Transcript HEALTH FRAMEWORK FOR

HEALTH FRAMEWORK FOR

CALIFORNIA PUBLIC SCHOOLS
 The Vision:
Health Literacy
Healthy Schools
Healthy People
THE VISION
We need to make a national commitment to
health education that is far greater then the
routine and merely ceremonial attention we
usually give it. We need to teach
youngsters that they must take charge of
their health...all of their lives...and we must
do more than teach; we must set an example
in the way we live.
C Everett Koop, MD
HEALTH IN THE ACADEMIC
ENVIRONMENT
Our youth are confronted with a scope of
health educational and social challenges
not experienced by any other generation
 Educational institutions are in a unique
and powerful position to improve health
out comes for youths
 Schools represent the only public
institution that can reach nearly all young
people
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Schools provide a setting in which
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Friendship networks develop
Socialization occurs
Norms that influence behavior are developed
and reinforced
This social support occurs before the health
behaviors or most youth become habitual
Educators are academically prepared to
organize developmentally appropriate learning
experiences to empower children to lead safer
and healthier lives
Emphasis must be placed on
developing lifelong, postitive
health-related attitudes
• Health education in the schools must be
supported by a comprehensive schoolwide
system to promote children's health and
must be developed and sustained by
collaborative efforts of school personnel,
parents, school board members
community leaders and health and social
services agencies and providers.
Health Framework for
California Public Schools
• Health Literacy
• The capacity of an individual to obtain interpret
and understand basic health information and
services ant the competence to use such
information and services in ways which are
health enhancing.
• A health literate person understands scientifically
based principles of health promotion and disease
prevention, incorporates that knowledge into
personal health related attitudes and behaviors
and makes good health a personal priority.
Goal of this framework
• Describe health education and
schoolwide health promotion
strategies that will help children and
youths become health literate
individuals with a lifelong
commitment to healthy living.
A PROGRAM MODEL FOR
BEST PRACTICES
• The best approach to managing
complex student health challenges
rests in organizing all appropriate
resources and expertise and
activities into a model representing
best practices.
Coordinated School Health System
Components
• Health Education – development, delivery,
and evaluation of a planned, sequential
curriculum for students in kindergarden
through grade twelve and for parents and
school staff and is designed to influence
positively people's knowledge, attitudes,skills
and behaviors related to health.
– Physical education
– Health Services
– Nutrition services
– Psychological and counseling services
– A safe and healthy school environment
– Health promotion
Commonly used terms
• Health - State of complete physical, mental, and
social well-being, not merely the absence of
disease and infirmity
• Health Literacy
• Coordinated School health system - An organized
set of policies procedures, and activities
developed and implemented through a
collaborative effort that includes parents, the
school and the community. Designed to protect
and promote the health and well being of
students and staff.
A COORDINATED SCHOOL
HEALTH PROGRAM
• Provides the formal model around which the
talents and efforts of many disciplines are
coordinated to promote student health and school
success
• Consistent health promoting messages are
delivered and reinforced across multiple
communication channels in the school and
throughout the community.
• Rather than competing for limited resources the
CSHP puts student health and achievement at the
heart of the matter and provides an efficient and
effective way to improve, protect and promote
the wellbeing of students, families, and
professionals in the education system
CSHP Model
• Maximize the impact of all available expertise and
resources directed toward risk reduction and
health promotion
• Conserve taxpayer dollars by reducing duplication
of efforts
• Maximize use of public facilities in the school and
community to promote health
• Enhance communication and collaboration across
health promotion professionals in the schools and
community
• Address student health risks in the context of
rather than in competition with the academic
mission of the school
Documented Research
– “the period prior to high school is
the most crucial for shaping
attitudes and behaviors”.
– By the time students reach high
school many already are engaging
in risky behaviors or may at least
have formed accepting attitudes
toward these behaviors.
Trends in California are consistent with
disturbing national findings.
• Declining access to healthcare:
– Increase risk of contracting
infectious diseases and developing
physical and mental disabilities.
– Preventable – mumps, measles,
rubella
– CDC – reports alarming levels use of
alcohol and other drugs
– Weapon carrying
– Early sexual activity and suicide.
Schools Role
• Recognize the bi-directional
connection between health and
education
– Children must be healthy in order to be
educated and children must be educated
in order to stay healthy
Given the needs
Schools must make health a priority in the
curriculum and overall school program
Basic patterns of healthy living are formed in
childhood and adolescence,
Schools cannot be resonsible for
meeting every need
• But where the need directly affects
learning, the school must meet the
challenge.
• So it is with health
• For Health education to be made
meaningful, systems must be in
place that support effective health
education and make health an
important priority in school
Schools plan must be well
planned, coherent, must be
implemented consistently
Supported by all adults in the school
Components must be mutually supportive
consistent with the overall goal of promoting and
enhancing children's health literacy
Eight Components of a Coordinated
School Health Program
Health Education
Physical Education
Health Services
Nutrition Services
Psychological and counseling services
Safe and Healthy School environment
Health Promotion for the staff
Parent and Community Involvement
California's Healthy Start
Initiative
• California State program established 1991 (education code
section 8800 et seq)
– Facilitate partnerships among local
educational agencies, families and
communities to benefit children and
youths to reach their full potential
California's Healthy Start
Initiative
– Philosophy
•Belief that educational success,
physical health, emotional support
and family and community strengths
are inseparable
•Each school community has its own
combination of assets and needs.
•Mix of support and services vary.
Health
is a very broad concept
and extends beyond a
foundation defined by
physical parameters
Joint Committee on Health Education
clarifies
Health is an integrated method of
functioning which is oriented towards
maximizing the potential of which the
individual is capable.
Health
• It requires that the individual maintain a continuum of
balance and purposeful direction with the environment
where he (she) is functioning.
Need balance among
Physical, emotional, social spiritual and vocational domains
of health.
Emotional domain
strong coping skills and express
a full range feelings in socially
acceptable ways.
Communicate self-control and
self acceptance
Social Domain
Comfortable intimancy and
connections with and communicating
respect and tolerance for others
view themselves and making
meaningful contributions to family
and community
Spiritual Domain
Not just sacred terms
Comfort withourselves and others
Strength of our personal value system
Capacity to integrate positive ethical and
moral standards, such as integrity, honesty
and trust, into their interactions.
Pursue meaningful purpose for our life
Vocational Domain
Collaborate with others on family
community or professional projects
Manifested in the degree to which one's
work makes a positive impact on others or
on the community.
Evaluate the quality of health
the key is balance among the
domains.
As educators in our elementary
and middle level schools it is
important that you reflect on
your own health across the five
domains
Healthy People
1979 – report on health promotion and disease
promotion
Validated Americans were living longer and
healthier lives than their counterparts who had
lived 100 years earlier
Despite the achievements the report
documented that we still had premature
death
50% due to factors beyond personal control
50% due to activities over which each of us could
exercise significant personal control
As a result of Healthy People '79
Local, State and Federal have been
committed to an ongoing broad and
collaborative initiative focused on
improving the health of all americans
Original objectives targeted for
achievement by 1990
Again some goals were met, some not;
others surpassed.
Then Came Healthy People 2000
Several objectives specified a role for
American Schools
Integration of planned sequential school
health education was targeted for at least
75% of the nations schools in
Kindergarden through twelfth grade
Again objectives not achieved and now
Healthy people 2010
Specific 2010 agenda
Increase the quality availability
and effectiveness of educational
and community based programs
designed to prevent disease and
improve quality of life
To reach these goals a systematic
approach to promoting and protecting the
nations health has been established
Formal structure for
Individual, organizations communities,
state and federal collaboration, efficiency
and effectiveness
Eliminate duplication, reduce costs
Health in the Academic Environment
The Co-ordinated health School
program
Your job will be to plan, coordinate
and implement health promotion
programming for individuals in the
school community
Coordinated School Health System
Components
–Physical education
–Health Services
–Nutrition services
–Psychological and counseling
services
–A safe and healthy school
environment
–Health promotion
Comprehensive School Health Education
The starting point: table 1.6
Quality education is grounded in activities
that bridge domains of learning
Cognitive, affective and psychomotor
must reflect current accurate
knowledge and incorporate
developmentally appropriate learning
materials and technological resources
More hours are needed to produce
changes in the affective domain than
in either of the other two domains
40-50 hours of formal health
education is necessary to produce
stable improvements across all three
domains in knowledge, attitude and
skills
CDC 6 Problem priority areas
Tobacco use
Poor eating habits
Alcohol and other drug risks
Behaviors tht result in intentinal and
unintentional injuries
Physical activity
Sexual behaviors that result in HIV &
other sexually transmitted diseases
or unintended pregnancy
The six problem priority
areas are confirmed to be
related to the leading causes
of death and illness and
death of americans
Knowing the CDC 6 Problem
priority areas
•
gives you the foundation for you as curriculum
developers and teachers to balance issues of
teaching quality with realistic time constraints by
organizing learning activities in these priority
high risk areas.
• Problem of developing effective health
education curricula
• Pinpointing the structural elements and
specific sources of authority has become
more difficult.
• The federal government provides only 7%
of all dollars spent on publication in the
US.
• 2000 “no child left behind”
Education in the US
• Education in US is grounded in
decentralization – not controlled by
the federal government
• The education of our youth is the
responsibility of each state
• Determination of curricular topics
reflect the unique interests and
standards of each state.
• The education of our youth is the
responsibility of each state
• Determination of curricular topics
reflect the unique interests and
standards of each state.
US Constitution asserts education is
the responsibility of each state
• The governor is responsible for the
budget and proposing initiatives
• Legislature has final authority
• Governors give lip service to
improving education outcomes
• Reality is compete for dollars
• The scope of influence the state ED
board varies
Local school districts must
comply with laws
• However the school board is
responsible for establishing policies
and practices for day to day
operations. (15,000 school boards
operating in the US)
Understand the organization
and sources of influence
• While the structure may be
cumbersome and confusing the
public schools are designed to
maximize input from taxpayers and
concerned stakeholders.
Health Services
Policies and Programs designed to assess
the health status of children
School Nurse
support student health and learning by
acting as a liaison among school, home
and the medical community
Nurses assume primary leadership for
providing health servies the teacher is in
the important postion to participate in
initial observation and referral of any
conditions evident in students
Providing School Health began in the early
20th century as a way to improve academic
outcomes for students.
• Nurses worked to reduce absenteeism
related to out breaks of communicable
disease
• Today get involved in more complex health
related barriers to achievement (Asthma,
child abuse & neglect, domestic and
school violence, adolescent pregnancy &
Parenting, Drug and ETOH abuse, Mental
health, lack of insurance.
Require periodic health examinations
Vision and Hearing
(elementary school years measure
height and wt.
Coordinate measures to prevent
communicable disease
health protection via compliance with
immunization mandates
Elements of Successful
Health Education
Goal: Help students develop the knowledge,
skills, attitudes and behaviors needed for
lifelong commitment to health.
CDC 6 Problem priority areas
1. Tobacco use
2. Poor eating habits
3. Alcohol and other drug risks
4. Behaviors tht result in intentinal and
unintentional injuries
5. Physical activity
6. Sexual behaviors that result in HIV
& other sexually transmitted diseases
or unintended pregnancy
Creating a Positive Learning Climate
Learning Centers have climates
..something you feel, something in the air.
You sense it in the way people interact with each
other, in how they listen and what they say
The environment in which you offer the program
can determine how effective you are as a
teacher and leader of children
Is it a nice place?
Do kids feel safe there?
Do they know what is expected of them?
Health Realization
– Enhance the life of the individual by
teaching the understanding of
psychological principles of the mind,
thought and consciousness and how
these principles function to create our
life experiences.
The Dimensions of Climate – creating an image
that people recognize and trust (in business they
call it branding)
Values – Core concepts you want the kids to
learn.
Environment – physical aspects of your
classroom
Patterns of Action – expectations for interacting
with each other
People – what it is all about.
A lot of people can help you do your
job
(Guest Speakers, parents other
staff can
provide a positive influence )
Culturally appropriate – attitudes, beliefs and
values regarding health related topics may vary
according to the ethnic and cultural makeup of the
community. Effective health education should be
based on awareness of the culture, background of
the students within each classroom and the
influence of culture on the information and skills to
be taught.
Make the curriculum accessible – not all students
learn the same way, nor are they motivated by the
same factors. Use a variety of strategies to provide
the student with a common experimental base.
Take advantage of opportunities for active
learning – every aspect of health education
focuses on behaviors or choices and every topic
presents opportunities for engagement and
motivation. Provide students with opportunities to
to be engaged in creating and construction what
they learn rather than passively receiving factual
information.
Focus on mental and emotional health
throughout – mental and emotional health are not
separate content areas. Both are considered crucial
to an individual’s motivation to act on healthrelated knowledge and use health-related skills.
Emphasize character development – Through
the health education curriculum students learn
strategies for making positive, healthy decisions
based on such ethical principles as integrity,
courage, responsibility and commitment
Throughout the health education curriculum,
moreover, the development of positive
commitments to one’s own health and the health of
the broader community and society is emphasized.
Use technology to embrace learning – in the classroom
use technology based resources to practice skills
example: develop personal health profile with a variety of
health indicators – encourage them to set goals for
improvement and monitor progress.
Connect concepts in health education with other learning
experiences.
Children learn best when the curriculum is focused on
meaning and thinking
ie – growth and development influenced by nutrition
Personal health habits play a role in spread of communicable
disease.
Use of alcohol, drugs tobacco increases risk of disease and
injury.
Effective Implementation: Foster Health Literacy
Present current and accurate content: All
health related education is based on up-to-date
scientific information.
Recognize similarities and differences among
students – many people face similar health-related
issues and choices. Differences should be
discussed, but care should be taken not to
emphasize them to the point of divisiveness
Emphasize not just health related information
but importance of behavior – view the school as
a safe laboratory for practicing and reinforcing new
behaviors.
Guest Speaker
Gabriela Maldonado
Santa Clara Valley Health & Hospital System
Department of Alcohol and Drug Services
Health Realization
The Health Realization Services Division
seeks to enhance the life fo the individual by
teaching the understanding of the
psychological
Principles of Mind, Thought and
Consciousness, and how these principles
function to create our life experience.
Through this educational process, individuals
will
realize their innate wisdom, and
resiliency which will enable them to live
healthier and more productive lives so that
the community becomes a model of
health
and wellness.
Health Realization
• Enhance the life of the individual by
teaching the understanding of the
psychological Principles of the mind
thought and consciousness and how
these principles function to create
our life experience.
Health Realization
• Individuals realize their innate
wisdom and resiliency which will
enable them to live healthier and
more productive lives.
• Based on fundamental principles that
offer a simple explanation about
how and why people function and
behave as they do.
Physical Activity
• We all have lots of excuses for not
consistently participating in physical
activity – despite research and even
what we instinctly know of the
benefits that are gained for all ages.
• Your challenge is to organize a range
of developmentally appropriate and
well designed strategies to instill a
sound foundation for maintaining
health and promoting school success.
Research has demonstrated
The way in which fitness
activities are taught and
reinforced contribute to student
attitudes about the value of being
active for a lifetime.
Research has documented that
participation in a pattern of consistent
activity results in:
Building and maintaining healthy
bones and muscle.
Reduces feelings of depression
and anxiety.
Promotes psychological well
being.
Helps control weight.
Builds lean muscle mass.
Reduces body fat.
1996 Surgeon General report on
physical activity and health concluded:
Regular participation in moderate
physical activity is an essential element
of a healthy lifestyle for all americans.
More research needed........
However, the following specific benefits
have been identified for school age children
and youth who participate in regular
physicial activity.
Improved aerobic endurance & muscular
strength
Reduced risk for cardiovascular disease
(decrease B/P and body mass index)
Decrease body weight among obese youths
Improved self esteem & self concept.
Decrease
anxiety and manifestations of
stress.
Increased bone mass density as a result of
participation in weight bearing exercise.
So why if we know this do so many adults remain
inactive?
We have millions of americans
suffering chronic illness that can
be prevented or improved by
participation in regular Physical
activity: 61% of the population
between 20-74 are obese.
12.6 million have Coronary heart disease
1.1 million have heart attacks in any given
year
17 million have diabetes (90-95 % of type
2 diabetes is associated with obesity and
physical activity)
50 million have hypertension
While children and youth are more physically active
than adults
Activity levels start to decline as
children approach adolesence and
continue their decline throughout the
teen years.
Among stludents 9 -12
1 in 3 do not participate in regular PA
Nearly one half do not participate in
team sports
Nearly one half are not enrolled in PA
classes
Participation starts to decline at age 10.
In younger children the picture is not much
better..........
Walking and bicycling in ages 5-15
dropped 40%
More than 1/3 of all trips made to school
are made from a distance of 1 mile or
less....students walk less than 1/3 of
those trips to school.
Young people ages 2 – 18 spend on
average over 4 hours per day watching
TV or videos, or playing video games or
using a computer.
- the majority of the time is watching TV
1/3 watch over 3 hours, 1/5 watch over
5 hours.
Physical inactivity has made a major
contribution in the prevalence of childhood
obesity in the US since 1980.
1999 California study revealed only 1 in 5
students grade 5 & 7 met the minimum
standards for all of the components of health
related fitness and 2 in 5 did not meet the
standard for cardio-respiratory fitness.
Physical Inactivity has become not only a
health, but an economic issue as well.
It impacts every segment of society
including the health care industry, american
workforce and even the military
Among youths 6 -17 yrs the number of hospital
admissions for obesity-related illness tripled in the
past 20 years
- % of costly obesity – diabetes
doubled
- % of obesity related gallbladder
disease tripled
- Sleep apnea among young people
increased 5-fold.
These pose severe economic burden in
our society....
Cost of hospitalization = $1500
average per day
So what are we doing about this and what
are healthy levels of physicial activity for
young people?
The international consenses conference on
physical activity guidelines for adolesence
has suggested:
All adolescents be physically active daily, or
nearly every day as part of play, games,
sports, work,
transportation, recreation
and physical education or planned exercise
in the context of family, school and
community activities.
Experts encourage – 3 or more
sessions/week of activities that last 20
minutes at a time that require moderate to
vigorous levels of exertion.
Growing body of literature
confirms –
participation in PA is associated
with improved academic
outcomes for students
-improved concentration
-better scores on math, reading
and writing skills tests
-reduced disruptive behaviors
-improved attitudes towards self
& school
Statement by California State
superintendent of public
instruction>......
Every student in California should
have a quality physical education
experiences from kindergarden to
high school.
Given the national focus on improving
proficiency test outcomes for students
I don't believe a change in schools
programming and policy are going to
happen in the near future
But we do know active learning has
advantages over sedentary learning
As classroom teachers you are
encouraged to:
>Integrate a blend of sitting and moving
into daily class room practice
>Engage students in greater variety of
postures and movement during
classroom instructions
>Encourage students to use their bodies
to learn
>Incorporate role play as a way to
dramatize key concepts
>Take stand and stretch breaks every 20
minutes to energize the class.
So what are the Barriers?
>Patterns of housing have centered in the
use of the automobile rather than walking
and bicycling
>Concerns for safety
>Appealing Technology (video games)
enable a sedentary lifestyle among children
>Schools have cut recess programs and
reduced requirements for participation in PE.
>In some districts unreasonable teacher
student ratios
>Budget constraints for development and
maintenance of facilities (parks & rec
centers close to homes)
For teachers – recognition of the issues is critical
as is the understanding of the scientific literature
to understand the terminology of PA and fitness.
PA = movement produced by skeletal
muscles resulting in expenditure of
energy.
Exercise is a subset of PA that is
planned, structured, repetitive and is
done with the purpose of improving or
maintaining physical fitness
Physical fitness includes a set of attributes
that are either health related or motor skill
related
Health related elements of physical
fitness
>Cardio-respiratory (aerobic)
endurance, muscular strength and
endurance, flexibility and body
composition
>Motor skills = balance, agility,
power, reaction time, speed and coordination.
Specific forms of PA &
Exercise
>Walking
>bicycling
>Unstructured play activities
>organized sports
>dancing
>Household chores
>Physicial tasks associated with
after school jobs
PA Pyramid
Level 1 =Daily lifestyle activities
require involvement of large
muscles of the body
Do most days of the week
Accumulate 30 + minutes
Level 2
Aerobic exercise = 3-5 days/week, 20 –
60 minutes
Flexibility exercise = 2-3 days/week,
hold each pose for 10-20 seconds
Strength exercise – 2-3 days/week, 8-10
exercises, 1 set 8 – 12 reps
Level 3
Recreational Activities – 2-3
days/week
Level 4
Do sparingly
Has some benefits in stress
reduction and relaxation
Not necessary to abstain if it
does not interfere with other
physicial activities
As a fromalized part of the co-ordinated
School Health Education Program
Schools and communities have the
potential to improve the health of school
age children and students by providing
instruction programming and servies to
promote life long PA
Since students spend a large percent of
their waking hours at school....a
formalized physical education
curriculium, planned recess and short
activity periods supplemented by a range
of opportunities for activity throughout
the school is essential
In recent years research has confirmed the
health benefits of a lifelong commitment to
physical activity
Activities should conform to the shorter
attention span of children
Children need frequent periods of rest
following bursts of activity
Feelings of success and accomplishment
are an important foundation for an
ongoing commitment to participation in
PA
Exercising with parents and other family
members can reinforce a commitment to
exercise participation
Class Activity
Using Table 11.2 (p 270)
The CDC recommendations (p
272/73)
NHES Learning and assessment
strategies
develop a program of fitness
evaluation for children in an
elementary class.
Sexuality Education
Health Education Mandates:
Instruction:
HIV/Aids/Std
EC 51201.5 (a & b), EC 51554 (a), EC
51820
Teacher Prep requirements:
EC 51229.8
Parent Notification
EC 51202.5 (a & b), EC 51240, 51555, EC
51820
Family Life/Sex Education
EC 51553 (a), EC 51554 (a)
Parent Notification
EC 51240, EC 51550, EC 51555,
Pregnancy/Parenting Education
EC 51220.5 (c), EC 8910-11
Sex Education (sometimes called sexuality
education or sex and relationship education
Is the process of acquiring
information and forming attitudes
and beliefs about sex, sexual
identity, relationships and
intimacy. It is also developing
young peoples skills so they make
informed choices about their
behavior and feel confident and
competent about acting on these
choices.
Sex Education seeks to both reduce the risks
of potentialy negative outcomes from sexual
behavior (ie unwanted pregnancies and std)
To be effective it needs to include opportunities
for young people to develop skills that are
linked to general life-skills.
(able to communicate, listen, negotiate, ask for
and identify sources of help and advice.
Being able to recognize pressures and resist
them, deal with and challenge prejudice, seek
help from adults.
Be equiped with skills to differentiate between
accurate and inaccurate information.
Forming attitudes and beliefs
You must be comfortable with your
beliefs and not let them influence
negatively the messages you
provide.