• research and evaluation,

• funding,

• local, state, and federal policy,

• personnel and training issues, and

• obstacles and opportunities.

In order to understand how comprehensive school health programs may possibly affect student health and education outcomes and future health literacy, the committee will examine the following questions:

• What are the basic health needs of children and young people? What are the role and responsibility of the school in meeting these needs?

• What lessons have been learned from the 150-year history of health programming in schools?

• What are appropriate measures of health status? Of educational achievement? What is known about the nature and extent of the linkage between health status and educational achievement?

• How, to what extent, and for what duration, might CSHPs influence health and education outcomes and future health literacy?

Some of the optimal outcomes of CSHPs described earlier may not be feasible to achieve or measure. Yet in order to establish criteria for determining the effectiveness of these programs, realistic and measurable program outcomes must be identified. Therefore, the committee will seek answers to these questions:

• What are the realistic and measurable student, teacher, parent, organizational, and community outcomes that can be expected from comprehensive school health programming?

• What are the similarities or differences in expected student outcomes, depending on developmental and grade level?

• Are changes in health knowledge and attitudes sufficient endpoints for measuring the effectiveness of CSHPs, or should programs be considered ineffective unless there is an impact on related health behavior and health problems are adequately and appropriately addressed?

• What changes in health status should be considered meaningful endpoints for CSHPs?