Defining a Comprehensive School Health Program: An Interim Statement

Diane Allensworth, James Wyche, Elaine Lawson, and Lois Nicholson, Editors

Committee on Comprehensive School Health Programs

Division of Health Sciences Policy

INSTITUTE OF MEDICINE

NATIONAL ACADEMY PRESS
Washington, D.C.
1995



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Defining a Comprehensive School Health Program: An Interim Statement Defining a Comprehensive School Health Program: An Interim Statement Diane Allensworth, James Wyche, Elaine Lawson, and Lois Nicholson, Editors Committee on Comprehensive School Health Programs Division of Health Sciences Policy INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. 1995

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Defining a Comprehensive School Health Program: An Interim Statement National Academy Press 2101 Constitution Avenue, NW Washington, DC 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the Councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for this report were chosen for their special competencies and with regard for appropriate balance. The report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. Support for this project was provided by the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the National Institutes of Health, and the Office of the Assistant Secretary (U.S. Department of Health and Human Services, Public Health Service). This support does not constitute an endorsement by the U.S. Department of Health and Human Service of the views expressed in the report. Additional copies of this report are available in limited quantities from: Institute of Medicine Division of Health Sciences Policy 2101 Constitution Avenue, NW Washington, DC 20418 Copyright 1995 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatlichemuseen in Berlin.

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Defining a Comprehensive School Health Program: An Interim Statement COMMITTEE ON COMPREHENSIVE SCHOOL HEALTH PROGRAMS IN GRADES K-12 DIANE D. ALLENSWORTH (Co-chair), Executive Director, American School Health Association, Kent, Ohio JAMES H. WYCHE, (Co-chair), Associate Provost, Brown University BEVERLY J. BRADLEY, Certified Health Education Specialist, San Diego City Schools, California DOROTHY R. CALDWELL, Director, Child Nutrition Programs, Arkansas Department of Education, Little Rock JOYCE G. DRYFOOS, Researcher, Carnegie Corporation, Hastings-on-Hudson, New York STEVE A. FREEDMAN, Director, Institute for Child Health Policy, Gainesville, Florida LA BARBARA GRAGG, Superintendent of Schools—Pontiac, Michigan (retired), Palm City, Florida JUDITH B. IGOE, Associate Professor and Director, School Health Programs, School of Nursing, University of Colorado, Denver ELAINE L. LARSON,* Dean, School of Nursing, Georgetown University JOSEPH D. McINERNEY, Director, Biological Sciences Curriculum Study, Colorado Springs, Colorado PHILIP R. NADER, Professor and Director, Child and Family Health Studies, University of California, San Diego ELENA O. NIGHTINGALE,* Scholar in Residence, Board on Children and Families, National Academy of Sciences, Washington, D.C. GUY S. PARCEL, Director, Center for Health Promotion Research and Development, the University of Texas Health Sciences Center, Houston KEN RESNICOW, Associate Professor, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University AARON SHIRLEY,* Director, Jackson Hinds Comprehensive Health Center, Jackson, Mississippi BECKY J. SMITH, Executive Director, Association for the Advancement of Health Education, Reston, Virginia LENORE K. ZEDOSKY, Director, Office of Healthy Schools, West Virginia Department of Education, Charleston * IOM Member

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Defining a Comprehensive School Health Program: An Interim Statement Study Staff VALERIE P. SETLOW, Director, Division of Health Sciences Policy LOIS NICHOLSON, Study Director ELAINE LAWSON, Research Assistant MARGO CULLEN, Project Assistant

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Defining a Comprehensive School Health Program: An Interim Statement Preface Education and health are often said to be inextricably linked: a familiar axiom declares that students must be healthy in order to be educated, and they must be educated in order to remain healthy. In this era of interest in educational standards and concern for the social and health problems confronting children and young people, the pivotal role that schools can play is receiving increased attention. Schools are the community institution that touch all families—schools are “where the children are.” Schools have the potential to provide more than traditional academic preparation. They are also well situated to assist in protecting and promoting students' health and well-being and to make a significant contribution to producing a new generation of healthy, productive adults. A new concept of school health programming—the comprehensive school health program—has emerged that may hold special promise for promoting the health and education goals for our nation's children and young people. The Institute of Medicine has appointed a 17-member committee to examine the structure, function, and potential of these programs. The committee represents a diversity of backgrounds and includes physicians, nurses, health educators, science educators, social scientists, school administrators, and experts in public and child health policy.

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Defining a Comprehensive School Health Program: An Interim Statement At its first meeting, representatives from various federal agencies presented their programs and priorities in the area of school health. The committee would like to express special thanks to the following agency representatives from the U.S. Department of Health and Human Services, Public Health Service: Linda Johnston (Health Resources and Services Administration, Maternal and Child Health Bureau); Jane Martin (Health Resources and Services Administration, Bureau of Primary Health Care); William Harlan, (Disease Prevention, National Institutes of Health); Evelyn Kappeler (Office of Population Affairs); and Peter Cortese (Division of Adolescent and School Health, Program Development and Services Branch, Centers for Disease Control and Prevention); and from the U.S. Department of Education (Federal Interagency Coordinating Council, Office of the Undersecretary), Connie Garner. In conjunction, with its first meeting, a public workshop was convened to examine selected elements of a comprehensive school health program in depth. The committee extends its appreciation to the following workshop speakers: Tom O'Rourke, Ph.D., M.P.H. (Professor, Department of Community Health, University of Illinois) for his review of new directions in health education; Mary Jackson, B.S.N., M.Ed. (Nurse Consultant, Bureau of Women and Children, Texas Department of Health) for her analysis of the relationship of health education to the core curriculum; Eulalia Muschik, M.S., R.D. (Supervisor of Food Services, Carroll County [Maryland] Public Schools) for her examination of nutrition education and food services; Karla Shepard-Rubinger, M.S. (the Conservation Company) and John Santelli, M.D., M.P.H. (Medical Epidemiologist at the Baltimore City Health Department and Adjunct Assistant Professor, Maternal and Child Health, Johns Hopkins School of Hygiene and Public Health) for their presentations about school-affiliated clinics and service delivery; and Genie L. Wessel, R.N., M.S. (Project Director, Making the Grade Program, Maryland Governor's Office) for her presentation on approaches for integrating school health programs. After the first meeting and workshop, the committee considered it important to develop this interim document for several reasons. First, committee members brought to the table a variety of backgrounds; we needed a common definition and understanding of what a comprehensive school health program is to serve as the foundation for our further study of these programs. Second, the committee realizes that a wide range of constituencies and disciplines are interested in these programs—teachers, administrators, health and social service professionals, parents, students, and community and political leaders. With this document, the committee hopes to inform these groups that the study has begun, generate discussion and possible informal feedback, and suggest a common language to facilitate interaction among these groups. The committee would like to thank Valerie Setlow, Director of the Division of Health Sciences Policy, for her enthusiasm and guidance in

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Defining a Comprehensive School Health Program: An Interim Statement launching this study. Special thanks are also owed to Study Director Lois Nicholson and Research Associate Elaine Lawson for their efforts in collecting background information, organizing the first meeting and workshop, and assisting in drafting this interim statement. Sincere appreciation is also extended to Project Assistant Margo Cullen for her excellent administrative support in making meeting and committee travel arrangements, assisting in the review process and producing this interim statement. Finally, the co-chairs wish to thank all committee members for their extraordinary spirit of teamwork and commitment. It has been a special opportunity to work with such a distinguished and dedicated group, and we look forward to continuing to work together in the development and production of the committee 's full report. Diane Allensworth, Co-chair James Wyche, Co-chair Committee on Comprehensive School Health Programs in Grades K–12

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