Schools and Health Our Nation's Investment (1997) / Chapter Skim
Currently Skimming:
3 Education
3 Education
Pages 81-152
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 81... ...
THE ROLE OF PHYSICAL EDUCATION IN COMPREHENSIVE SCHOOL HEALTH PROGRAMS Introduction The physical education instructional program is an integral part of a comprehensive school health Program because it teaches the knowledge -- -r - -- -- - -- - - - - -- - - - - - -- -- - -- - r - - A- -- -- -' ~ - -- - -- - - - - -- -- -- -- - -- -- -- - -- - - -- -- I .
|
From page 82... ...
, it is prudent to provide children with the information and skills necessary to maintain a physically active life-style. Physical education programs in schools should prepare children for a lifetime of physical activity (Sallie and McKenzie, 1991~.
|
From page 83... ...
The relationship between quality school physical education and health status was also recognized by the developers of Healthy People 2000, the national decade-long public private initiative to improve the health of the nation (U.S. Department of Health and Human Services, 1991~.
|
From page 84... ...
Health-Related Physical Fitness Health-related physical fitness refers to performance levels in one or more of these fitness components: muscular strength and endurance, cardiovascular endurance, flexibility, and body composition. Health-related physical fitness is the aspect of a quality physical education program most readily identified as physical education's contribution to public health.
|
From page 85... ...
Of those who 1The School Health Policies and Programs Study was carried out in 1994 to examine policies and programs across multiple components of school health programs at the state, district, school, and classroom levels across the country. The October 1995 issue of The Journal of School Health is devoted to a summary report of SHPPS findings and includes separate analyses of school health education; school physical education; school health services; school foodservice; and school health policies prohibiting tobacco use, alcohol and other drug use, and violence.
|
From page 86... ...
Pp. 30-48 in Effects of Physical Activity on Children (The American Academy of Physical Education Papers, No.
|
From page 87... ...
This article provides working definitions of and distinctions among physical activity, exercise, and physical fitness. This article reviews several large-scale studies from perspective of accepted standards that have evolved since 1985.
|
From page 88... ...
(Pate et al., 1995~. Not only do most schools provide students with less daily exposure to physical education than the national health objectives have set as appropriate, but the instructional activities most commonly included in physical education classes are not the recommended lifetime physical activities or activities ensuring moderate aerobic exercise for all participants; but rather they are competitive sport activities (Table 3-4~.
|
From page 89... ...
Recently, however, the Child and Adolescent Trial for Cardiovascular Health (CATCH) has shown that it is possible to increase significantly the intensity of physical activity in physical education classes; in CATCH intervention schools, students spent 40 percent of class time in moderate to vigorous physical activity (Luepker et al., 1996~.
|
From page 90... ...
Pp. 49-63, in: Effects of Physical Activity on Children (The American Academy of Physical Education Papers, No.
|
From page 91... ...
This is a position statement advocating daily physical education and physical activity in the schools. Targeted health-related objectives and teacher training increased student activity and lesson quality for 4th grade students when compared to control classes.
|
From page 92... ...
1987. Physical education and its role in school health promotion.
|
From page 93... ...
Recommendations to make physical education more effective are provided. Documents level of physical activity in selected physical education classes as less than moderately vigorous and urges that structured physical activity and physical education programs be enjoyable and moderately vigorous.
|
From page 94... ...
When asked which topics they would like as staff development programs, the teachers identified developing individualized fitness programs (45 percent) , increasing student's physical activity in physical education class (41 percent)
|
From page 95... ...
SOURCE: Pate et al., 1995. Activity TABLE 3-4 Percentage of all Physical Education Courses in Which More Than One Class Period Was Devoted to Each Activity by Activitya All Courses (%)
|
From page 97... ...
iThe guidelines include such wide-ranging policies as providing physical activity instruction and programs that meet the needs and interests of all students, regardless of gender, culture, physical competence, physical disability, cognitive disability, and chronic health conditions; employing properly prepared physical education teachers, coaches, and physical activity program directors, and preparing volunteer coaches to have appropriate qualifications for sports and recreation programs; establishing discipline policies that do not include the use of physical activity as a
|
From page 98... ...
2. Curriculum: Implement coordinated physical activity curricula through pre-K to grade 12 school physical education programs and health education programs that are consistent with national education standards.
|
From page 99... ...
School health education is an integral component of a comprehensive school health program and is defined as "the development, delivery, and evaluation of a planned instructional program and other activities for students preschool through grade 12, for parents and for school staff, and is designed to positively influence the health knowledge, attitudes, and skills of individuals" (joint Committee on Health Education Terminology, 1991~. In 1990, the Centers for Disease Control and Prevention prepared an interim operational definition of health education that identified its instructional elements as the following (Collins et al., 1995~: 1.
|
From page 100... ...
4.13 Provide to children in all school districts and private schools primary and secondary school education programs on alcohol and other drugs, preferably as part of quality school health education. 5.8 Increase to at least 85 percent the proportion of people aged 10 through 18 who have discussed human sexuality, including values surrounding sexuality, with their parents and/or have received information through another parentally endorsed source, such as youth, school, .
|
From page 101... ...
The CDC recommends that these be the priority areas for health education instruction: sexual behaviors that result in HIV infection, other STDs, and unintended pregnancy; alcohol and other drug use; behaviors that result in unintentional and intentional injuries; tobacco use; dietary patterns that result in disease; and sedentary life-style. Desired Practice in Health Education National Standards for Health Education As is the case with physical education, the status of health education in the curriculum is sometimes questioned by school policy makers because health was not originally mentioned in the National Education Goals as one of the core subjects in which students should demonstrate competence.
|
From page 102... ...
Once curricula have been redesigned to attain the performance indicators for each standards, it is anticipated that students will be able to do the following (joint Committee on National Health Education Standards, 1995~: 1. Comprehend concepts related to health promotion and disease prevention.
|
From page 103... ...
, as well as studies of programs that use a comprehensive health education curriculum to prevent or reduce certain debilitating behaviors such as tobacco, alcohol, and drug use; imprudent dietary behaviors; physical inactivity; and inappropriate sexual behaviors (Botvin and Eng, 1982; Connell et al., 1985; Ross et al., 1989; Williams et al., 1983~. Table 36 identifies some illustrative studies of the outcomes of various health education curricula.
|
From page 104... ...
04 SCHOOLS AND HEALTH TABLE 3-6 Illustrative Prevention Programs in Health Education Targeted Population Group or Sample Size Grade Name When Project Began Levels Growing Healthy N = 30,000 4-7 Know Your Body Teenage Health Teaching Unknown Modules N = 2,283;1,105 K-6 7-12 Go for Health Unknown 3-4 Cardiovascular Heart Healthy Unknown Eating and Exercise Hearty Heart Unknown 3 4-5
|
From page 105... ...
EDUCATION 105 Risk Factors Addressed Outcomes for Total Intervention References Unhealthy behaviors Substance abuse, nutrition, safety, physical activity, dental health, environmental health Substance abuse, nutrition, safety Cardiovascular risk factors Decrease consumption of saturated fats, cholesterol, sodium, and sugar; increase consumption of complex carbohydrates; increase physical activity Lack of nutrition knowledge, poor eating habits by students and parents Increased health knowledge, attitudes, and behaviors; reduction in smoking; improved reading scores; positive changes in health practices among parents Lower cigarette smoking onset, reduced saturated fat consumption, increased carbohydrate consumption; reduction in total cholesterol and blood pressure increases in health knowledge; health attitudes were unchanged among THTM schools but deteriorated among control schools; increased abstinence from cigarette and smokeless tobacco use, illegal drugs and alcoholic drinks in past 30 days Moderate to vigorous physical activity increased, self-reported salt use declined, selections of fresh fruits and vegetables increased significantly 38% increase in heart healthy foods found in student lunches, observed changes in physical activity minimal Reduction in total fat, Reduction in total fat, monosaturated fat; increased intake of complex carbohydrates; parents had more healthy foods on shelves. Connell et al., 1985; Owen et al., 1985 Bush et al., 1989a, 1989b; Walter, 1989; Walter and Wynder, 1989; Walter et al., 1989; Resnicow et al., 1989; Taggart et al 1990; Resnicow et al., 1991; Resnicow et al., 1992; Resnicow et al., 1993a, b Nelson et al., 1991; Ross et al., 1991; Errecart et al., 1991; Gold et al., 1991 Parcel et al., 1989; Simons-Morton et al., 1991 Coates et al., 1981 Crockett et al., 1989; Perry et al., 1989
|
From page 106... ...
106 TABLE 3-6 Continued SCHOOLS AND HEALTH Targeted Population Group or Sample Size Grade Name When Project Began Levels Pawtucket Heart Health Progam N = 105 7-12 Stanford Adolescent Heart Health N = 1,447 9-10 Program Nutrition in a Changing World N = 880 3-5 Nutrition for Life N = 1,863 7-8 Postponing Sexual Involvement Unknown 8 Peer Power and ADAM Unknown 6-8 Reducing the Risk N = 586 10 San Francisco AIDS Prevention N = 639 Education Curricula 6-12 NOTE: Programs described in this table represent only a sample of school health programs that have been evaluated. No attempt has been made by the IOM Committee on Comprehensive School Health Programs in Grades K-12 to determine the quality and validity of the methods of evaluation or the findings of these programs.
|
From page 107... ...
EDUCATION 107 Risk Factors Addressed Outcomes for Total Intervention References Cardiovascular disease Cardiovascular disease, smoking, physical activity, nutrition, stress Nutrition Nutrition Premature sexual activity and pregnancy, STDs Premature sexual activity, school dropout Sexual behavior Sexual knowledge Reduced blood cholesterol. Increased knowledge, increased physical activity, better resting heart rates, enhanced body mass index and triceps skin fold thickness, increased nutritional choices Gans et al., 1990 Killen et al., 1988; 1989 Increased nutrition knowledge, Shannon and Chen, improvement in eating 1988 behaviors Improvements in nutrition knowledge behavior and attitude scores Rates of sexual abstinence doubled, improved school attendance, reading and math ability more likely to remain at or above grade level than for controls Delays in sexual involvement, increase in knowledge, increase in discussion of abstinence with parents Increased knowledge about AIDS transmission, increased acceptance of persons who have AIDS Devine et al., 1992 Howard and McCabe, 1990 Ounce of Prevention Fund, 1990 Kirby et al., 1991 DiClemente et al., 1989 on other publications or reports.
|
From page 108... ...
, has developed standards for preservice preparation of health education teachers (American Alliance for Health, Physical Education, Recreation, and Dance, 1995~. Unfortunately, less than one-half of middle and secondary health education teachers are state certified (Collins et al., 1995)
|
From page 109... ...
Further, health education is undergoing important changes as curricula, pedagogy, and assessment are becoming aligned with the National Health Education Standards and as new research on effective approaches is published. Consequently, professional development programs (also called staff development or inservice programs)
|
From page 110... ...
Typically, at the elementary level, health topics are woven into the general curriculum as time and teacher interest dictate; at each of the middle and secondary levels, often only a single semester of health education is required. Current Practice in Health Education As described earlier, in 1994 the CDC commissioned a nationwide survey, the SHPPS, that examined school health at the state, district, and school levels.
|
From page 112... ...
Topic (%) Alcohol and other drug use prevention 75.0 86.0 90.4 Community health 54.8 73.5 58.9 Conflict resolution, violence prevention 38.5 61.0 48.0 Consumer health 55.8 70.6 56.6 Cardiopulmonary resuscitation 37.5 61.9 48.0 Death and dying 25.0 54.1 52.5 Dental and oral health 51.2 78.2 56.7 Dietary behaviors and nutrition 68.9 80.1 84.3 Disease prevention and control 68.9 81.3 84.5 Emotional and mental health 64.4 76.8 73.8 Environmental health 59.1 70.5 59.9 First aid 55.8 73.9 58.8 Growth and development 62.2 79.5 80.2 HIV prevention 78.7 83.0 85.6 Human sexuality 48.9 76.0 80.0 Injury prevention and safety 62.2 74.5 66.2 Personal health 63.0 81.2 79.0 Physical activity and fitness 65.2 81.9 77.6 Pregnancy prevention 43.9 72.1 69.3 Sexually transmitted disease prevention 65.1 80.9 84.1 Suicide prevention 37.8 66.7 58.1 Tobacco use prevention 71.7 83.2 85.6 aSchool Health Policies and Programs Study, 1994.
|
From page 113... ...
infused health education content into a course that focused primarily on another subject. Both types of health education teachers were asked to identify the topics that were addressed in their classes that focused on the priority health issuesunintentional and intentional injury, tobacco use, alcohol and other drug use, sexual behaviors, HIV infection and AIDS, dietary behaviors, and physical activity (Table 3-9~.
|
From page 114... ...
Spending Spending More Than More Than One Class One Class Teaching Period Teaching Period Topic on Topic Topic on Topic Alcohol and other drug use prevention 79.3 77.5 62.8 50.9 Community health 37.4 32.0 28.0 17.5 Conflict resolution/ violence prevention 37.4 31.7 34.7 24.4 Consumer health 33.6 27.5 30.9 20.4 Cardiopulmonary resuscitation 36.8 31.8 14.8 7.3 Death and dying 28.6 19.1 29.3 17.9 Dental and oral health 49.0 31.4 33.1 14.8 Dietary behaviors and nutrition 66.8 64.2 54.0 46.0 Emotional and mental health 67.8 65.6 41.5 28.6 Environmental health 35.3 29.4 43.8 34.8 First aid 43.9 41.5 23.6 15.8 Growth and development 57.2 52.9 61.6 55.1 HIV prevention 83.6 44.7 71.5 24.1 Human sexuality 52.1 46.0 51.4 43.8 Injury prevention and safety 36.1 31.7 30.8 20.6 Personal health 47.7 44.1 41.9 33.6 Physical activity and fitness 44.4 41.4 31.6 21.9 Pregnancy prevention 38.9 30.9 33.8 19.6 Sexually transmitted disease prevention 54.2 47.6 41.5 26.9 Suicide prevention 38.0 28.9 16.1 6.8 Tobacco use prevention 58.9 52.9 44.8 28.4 aSchool Health Policies and Programs Study, 1994. SOURCE: Collins et al., 1995.
|
From page 115... ...
Nationwide, only 5 percent of all health teachers and 1 percent of teachers who infuse health content into another subject majored in health education as part of their college preservice teacher training. An additional 28 percent of classroom teachers had a joint major in health and physical education, and another 14 percent had a minor in health education.
|
From page 116... ...
In writing a commissioned textbook article on school health education, Gold (1994) proposed the following lessons learned, gleaned from a review of the scientific literature on health education: · Significant improvements in outcomes are achieved with attention to multiple-risk behaviors, rather than focusing on separate categorical behaviors.
|
From page 117... ...
· Relapse prevention efforts are necessary to sustain behavior The U.S. Department of Education's Comprehensive School Health Education Program commissioned three papers to identify the research base for school health education; the papers were published by the department and later by the Journal of School Health (Allensworth, 1994; DeGraw, 1994; English, 1994~.
|
From page 120... ...
20 SCHOOLS AND HEALTH TABLE 3-11 Selected Summary of Pertinent Research Literature Selected Lessons Learned Citations Significant improvements in outcomes are achieved with attention to multiple-risk behaviors The reasons people make changes in health-related behaviors are varied and individualized Dwyer et al., 1991; Johnson, 1992; Kottke et al., 1985; Lorion and Ross, 1992; Puska et al., 1981; Shane and Kaplan, 1988; Wynne, 1989 Davis et al., 1987; Iverson et al., 1989; Wynne, 1989 Although most health education programs Elders et al., 1993, Hansen and Graham, and interventions are based on several 1991; Lefebvre et al., 1987; McCaul and behavior theory constructs, it is not yet Glasgow, 1985; Pentz et al., 1989; Puska possible to identify which are most et al., 1988; Resnicow and Botvin, 1993; important Resnicow et al., 1993c; Sussman et al., 1993 School health instruction based on skills training, peer involvement, social learning theory, and community involvement has the greatest impact Self-monitoring may enhance behavior change efforts Environmental variables influence the prevalence and consequences of behavior choices Relapse prevention efforts are necessary to sustain behavior changes; however, little is known about factors influencing relapse for specific behaviors Social support affects all phases of behavior change The characteristics of the individual influence the success of potential interventions Significant benefits can come from the active and appropriate engagement of parents and families in prevention programs Botvin and Eng, 1982; Flay, 1985; Glider et al., 1992; Hansen et al., 1988; Johnson et al., 1986; Johnson, 1992; Murray et al., 1987; Schinke et al., 1985; Thomas et al., 1992 Bertera and Cuthie, 1984; King et al., 1988; Koegel et al., 1986 Decker et al., 1988; Hoadley et al., 1984; Marburger and Friedel, 1987; Mayer et al., 1986; Pentz et al., 1989; Seekins et al., 1988; Simons-Morton et al., 1991; Taggart et al., 1990; Wagner and Winnett, 1988 Vaillant, 1988 Lewis et al., 1990; Broadhead et al., 1989; Morisky et al., 1985 Holloway et al., 1988; Jarvik and Schneider, 1984; Klesges et al., 1988 Bruce and Emshoff, 1992; DeMarsh and Kumpfer, 1986; Freedman, 1988; Johnson, 1992; Kumpfer, 1987; Perry et al., 1989; Resnicow et al., 1993c; RuchRoss, 1992; Springer et al., 1992
|
From page 121... ...
, · from a school health program that ignores media and its influence to a health promotion program that designs strategies to negate directly the negative messages of media and that develops media campaigns to promote positive health-enhancing messages (Allensworth) , · from a school health classroom approach to an interdisciplinary~nteragency team approach within the community (Allensworth, DeGraw, English)
|
From page 122... ...
. Cost-Effectiveness Rigorous experimental studies have not been undertaken to establish the cost-effectiveness of school health education.
|
From page 123... ...
Ninety-one percent of the students believed their health classes to be "useful." Among parents surveyed, 78 percent believed that comprehensive health educations is "very important;" another 20 percent believed such class work to be "somewhat important;" 84 percent also believed it was important for their child's school to get involved in teaching about good health habits. However, only 36 percent of the teachers interviewed through the Harris survey believed that their schools supported the health education program "very strongly." 3The term '~comprehensive health education,, refers only to the educational program component and should not be confused with a '~comprehensive school health program, which involves all components.
|
From page 124... ...
The change in public attitude tells us the time is right to push ahead in this area, to take up leadership that is necessary to bring better health to all Americans" (joint Committee on National Health Education Standards, 1995~. In summary, these surveys provide a profile of support for school health education instructional programs.
|
From page 125... ...
Health-related information is an integral part of a wide variety of disciplines, including biology and other sciences, physical education, home economics, psychology, and even social studies and language arts. Given the interdisciplinary nature of contemporary health problems, it can be asserted that health issues should have a place in virtually all other 4 The term integration as used in this section refers to planned and deliberate efforts to address common content in separate but related courses.
|
From page 126... ...
Two levels of interaction between health issues and other subjects are immediately obvious. The first concerns those disciplines where there is a direct connection to health: science, physical education, and home economics.
|
From page 127... ...
As long ago as 1974, geneticist Barton Childs (Childs, 1974) highlighted the natural relationship between genetics and heath education, explaining that the objectives of health promotion and disease prevention are congruent with a genetic view of human disease, which holds that much morbidity results from genetic factors expressed in environments that precipitate disease.
|
From page 128... ...
The physical education curriculum should support classroom health education instruction by emphasizing lifelong physical fitness, proper nutrition, good health habits, and self-discipline and respect. Home Economics.
|
From page 129... ...
all provide support for the type of integrated education to promote health that should be found in a comprehensive school health program. The following excerpts from documents published by each of these groups, illustrate areas in common and possibilities of integration between science and health.
|
From page 130... ...
Students should understand various methods of controlling the reproduction process and that each method has a different type of effectiveness and different health and social consequences. · Science for All Americans (American Association for the Advancement of Science, 1989~: To stay in good operating condition, the human body requires a vari ety of foods and experiences.
|
From page 131... ...
Rationale: Basic to health education is a foundation of knowledge about the interrelationship of behavior and health, interactions within the human body, and the prevention of diseases and other health problems. Comprehension of health promotion strategies and disease prevention concepts enables students to become health-literate, self-directed, learners which establishes a foundation for leading healthy and productive lives.
|
From page 132... ...
Yet, according to SHPPS, only 53 percent of health education teachers spent more than one class period discussing the topic, and only 29 percent of infused classroom teachers allotted more than one class period to this topic (Table 3-9~. Whether this is the fault of the curriculum or teachers' implementation of the curriculum is not clear.
|
From page 133... ...
Have Have Students Students Teaching Practice Teaching Practice Skill Skill Skill Skill Skill Communication 86.6 62.8 72.3 53.8 Decision-making 90.2 76.9 81.9 60.2 Goal-setting 79.9 59.1 72.3 45.3 Non-violent conflict resolution 72.5 44.2 64.9 34.4 Resisting social pressure for unhealthy behaviors 89.6 60.8 73.9 40.2 Stress management 82.2 52.2 60.3 27.3 aSchool Health Policies and Programs Study, 1994 SOURCE: Collins et al., 1995. smaller proportion of regular and infused teachers, perhaps due to lack of emphasis on skills practice in curricular packages or teachers' lack of comfort with skills practice.
|
From page 134... ...
In some school districts, it is traditional for physical education teachers to teach health education. Because physical education teachers have extensive health science training (biology, anatomy, physiology, and so forth)
|
From page 135... ...
The most notable of these initiatives include the National Action Plan for Comprehensive School Health Education, the National Health Education Standards, and recommendations emanating from the SHPPS analysis of health education. There is considerable commonality and synergism among these sets of recommendations, and the committee believes that these collective recommendations provide a strong foundation and direction for health education in the future.
|
From page 136... ...
The developers of these standards realized that health education is sometimes criticized because health problems among children and youth are not changed or eliminated after health instruction occurs, but that the effectiveness of health education is often compromised by deficiencies in the delivery system. To address this problem, the National Health Education Standards include a section on Opportunity-to-Learn Standards for local and state education agencies, communities, state health agencies, institutions of higher education, and national organizations.
|
From page 137... ...
create community awareness and support for school health instruc tion, 2. provide learning opportunities at home and in the community that enhance and reinforce student achievement of the National Health Education Standards, 3.
|
From page 138... ...
prepare future school health educators in a manner consistent with the National Commission on Health Education Credentialing, Inc., 2. provide health instruction preservice programs taught by qualified and experienced school health education faculty, 3.
|
From page 139... ...
Three recent documents the National Standards for Physical Education, the School Health Programs and Policies Study,6 and the CDC Guidelines for School and Community Health Programs to Promote Physical Activity Among Youth emphasize the new priorities and recommendations in physical education and collectively provide a sound basis for quality physical education programs in the future. The committee supports these recommendations.
|
From page 140... ...
RECOMMENDATIONS The committee believes that three recently released documents the National Action Plan for Comprehensive School Health Education, the National Health Education Standards, and the SHPPS report collectively provide comprehensive recommendations and a strong framework to move health education forward in the future. Several areas merit further emphasis and discussion.
|
From page 141... ...
The committee recommends that a one-semester health education course at the secondary level immediately become a minimum requirement for high school graduation. Instruction should follow the National Health Education Standards, use effective up-to-date curricula, be provided by qualified health education teachers interested in teaching the subject, and emphasize the six priority behavioral areas identified by the CDC.
|
From page 142... ...
Journal of School Health 59~2~:56-65. American Alliance for Health, Physical Education, Recreation, and Dance.
|
From page 143... ...
1991. Promoting healthy body image through the comprehensive school health program.
|
From page 144... ...
1990. Descriptive analysis of nonspecialist elementary physical education teachers' curricular choices and class organization.
|
From page 145... ...
In The Comprehensive School Health Challenge: Promoting Health Through Education, P Cortese and K
|
From page 146... ...
1994. Comprehensive school health education programs: Innovative practices and issues in standard setting.
|
From page 147... ...
1991. Physical education's role in achieving national health objectives.
|
From page 148... ...
Journal of School Health 60~4~:133-138. National Association for Sport and Physical Education.
|
From page 149... ...
1995. School physical education.
|
From page 150... ...
1993a. Ten unanswered questions regarding comprehensive school health promotion.
|
From page 151... ...
1990. The comprehensive school health curriculum: Closing the gaps between the state-of-the-art and the state-of-the-practice.
|
From page 152... ...
1993. School Health: Findings from Evaluated Programs.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.