, 26 poverty, 23 History of school health programs, 1 lessons learned from, 48-50 1960s to present, 45-48 1700s through early 1900s, 33-38, 82 World War I to 1960s, 38-45 HIV/AIDS Higher Education Consortia, 458 HIV Education Program, 100, 436-437 Hogg Foundation for Mental Health, 383, 404 Home economics, 69, 70, 72, 125, 126, 128, 129 Honeywell Corporation, 384-385 How to Fund Public Health Activities, 215 How to Live with 10-15 Year Olds, 462 Human Genome Project, 127 Human growth and development, 69, 112, 114, 119 Human Services Reauthorization Act, 48 n.4 Human sexuality, 49, 69, 100, 112-115, 119, 130, 166, 409, 421 I Illinois, 35, 56, 58, 194, 374, 380 Immunizations, 34, 155, 157, 160, 396, 398, 427-428 Improving America's Schools Act, 48 n.4, 73 n.10 Indian Health Service Clinical Services, 432-433 Individualized Education Plans, 50, 155, 156, 168, 177 Individuals with Disabilities Education Act, 168, 170, 172, 173, 187, 207, 210, 242, 244, 248, 436-437 Infant mortality rates, 18 Infrastructure building for CSHPs advisory and coordinating councils, 247, 252-254, 259-260, 263, 264-265, 297-298 barriers to, 11, 256-259, 298-299, 448 CDC/DASH models, 247-248 collaboration in, 256, 259, 260-261, 298 communications, 250, 263, 298, 448 community or district level, 10-11, 252-253, 259-260, 264-265, 266 , 461-462

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School & Health: Our Nation's Investment community support mobilization, 252, 259-260 controversy management, 11, 257-259 district school health coordinator, 253 extension service, 10, 251-252, 263, 264 federal programs, 241-245, 451 funding streams, 10, 241-245, 248-251, 262-264, 298-299, 450 health education, 457-458 health services, 247, 253-254, 265-268, 458-459 interagency collaboration, 9-11, 247, 256, 263 Interagency Committee on School Health, 9-10, 47, 238-240, 262 interdisciplinary teams, 254-256, 257, 265, 267-268, 298, 457 leadership, 9, 247 local level, 252-261 mental health and pupil services, 460 models, 456-462 National Coordinating Committee on School Health, 9, 10, 240-241, 262 national level, 9-10, 238-246, 262-263, 266 objectives, 246 nutrition and foodservices, 460-461 personnel training needs, 11, 249, 256-257, 265, 267-268, 449-450 physical education, 459 recommendations, 9-11, 261-268 research and evaluation, 262-263 resources, 249, 259, 449-450 school environment, 460 school level, 11, 253-254, 265-268, 460 state level, 10, 239, 246-252, 263-264, 266, 451 teacher and staff wellness, 461 technical assistance, 251-252, 263, 264 and turf battles, 259, 406-407 Injury prevention and control, 100, 112-115, 119, 218-219, 320-321 , 421 Institute of Medicine Committee on Comprehensive School Health Programs in Grades K-12, 154 n.1 Committee on the Future of Primary Care, 154 n.1 Instruction duration, sequence, and timing of, 103, 109-110, 115, 135, 140, 141 , 283-284 health education, 45, 46, 52, 98, 99, 100-101, 103, 109-110, 115, 117, 120, 121-122, 126, 127, 132-133, 135, 140, 141, 283-284, 342 physical education, 98, 348 social skills, 132-133 Instructional materials, 342-343 Interagency Committee on School Health, 9-10, 47, 238-240, 262 Interdisciplinary teams, 171, 254-256 International models of CSHPs, 58-59 Inwood House, 372-373 J Jackson-Hinds Comprehensive Health Center (Mississippi), 374 Johns Hopkins University, 66, 196, 243 n.4, 386 Joint Committee on Health Education Terminology, 59-60 Joint Committee on National Health Education Standards, 101-102, 129, 131 Jump Rope for Heart, 94 Junior high, see Middle school Junior League, 184, 381 Just Say No clubs, 378 K Kentucky, 185, 379, 382, 403, 406, 408 Kiwanis Club, 376 Know Your Body, 104-105, 132, 281, 282 L Language arts, 69, 70, 125, 126, 127, 128-129 Latchkey children, 26-27 Leadership, 9, 247 Legislation, 41, 45, 48 n.4, 73 n.10, 100-101, 157, 179, 379. See also specific statutes Lehigh University College of Education, 381 Life Skills Training, 284-285 Local community extended service providers, 369 funding sources, 207-208 health education role, 137 infrastructure building, 252-261 process evaluation, 12 Locust Point Demonstration, 43 Los Angeles, 191, 377, 390 Louisiana, 175, 374 Low-income families. See also Poverty children in, 23 health problems in, 160-161 utilization of extended services, 265-266

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School & Health: Our Nation's Investment M Maine, 248, 443-455 Making the Grade, 183, 212, 213, 246, 404 Managed care, 10, 207-208, 211, 213, 214-215, 241, 247, 298-299, 374, 403, 404-405 March of Dimes, 207 Maryland, 43, 182-183, 191, 368, 386, 390, 394 Massachusetts, 34, 35, 82, 251, 374, 376 Maternal and child health agencies, 40, 207, 458, 459 Maternal and Child Health Bureau, 47, 48, 217 n.7, 243 Maternal and Child Health State Block Grants, 183, 213, 243, 244, 250, 374, 402, 434-435 Mathematics, 69, 70, 75, 126, 127, 128-129 Media role, 55, 121 Medicaid, 45, 244 and access to health care, 160 Early and Periodic Screening, Diagnostic, and Treatment Program, 24, 207, 209, 219, 221, 243-244, 402-403, 432-433 eligibility screening, 459 nutrition-related funding, 177 for school health services, 160, 183, 207, 208-209, 212, 213, 214, 243-244, 374, 389, 402-403, 459 Memphis City Schools Mental Health Center, 377-378 Mental health and pupil services. See also Mental health centers community health linkages, 71, 172, 173-174 counseling, 3, 49, 155, 156, 157, 169, 171-172, 184, 192, 248, 297 , 391, 460 demand for, 365-366 direct services to students, 349-350 education, 112, 114, 119, 125 funding, 169, 170, 172, 173 goals, objectives and outcomes, 3, 71, 349 guidelines, 349-350 infrastructure building, 460 issues, 170-172, 173 mechanisms for providing, 173-174 models, 464, 469-470 need for, 71-72, 297 outcomes, 394 policy and administrative support, 349 poverty and, 160 problem identification and resolution, 222 professional development, 119, 170, 171, 173, 350 psychological, 3, 8, 155, 156, 169-171, 297, 460 recommendations, 8, 226 in school-based clinics, 464, 469-470, 472 social morbidities and, 71-72 social services, 3, 71, 169, 172-173, 222, 460, 472 staffing, 170, 171, 172-173 standards, 170, 173, 464, 469-470, 472 student assistance programs, 174, 372-373 team approach, 66, 67, 171, 173-174, 370-372, 386 utilization, 191, 395 Mental health centers, 184, 376-379 Metropolitan Life Foundation, 123 Metropolitan Life Insurance Company, 43, 283 Michigan, 242 n.3, 374, 395, 407 Mid-Century White House Conference on Children and Youth, 44 Middle school health education, 5-6, 110-112, 140, 283-284 physical education, 85, 88 psychosocial interventions, 67, 460 school health services programs, 201 substance abuse prevention, 283-284 Milbank Memorial Fund, 43 Minimum Health Requirements for Rural Schools, 39 Minnesota, 192-193, 242 n.3, 384-385 Missouri, 195, 199, 201, 382, 396, 397 Modern Health Crusaders, 36 Motor vehicles driver training, 41 and mortality, 23 and risky behaviors, 20 N Nashville, Tennessee, 380, 398 Nation at Risk, A, 46 National Action Plan for Comprehensive School Health Education, 5, 135, 136, 140, 246, 262 National Adolescent Health Information Center, 243 n.4 National Adolescent Health Resource Center, 217 n.7, 243 n.4

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School & Health: Our Nation's Investment National Alliance of Pupil Services Organizations, 173, 370 National Assembly for School-Based Health Care, 48, 374 National Assessment for Educational Progress, 240 National Association of: Community Health Centers, 242 Elementary School Principals, 241 School Nurses, 48, 153-154, 161 n.3, 162, 163, 241, 464, 465, 471 School Psychologists, 154, 162 n.3, 170 Secondary School Principals, 241 Social Workers, 154, 162 n.3, 172-173, 464, 469-470, 472 State Boards of Education, 47, 245 National Cancer Institute, 251 National Center for: Education in Maternal and Child Health, 243 n.4 Health Statistics, 168 Leadership Enhancement of Adolescent Programs, 243 n.4 Partnership Development, 381 National Cholesterol Education program, 158 National Commission on Children, 46, 245 National Commission on the Role of the School and the Community in Improving Adolescent Health, 444 National Committee on School Health Policies, 40 National Conference for Cooperation in Health Education, 40 National Congress of Parents and Teachers, 36 National Coordinating Committee on School Health, 9, 10, 47, 238, 240-241, 262, 430-431 National Council for the Accreditation of Teacher Education, 44, 108, 109 National Education Association (NEA), 36, 39, 40, 241 National Education Goals, 4, 19-20, 47, 89-90, 101, 102, 139, 238 National Food Service Management Institute, 177 National Health and Education Consortium, 183 National Health Education Standards, 4, 5-6, 48, 101-103, 108, 109 , 129-131, 132, 135, 136-138, 139-140, 141, 176, 240, 246, 262 National Heart, Lung, and Blood Institute, 179, 422 National Institute of Alcohol Abuse and Alcoholism, 372 National Institute of Dental Research, 168 National Nursing Coalition for School Health, 48, 163 National organizations. See also individual organizations extended services from, 369 health education role, 138 infrastructure building, 238-246, 262-263, 266 National Parent Teachers Association, 241 National School-Based Oral Health/Dental Sealant Resource Center, 243 n.4 National School Boards Association, 47, 109-110, 167, 241, 245-246 , 253, 376 National School Health Bill, 42 National School Health Leadership Conference, 244 National School Health Project, School-Based Adolescent Health Care , 246 National School Lunch Act, 41, 175, 177, 179 National School Lunch Program, 25, 175, 211, 438-439 National Science Education Standards, 129-130 National Standards for Physical Education, 4, 48, 83, 85, 97, 139 National State School Nurse Consultants Association, 48 National Tuberculosis Association, 36, 43 NEA-AMA Joint Committee on Health Problems in Schools, 39, 40, 166 New Beginnings (San Diego), 383-384, 405-406 New Futures School, Inc. (Albuquerque), 384 New Jersey, 175, 378-379, 403, 404 New Mexico, 54, 242 n.3, 384 New Vistas High School (Minneapolis), 384-385 New York City Astoria Plan, 41, 43-44 Beacons program, 185, 382 Drop-Out Prevention Initiative, 195 full-service schools, 387-388, 408 Health Day, 41

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School & Health: Our Nation's Investment lunch program, 49, 179 medical inspection of schools, 34-36, 41 school health services, 37, 396 Teen Choice program, 372-373 New York State, 36, 193, 242 n.3, 372, 374, 396, 400 North Carolina, 185, 371, 379, 410, 462 Nurse Practitioner/Nurse-Midwifery, 436-437 Nurses and nurse practitioners burdens and responsibilities, 165, 407 evaluation of activities, 189, 400 historical role in schools, 35, 42, 45, 366 issues related to, 164-165, 222-223, 406 as primary care providers, 222-223 qualifications and professional training, 153-154, 163, 164, 345-346 services provided by, 45, 71, 75, 153, 162-163, 386, 388, 400, 406 staffing patterns, 163-164 standards, 48, 153, 163 Nursing Special Projects Grant Program, 438-439 Nutrition and foodservice. See also Dietary behaviors breakfast program, 41, 45, 73, 175, 243, 438-439 counseling, 155, 156, 158, 176-177 education, 69, 72, 74-75, 112-115, 119, 129, 130, 176, 180-181, 243 , 421 funding, 175, 177, 179-180, 243 goals and objectives, 3, 52-53, 351 guidelines, 350-352 and health status, 72 infrastructure building, 460-461 integrated approach, 74-75, 129, 247 issues related to, 20, 23, 177-181 legislation, 175, 176, 179 lunch programs, 25, 37, 41, 49, 175, 178, 179, 211, 243, 244, 438 439 perceptions of nutrition, 180 personnel, 177 policy and administrative support, 179, 350-351 professional development/training, 119, 177, 181, 352 profit-making, 180 recommendations, 8, 226 research, 73 and risky behaviors, 21 screening related to, 158, 176-177 services provided, 174-177, 351-352 Snack Program, 243 Special Milk Program, 243 for special-needs children, 177 standards, 48, 154, 177, 178, 180, 239 and student performance, 73, 178 vending machines, special events, and fundraisers, 73, 75, 176, 178 , 460 Nutrition Education and Training Program, 45, 176, 243, 248, 436-437 Nutrition for Life, 106-107 Nutrition in a Changing World, 106-107 O Obese children, 86-87 Obsessive-compulsive disorder, 24 Occupational Safety and Health Administration, 64 Occupational therapists, 168 Office of Technology Assessment of the U.S. Congress, 47, 64-65 Ohio Research Study, 43 One-Stop-Shopping in a Northeast Nashville Community, 380, 398 Open-air classrooms, 36 Opportunity-to-Learn Standards, 136-138 Oregon, 191, 258, 390 Outcomes behavioral change as, 278-279, 313-322 community, 51 desired, 50-51 dose-response relationship, 282-283 effectiveness trials, 187, 273, 276 efficacy testing, 273, 276, 277 evaluation, 11-12, 13, 14, 50-51, 271-272, 273, 275, 276, 287-288 of health education curricula, 103-107, 116, 282-283, 287-288, 313 -322 health-services-related, 14, 189, 394-396 implementation effectiveness trials, 273-274 measures of, 7-8, 12-13, 277, 278-279, 289 mental health, 14, 394 null or negative, interpretation of, 12-13 positive, protective factors for, 23 poverty and, 159-161 pregnancy-related, 192-193, 392-393 programmatic and organizational, 51 realistic, 287-288 school-based health centers and, 7-8, 190, 191-193, 366, 392-398 school-related, 14, 396-398

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School & Health: Our Nation's Investment of standards development, 102-103 student, 50 substance abuse-related, 393-394 P Parental consent for health services, 190, 205, 206, 389, 399, 465-467, 468-470, 471-473 Parental involvement. See also Teen parent programs and academic achievement, 25 and confidentiality of student records, 205, 206, 419 disadvantaged students, 66 funding for programs, 248 goals for, 47, 54 and health and welfare of children, 18 in health education, 101, 117 in health services, 185-186, 190 historical examples, 44 importance of, 41, 398 in infrastructure building, 258-259 interventions involving, 66, 386, 387 in physical education, 98 Parent to Parent training, 378 Partnership for Prevention, 215 Pawtucket Heart Health Program, 106-107 Peer cluster theory, 310 Peer Mediation Training, 250 Peer Power and ADAM, 106-107 Pennsylvania, 35, 37, 386, 387 Personal health, 112, 114, 119 Philadelphia, 35, 37, 386 Physical education and academic achievement, 68, 85, 90-91 academic rigor and, 90-92 attendance, 21 CDC recommendations, 97-98, 139 community-based programs and facilities, 98 contributions of, 3, 94, 97-98, 139 current practice, 85, 88-92 curriculum, 37, 52, 68, 84, 85, 88-92, 95, 98, 139, 347-348 evaluation, 88-89, 98 exemptions from, 85 extracurricular activities, 98 goals and objectives, 4, 47, 52, 68, 81, 82, 83-84, 92-93, 97, 101 , 346-347 grade level and, 68, 85, 88, 93-94, 95 guidelines, 139, 346-349 health education and, 98, 112-115, 125, 126, 128, 134, 421 and health services, 98 and health status, 4, 68-69, 81-82, 83, 84, 90-91, 94, 97, 139 history of movement, 37, 41, 82 infrastructure building, 459 instruction methods, 98, 348 intensity of activity, 89, 92-93 legislation, 41 motor skill development, 84, 90-91 nutrition education in, 72 parental involvement, 98 personnel/teachers, 92-94, 96, 98 policy and administrative support, 97-98, 346 professional development/training, 84, 90-91, 93-94, 96, 98, 119, 134, 348 and public health, 82, 92-93 quality of, 83-84, 85, 88-89 recommendations, 97-98, 139 requirements, 68, 85, 88, 94, 95 research evidence on, 81-82, 84-85, 86-91, 139 research needs, 85 role in CSHPs, 81-98 scheduling and environmental factors, 89-90 school-based programs and facilities, 98 standards, 4, 83, 139, 239 strategies to promote physical activity, 94 student outcomes, 68-69, 84, 347 and substance abuse, 85 testing of students, 94, 459 Physical environmental of schools, 340-341 hazards, 65 legislation, 64-65 program elements of, 2, 64-65 structural condition of schools, 24-25 Physical examinations, 36, 43-44, 419 Physical fitness, health-related, 20, 84 Physical therapists, 168 Physicians historical role in schools, 37-38, 42, 166 issues related to, 166-167 qualifications and professional training, 166, 345 services provided by, 71, 165-166 "snip doctors," 37 social contract, 167 staffing patterns, 164

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School & Health: Our Nation's Investment Pinal County Prevention Partnership (Arizona), 381 Pinkston High School (Dallas), 375 Policy and administrative support, 349, 352 elements of, 2 environment, 2, 65, 135, 339 health education, 135, 341 health services, 225-226, 343-344 nutrition and foodservice, 179, 350-351 physical education, 97-98, 346 Population-based prevention, 157-158 Portland, Oregon, 258 Postponing Sexual Involvement, 106-107 Poverty and academic achievement, 24 and health care, 24 and health outcomes, 22-25, 159-161, 167-168 measure of students in, 25 and nutrition, 180 rates, 18 and school environment, 24-25 and school health services, 16, 38, 158-161, 167-168 and social morbidities, 24 Pregnancy, see Teen pregnancy Preschool programs, 66 President's Physical Fitness Test, 459 Primary care defined, 154 nurses as providers, 222-223 regional approaches to delivery, 186, 188 in school-based health centers, 15, 42, 45, 58, 154, 158, 160-161, 182, 187, 201, 217-218, 222-223, 373, 466, 469, 471-472 Principles and Practices of Student Health, 64 n.6, 219 Principles to Link By, 47 n.3, 261 Professional development, training, and certification computer network discussion groups, 109 demand for, 5, 116, 118-119, 140 elementary school teachers, 141 funding for, 248, 250 health care services, 153-154, 163, 164, 166, 169, 345-346 health education, 5, 6-7, 103, 108-109, 115-116, 117, 118-119, 121 , 133-134, 137, 138, 140, 141-142, 343 infrastructure building, 11, 256-257, 265, 267-268, 449-450, 457-458 interdisciplinary approach, 11, 257, 265, 267-268 issues, 408-409 mental health and pupil services, 66, 170, 171, 184, 350 nurses, 153-154, 163, 164, 345-346 nutrition and foodservice, 119, 177, 181, 352 and outcomes, 103 peer coaching, 109 physical education, 84, 90-91, 93-94, 96, 98, 348 physicians, 166 recommendations, 6-7, 11, 137, 138, 265, 267-268, 449-450 research on, 44 for special-needs services, 169 standards, 108-109 transfer of training, 109 Program facilitators and coordinators, 66 Programs That Work project, 108 Project Pride, 194 Project School Care, 189 Psychologists issues related to, 170-171 personnel, 170 services provided by, 169-170, 371 Psychosocial environment and academic achievement , 65-66 elements of, 2-3, 65-67, 339-340 School Development Program, 66 Success for All, 66-67 Turning Points, 67 Public education, compulsory, 33-34 Public health, physical education and, 82, 92-93 Public perceptions of health education, 36, 123-124, 140 of nutrition, 180 of school health services, 410 of school role in integrating services, 445 Pupil personnel teams, 173-174, 370-372 Q Quality physical education, 83-84, 85, 88-89 school-based health centers, 190, 196, 389, 391 school health services, 8, 14, 154 Quincy, Florida, 398-399

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School & Health: Our Nation's Investment R Race/ethnicity and poverty , 23 Ranier Beach High School (Seattle), 396 Reading, 66, 90-91 Recommendations CDC, 97-98 confidentiality of health records, 227 data collection, 227 extended services, 227 funding, 227 health education, 5-7, 135-142 infrastructure building, 9-11, 261-268 physical education, 97-98, 139 research, 13-14, 289-291 school health services, 8-9, 226-227 SHPPS, 138-139 Recommended Dietary Allowances, 178 Reducing the Risk, 106-107 Regional approaches, 186, 251-252 Reports and publications, influential/landmark, 34, 38-41, 245 Requirements for graduation health education, 5, 6, 110-112, 140, 141 physical education, 68, 85, 88, 94, 95 Research and evaluation. See also individual projects and studies basic, 11-12, 13, 272-273, 288, 290 challenges, 12, 75-76, 240, 271-272, 275, 289 components of programs, 12, 14, 285-286, 291 coordination of, 240 data collection, 198-199, 280 dependent variables, defining, 278-279 diffusion-related, 13 dose-response relationship, 275, 281-284 effects of comprehensive programs, 281, 284-285 ethical issues, 277 feasibility, 280, 289, 327 funding for, 262-263 goals, 51 guidelines/manuals on, 280 Hawthorne effect, 279 health education, 5, 103-107, 108, 110, 116-124, 132, 135, 138, 281 -288, 312 historical context, 43-44 independent variables, defining, 277-278 infrastructure building, 262-263 on integration of program components, 75-76 linking outcome and process evaluations, 275 methodological challenges, 190, 274, 276-280, 389 organization, governance, and financing, 186, 187, 398-400 outcome evaluation, 7-8, 11-12, 50-51, 63, 170, 189, 271-272, 273, 275, 276, 287-288, 290, 392-398 overview, 271-276 physical education, 81-82, 84-85, 86-91, 98, 116-124 process evaluation, 11-12, 247-248, 274, 275, 276, 288, 289, 312 professional education and training, 44 recommendations, 13-14, 289-291, 450-451 reporting bias, 280 researchers, 275-276 school-based health centers, 7-8, 226, 190-199 school health services, basic, 8, 40-41, 186-189 self-reporting biases, 279 student health needs, 186-187 Type III error, 279 types of, 272-276 uses for, 276 utilization studies, 389-392 validity assessment, 277-280 workforce issues, 186, 187 Resource Coordinating Team, 173-174, 370-371 Responsible Students Program, 460 Rhode Island, 34, 242 n.3 Risks to Students in Schools, 64-65 Robert Wood Johnson Foundation, 45, 46, 183, 187, 190, 192, 193, 212, 246, 258, 374, 390, 391, 395, 399, 404 Rules of the Health Game, The, 39 S Safe and Drug-Free Schools and Communities, 172, 174, 183, 207, 242 , 244, 250, 374, 377, 436-437 Safety programs, 41, 165, 218-219 San Antonio, Texas, 383 San Diego, California, 383-384, 405-406 San Fernando, California, 394-395, 396 San Francisco, California, 106-107, 394 San Jose, California, 394 School advisory councils and committees, 66, 138-139, 253-254, 386 School-Based Adolescent Health Care Program, 46, 183, 193

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School & Health: Our Nation's Investment School-Based Clinics That Work, 183 School-based health centers. See also Mental health centers and academic performance/graduation rates, 396-398 and access to care, 7, 196, 226, 298, 366, 394, 403 administration, 467 and behavior change, 7, 190, 191-192, 226, 366, 390-391 case studies, 183 client characteristics, 161, 190-192, 390-392 community health linkages with, 7, 374, 470, 473 confidentiality issue, 191, 390 controversies, 398 cost-benefit studies, 193-196, 389, 400 data collection and management, 198-200 definition, 373 dental services, 473 education role, 182, 373, 470, 472-473 enrollment, 389-390 funding and expenditures for, 46, 183, 212-213, 243, 374, 398, 403 and hospital/emergency room utilization, 193, 196, 366, 394, 400 measures of effectiveness, 7-8, 226, 366 mental health services, 464, 469-470, 472 mobile vans, 182-183, 373-374, 375 models, 203, 374, 467-473 number of, 182, 373 organization of, 373-375, 470-471 outcome data, 7-8, 190, 192-195, 392-398, 400 parental consent, 190, 389, 399, 468-470, 471-473 part-time, 467-470 personnel/staffing, 182, 312, 398, 468, 471 primary care in, 15, 42, 45, 58, 154, 158, 160-161, 182, 187, 217 218, 373, 466, 469, 471-472 quality of care, 190, 196, 389, 391 referral and follow-up, 466, 469 research and evaluation, 190-199, 226 research needs, 7, 196, 199 services, 71, 167, 182, 183, 203, 374-375 standards of care, 239, 469-470, 471-473 strengths and weaknesses, 196, 197-198 utilization, 161, 190-192, 389-392, 393, 394-396 School Breakfast Program, 45, 175-176, 438-439 School-Community Health Project, 43 School Development Program, 66, 385-386 School Enrollment-Based Health Insurance concept, 210-211 School environment CSHP , 64-68, 339-341 eight-component program, 53 goals, 51, 53, 101 guidelines, 339-341 infrastructure building, 460 issues, 224 physical, 2, 24-25, 34-35, 64-65, 340-341 policy and administrative, 2, 65, 135, 224, 339 poverty and, 24-25 psychosocial, 2-3, 65-67, 339-340 sanitary inspections, 34-35 three-component program, 52, 53 School guidance counselors. See also Vocational counseling issues related to, 171-172 personnel, 171 services provided by, 75, 169, 171 visiting teachers, 38 School Health Care Online!!!, 199, 200 School Health Challenge, 64 n.6 School Health Coordinating Council, 11, 355 School Health Education Evaluation, 282, 313, 322-323 School Health Education Study (SHES), 4, 45, 100-101, 117 School Health Education Study: A Summary Report, 45 School health extension service, 10, 251-252, 263, 264 School Health Policies and Programs Study (SHPPS), 4, 5, 69, 71, 85, 92, 110-116, 132, 135, 138-139, 140, 141, 153, 155, 163, 182, 247, 252, 297, 373 School Health: Policy and Practice, 64 n.6, 154, 163, 217 n.7, 219 , 464, 465, 471 School health programs. See also Community participation in CSHPs; Comprehensive school health programs; History of school health programs access to health care and, 27-28 components, 313-316

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School & Health: Our Nation's Investment conferences and collaborative efforts, 44-45 context for, 16, 18-28 effectiveness, 313-316, 322-323 family structure changes and, 25-27 importance of education and, 15, 18-20 models, 167 nature of, 41-43 poverty and, 22-25 reports and publications influencing, 38-41 research and experimentation, 43-44 social morbidities and, 16, 20-22 School Health Resource Services, 243 n.4 School health services. See also Extended services; School-based health centers; Screening programs barriers to utilization, 212 basic, 14-15, 161-181, 186-189, 201, 202, 463-465 community linkages, 165, 172, 173, 187, 217, 225-226, 403-404, 464 , 467 components, 7, 71, 153-157, 225, 367 confidentiality of records, 8-9, 204-206, 227 coordination of, 345 crisis medical situations, 218-219 data collection, 8-9, 198-199, 227 definition, 153 delivery of, 15, 45, 186, 187, 188, 202-203, 419 evaluation of programs, 8-9, 187, 224-225 financing, see Funding of school health services first aid and administration of medicines, 71, 155, 156, 218 goals and objectives, 3, 42, 51, 52, 53, 71, 154, 216-217, 344, 367 guidelines, 343-346, 458-459 health education, 166, 182, 215, 218-219, 223-224, 373 history, 37, 42 implementation steps, 216-225 infrastructure building, 247, 253-254, 265-268, 458-459 issues of concern, 70-71, 164-165, 166-167, 169 legislation affecting, 157 levels matched with needs, 199, 201-204 medical inspections of schools, 35-36, 41-42 mental health, see Mental health and pupil services need for, 157-159, 186-187, 225 needs assessment, 217, 245 nurses and nurse practitioners, 162-165, 189, 345-346, 366 nutrition, see Nutrition and Foodservice organization and governance, 186, 187, 188, 464 outcomes, 189, 192-193 parental consent for, 190, 205, 206, 389, 399, 465-467, 468-470, 471-473 personnel/staffing, 40, 71, 186, 187 physical education and, 98 physicians, 165-167, 345 policy and administrative support, 225-226, 343-344 poverty and, 158-161 primary care, 15, 42, 45, 58, 154, 158, 160-161, 163, 182, 201, 217 -218 problem identification and resolution for students, 221-223 professional development/training, 163, 166, 169, 346 quality, 8, 14, 154, 226 rationale for, 401-402 recommendations, 8-9, 226-227 referral and follow-up of students, 40-41, 42, 174, 218 n.8, 221-222 research on, 40-41, 186-199 and school environment, 224 SHPPS survey, 155, 157 for special-needs students, 155, 156, 157, 165, 168-169, 170, 177, 187-188, 189, 209, 210, 214 standards, 162, 463-464, 466 status of, 401 student services, 344-345 team approach, 43, 121, 165, 188, 221, 247, 254-256 School Health Study, 43 School Mental Health Centers, 243 n.4 School Mental Health Project, 184, 377 School Nutrition Dietary Assessment Study, 73, 178 School-to-Work Opportunities Act, 48 n.4 Schools for the Future Project, 383, 404 Science assessment measures, 108 health education in, 13, 69, 70, 125, 126, 127-128, 129-131, 134

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School & Health: Our Nation's Investment national standards, 129-130 nutrition education in, 72, 75 profession qualifications and training, 134 Science for All Americans, 130-131 Screening programs alcohol and drug, 156, 422, 424 anticipatory guidance, 209, 403 cardiovascular, 156, 316-317, 422-423 child abuse, 426 cholesterol, 158, 422-423 criteria for effective programs, 220 dental, 167, 209 Early and Periodic Screening, Diagnostic, and Treatment Program, 24, 207, 209, 219, 221, 243-244, 402-403, 432-433 eating disorders and obesity, 165, 176-177, 423-424 emotional/mental health, 426 evaluation of, 187, 189 follow-up and referral, 40-41, 42, 176-177, 221-222 funding for, 209, 219, 221 GAPS recommendations, 422-427 height and weight, 71, 156, 165, 209, 423 HIV, 425-426 hypertension, 422 implementation, 219-221 issues, 221 learning or school problems, 427 Pap tests, 426 physical fitness, 156 rationale for, 157 recommendations, 219 responsibility for, 42 scoliosis, 155, 166, 189 sexual behavior, 424-425 sexually transmitted diseases, 425 tobacco use, 424 tuberculin skin test, 427 vision and hearing, 71, 155, 156, 165, 189, 209, 221-222 Search Institute, 27 Seattle, Washington, 396 Secondary schools completion rates, 20 dropouts, 19-20, 21, 195, 380-381 health education, 6, 110-112, 115-116, 182 school-based health centers, 182 Self-efficacy, 68, 357-359, 362-363 Services. See also Nutrition and foodservice; School health services; other specific services elements of, 3 Settlement-house workers, 38 Sex education, see Human sexuality Sexual behavior, 20 cost-effectiveness of interventions, 122, 123 health education and, 123, 132 and mortality, 23 trends, 20-21, 72 Sexually transmitted diseases, prevention, 16, 20, 46, 69, 100, 112 -114, 119, 122, 123, 129, 196, 400 Single-parent households, 18, 26-27 Skills, see social skills Smallpox, 34 Smoking, see Tobacco use Social learning theory goals, 116, 361-363 and health education, 116, 117, 120, 310 outcome expectations, 359-361, 362-363 self-efficacy, 357-359, 362-363 skills, 362-363 Social morbidities, new, 20-22, 46, 49-50, 72, 101, 139, 158-159, 245, 401-402, 416, 444-445 Social services. See also Social workers community linkages, 71, 222 model programs, 38, 466 standards, 466 Title XX, 374 Social skills and behavior change, 13, 117, 120, 131, 285-286, 362-363 communication and decision-making, 133 conflict resolution, nonviolent, 100, 112, 114, 118, 133, 378 curriculum, 66, 122, 132-133, 386 goal-setting, 133 measures of, 13 practice by students, 132-133 resisting social pressures, 133 stress management, 133 Social studies, 69, 70, 75, 125, 126-127, 128-129 Social support theory, 310 Social workers issues related to, 173 personnel, 172-173

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School & Health: Our Nation's Investment services provided by, 169, 172, 371, 380-381 Society for Public Health Education, Inc., 59 n.5 Society of State Directors of Health, Physical Education, and Recreation , 59 n.5 Sociocultural perspectives in delivery of health services, 419 in health care utilization, 212 in health education, 117, 121 South Tama County Partnership Center (Iowa), 379, 397 Southern Council on Collegiate Education for Nursing, 165 Southern Regional Education Board, 165 Solving School Health Problems, 44 Special-education and special-needs students, 37-38, 50, 71, 155, 156, 157, 165, 170, 177, 187-188, 189, 209, 210, 214, 248 Special Supplemental Food Program for Women, Infants, and Children (WIC), 438-439 Speech, language, and hearing therapists, 168-169 Spiral of silence theory, 310 Sports, see Competitive sports Sports medicine programs, 166 Standards for Social Work in Health Care Settings, 469-470, 472 Stanford Adolescent Heart Health Program, 106-107 Stanford University, 385 St. Louis, Missouri, 195, 382 St. Paul, Minnesota, 192-193, 298 State agencies and organizations advisory councils , 247 extended services from, 369 funding sources, 179-180, 207-208, 213 health education role, 137 infrastructure building, 10, 246-252, 263-264, 266 interagency coordinating council, 241, 247 State Collaborative on Assessment and Student Standards project, 108, 240 State Nurse Practice Act, 163 Strategic prevention concept, 311-313 Stress prevention, 314-315 Student Assistance Model, 372 Student assistance programs, 174, 250, 312-313, 372-373, 378, 394 Student Leadership Training, 378 Student outcomes desired, 50 expectations, 359-361, 362-363 health centers and, 192-193 health education, 341-342 physical education, 347 Student services, 344-345 Substance abuse, see Alcohol and drug abuse Substance Abuse and Mental Health Services Administration, 280 Success for All, 66-67, 386, 397 Suggested School Health Policies, 40 Suicide and suicide prevention, 20, 22, 72, 112, 114, 119, 322-332 Supplemental School Health Program, 371-372, 392-393 T Teachers and personnel. See also Professional development, training, and certification burden on, 44 health education, 5, 108-109, 115-116, 133-134, 138 health promotion for, 3, 53, 67-68, 224, 352-353, 461 health status of, 41 physical education, 84, 92-94, 96, 98 as role models, 68, 109 training/qualifications, 42, 84, 98 Teaching methods, see Instruction Team Nutrition program, 243 Technical assistance, 184, 251-252, 263, 264 Teen Choice, 372-373, 393 Teen Health Centers, 214, 395, 407-408 Teen Health Corps, 381 Teen parent programs, 384-385 Teen pregnancy, 16, 20, 46 outcomes of interventions, 192-193, 196, 392-393, 400 prevention, 112, 114, 119, 122, 123, 192-193, 316-319, 322-323, 372 -373, 375 Teenage Health Teaching Modules, 104-105, 132, 282 Television, 27 Temperance movement, 36-37 Tennessee, 377-378, 380 Texas, 129, 195, 371, 374, 375, 383

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School & Health: Our Nation's Investment Tobacco use, 20, 21, 23 Tobacco use prevention, 69, 100, 112-115, 119, 122-123, 251, 314-315 , 318-321, 460 Transportation, 37, 408 safety, 64 Travis County Health Department (Texas), 371 Trois Riveres study (Canada), 90-91 Tuberculosis, 36, 43 Turner School (Philadelphia), 387 Turning Point, 67, 404 U United Way, 184, 185, 381 University of: Colorado Health Sciences Center, 155, 162, 243 n.4 Maryland at Baltimore, 184, 243 n.4 Medicine and Dentistry of New Jersey, 378-379 Minnesota, 217 n.7, 243 n.4 Texas Health Sciences Center at Galveston, 214 U.S. Children's Bureau, 43 U.S. Department of Agriculture, 175, 177, 238, 243, 248, 459 U.S. Department of Education Comprehensive School Health Education Program , 117 cooperation with the Department of Health and Human Services, 238 funding for health services, 207, 241 National Diffusion Network, 103, 108, 242 U.S. Department of Health and Human Services, 21, 207, 208, 217 n.7, 238, 243, 280 U.S. Department of the Interior, 38-39 U.S. General Accounting Office, 19, 24, 175 U.S. Office of Education, 40 U.S. Public Health Service, 21 Bureau of Primary Health Care, 48 Healthy People 2000 initiative, 22, 39-40, 46-47, 67-68, 83-84, 85 , 99, 102, 112-115, 177-178 Healthy Schools, Healthy Communities initiative, 48 Maternal and Child Health Bureau, 47, 48 V Vaccination, see Immunizations Values and Opinions of Comprehensive School Health Education in U.S. Public Schools,124 Vanderbilt study, 189 Victorian attitudes, 36 Violence, 16, 72 Violent Crime Control and Law Enforcement Act of 1994, 48 n.4 Vision examinations, 35 VISTA, 184, 381 Visual and Performing arts, 69, 70, 126 Vocational counseling, 38, 172 Vocational education, 69 Volusia County, Florida, 210-211 W Walbridge Caring Community (Missouri), 195, 382, 396, 397 War on Poverty, 45 Washington Heights, New York, 387-388 Washington, D.C., 242 n.3 Washington State, 396 West Virginia, 242 n.3, 248, 251, 456-462 Westchester County Student Assistance Model, 372 White House Conference on: Child Health and Protection, 42, 44 Child Welfare, 44 Children and Youth, 44, 46 Children in a Democracy, 44 Food, Nutrition, and Health, 44 Wisconsin, 185, 242 n.3, 379 W.K. Kellogg Foundation, 43 Workforce 2000 report, 19 World Health Organization, 16 n.1, 58, 154 Y Yale University Child Study Center, 66, 385-386 Youth employment, 46, 184 Youth Risk Behavior Survey, 20-21 Youth Service Centers, school-based, 184-185, 382, 393, 404 Youth Violence Prevention Demonstration Grant Program, 434-435 Z Zigler's Schools of the 21st Century, 383, 404