School Health Program

In subject area: Medicine and Dentistry

School health programs are defined as comprehensive initiatives that include a coordinated set of
strategies and activities aimed at promoting the social, emotional, physical, mental, nutritional, and
educational development of students. These programs typically encompass components such as health
education, physical education, health and medical services, nutrition, psychological and social services, a
healthy school environment, health promotion, and family and community involvement.

AI generated definition based on: International Journal of Pediatrics and Adolescent Medicine, 2017

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Chapters and Articles

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Review article

Adolescent health and health care in the Arab Gulf countries: Today's needs and tomorrow's challenges

2017, International Journal of Pediatrics and Adolescent Medicine

2.12 School health/School health services

Schools are important and hold a unique position with respect to health care, as the personnel who
promote positive healthy life choices can reach a large number of adolescents. Therefore, schools are a
good place to promote health, apply preventive measures, and communicate values and information to
the community-at-large, including families, friends and neighbors. Accordingly, it is necessary to adopt a
comprehensive school program that includes a quality coordinated school health service program. Thus,
school health services should include a set of planned, sequential strategies and activities aimed to
promote the optimum social, emotional, physical, mental, nutritional and educational development of
the students [60]. It is further concluded that a coordinated school health program should include eight
components, namely, health education; physical education; health and medical services; nutrition,
psychological and social services; positive, healthy school environment; health promotion; and family
and community involvement [60].

Chapter

Health Promotion in Schools

2004, Encyclopedia of Applied Psychology

Ellis P. Copeland, Franci Crepeau-Hobson

4 Coordinated School Health Programs

A health-promoting school is a school in which all members of the school community work together to
provide students with integrated and positive experiences and structures that promote and protect their
health. This includes both formal and informal curricula in health, the creation of a safe and healthy
school environment, the provision of appropriate health services, and the involvement of the family and
the wider community in efforts to promote health.

Full-service schools (schools in which health, mental health, social, and/or family services may be
located) or comprehensive health education are considered effective formats to promote healthy
behaviors and prevent dysfunctional choices. However, without a radical change in school missions and
society values (i.e., society choosing to directly address major issues such as poverty and unsafe
environments), most of the 100,000 schools in the United States will not implement such a program in
the near future. Selective or indicated prevention approaches are more consistent with current federal
funding (need-based block grants) and perhaps offer the best option for the near future.
The School Health Programs has developed a comprehensive school health program model. According
to the model, a comprehensive school plan provides

A curriculum that addresses and integrates education about a range of categorical health issues at
developmentally appropriate ages

Programming for grades K–12

Instruction for a prescribed amount of time at each grade level

Integrative activities to help young people develop the skills they need to avoid the use of tobacco,
dysfunctional behaviors, and engaging in a sedentary lifestyle

Appropriate instruction from qualified teachers, health professionals, and concerned community
members

Ideally, a school health-promotion model would be one that is holistic and that includes the
interrelationships between the physical, social, emotional, and environmental (e.g., shaded play area)
aspects of health. Health-promoting schools provide opportunities for families to take part in the
development of health skills and knowledge of their children. Furthermore, an effective and
comprehensive health-promotion model addresses the importance of the social ethos of the school in
supporting a positive learning environment—an environment in which both healthy relationships and
the emotional well-being of children are strengthened.
Schools, by themselves, should not be expected to address the nation’s most serious health and social
problems. However, school health programs can be one of the most efficient means of preventing major
health and social problems. By reducing the incidence of mental and physical health problems that afflict
young people and often continue into adulthood, school health programs may reduce the spiraling cost
of health care, improve educational outcomes, and increase productivity and quality of life. Schools are
widely recognized as the major setting in which activities should be undertaken to promote competence
and prevent the development of unhealthy behaviors. Furthermore, from a primary and secondary
prevention perspective, an economic perspective, and a demographic standpoint, it appears essential
that social initiatives such as health promotion be linked to schools.

4.1 Positive Youth Development

According to Larson, high rates of boredom, alienation, and disconnection from meaningful challenge
are typically not signs of psychopathology but, rather, signs of deficiency of positive youth development.
Furthermore, many cases of problem behavior, such as drug use, aggression, premature sexual activity,
and minor delinquency, may also be related to an absence of a positive life trajectory. Although
involvement in extracurricular activities, such as sports, art, and drama clubs, has been clearly
demonstrated as beneficial in reducing high-risk behaviors and increasing academic success, these
advantages are not being fully promoted by schools or engaged by a significant number of today’s
youth. Due to a variety of factors, many schools are not fully addressing the mental and other health
needs of children and youth. Unfortunately, most efforts have been focused on when and how things go
wrong for youth, while neglecting the positive aspects. Indeed, today’s schools are so focused on the
development of academic skills and raising test scores that health promotion and the benefits of
extracurricular activities are largely ignored.

After-school programs offer an alternative that can aid in the promotion of positive youth development
and provide a diversion between 3:00 and 8:00 pm, the peak hours for violent juvenile crimes. The
development of “assets” has been key to a number of successful after-school programs. Survey data
collected by the Search Institute identified 40 developmental assets that young people need to build in
order to be healthy and successful. The survey data revealed the protective power of assets: The more
assets a child has, the more likely it is that he or she will do well in school, engage in community service,
and value diversity, and the less likely it is that the young person will engage in risk-taking behaviors
such as drug or alcohol abuse, drop out of school, or engage in violent behavior. These assets are
commonsense values and experiences that help youth to grow up caring, healthy, and responsible.
Applying the assets as a framework for positive youth development provides schools and communities
with a set of factors that are associated with fewer risk behaviors and increased health. Furthermore,
the assets provide a common language for talking about what young people need and for pulling people
together across different social groups.
Structured voluntary activities have promoted positive youth development and may be a key to
successful in-school social and emotional learning. An adolescent’s time is too often spent in two
opposite experiential domains. In school, youth experience concentration and challenge without being
intrinsically motivated. Conversely, in most leisure activities, they report experiencing intrinsic
motivation but a lack of challenge and concentration. An exception to this is structured voluntary
activities. Voluntary activities are those with rules, constraints, and goals as well as those in which the
adolescent is highly motivated to be involved. They include sports, arts, hobbies, and participation in
youth organizations. Based on a review of the literature, Larson concluded that involvement in
structured voluntary activities is associated with multiple positive outcomes, including the development
of initiative, greater achievement, and diminished delinquency. Thus, schools promote positive youth
development when they provide opportunities for youth to engage in service learning and/or structured
activities that contain the elements of intrinsic motivation, concentration, and challenge.

In recent years, a number of national reviews of school-based prevention programs have been
performed to determine “best practices” in positive youth development. Using core competencies of
social and emotional learning (SEL) as a basis for evaluation of programming and implementation, the
Collaborative for Academic, Social, and Emotional Learning (CASEL) reviewed 81 programs that met its
rigorous review standards. Following a 3-year review process, CASEL identified 22 programs that met its
final criteria of outstanding SEL instruction, evidence of effectiveness, and outstanding professional
development. Many of the programs selected were for all grade levels (K–12) because
evidence-based/effective SEL programming typically begins at an early age and continues through high
school.

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Chapter

School Health Education

2010, International Encyclopedia of Education (Third Edition)

J.S. Yang

Coordinated School Health Programs

Early health-education programs focused on hygienic behaviors that would help stem the transmission
of communicable diseases. As the conditions that afflicted children and adolescents shifted to chronic,
noncommunicable, multifactoral diseases and conditions, the limits of traditional health education
became apparent. Didactic strategies alone could not meet the behavioral goals of school health
programs. Over time, the economic, social, and political – as opposed to an individualistic and behavioral
– determinants of health became more widely accepted as a part of health education. As they were,
school health education became embedded within the broader framework of coordinated school health
programs.

Coordinated school health programs approach child and adolescent health as a multisectoral enterprise
to be shared by health, medical, educational, and social-service organizations. Working together,
multiple agencies provide students with a comprehensive set of programs and services to prevent
disease and promote health.

One model includes eight components in a coordinated school health program (Figure 1) (Fisher et al.,
2003). Access to health services through direct care or referral services allows for control and
management of chronic diseases and provision of emergency services. Counseling, psychological, and
social services provide resources to improve student mental and emotional health and ensure a healthy
social environment. Health promotion for staff includes health education and activities that can improve
health status, morale, and commitment to the school's overall health program. A healthy school
environment ensures that the design and structure of the school environment is optimal, protects
students from biological or chemical agents damaging to health, and enhances the psychological,
emotional, and social culture of the school. Access to nutritious and appealing meals that meet the
nutritional needs of all students are part of appropriate nutritional services. A high-quality physical-
education curriculum provides cognitive content and experiential activities in a variety of movements.
Involvement of family and community actors helps build support for coordinated school health
programs while helping to build reinforcing factors for healthy behavior outside of schools.

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Figure 1. Coordinated school health programs. From US Centers for Disease Control and Prevention.

School health-education programs are most effective when they not only follow best practices but are
located within the broader context of a coordinated school health program. The access to resources,
school culture, organizational structure, and prioritization of health created by coordinated school
health programs amplify the impact of school health education. Coordinated school health programs
provide the context to effectively translate change among proximal targets of school health education –
knowledge, beliefs, attitudes, skills, critical thinking, and decision making – into health-promoting
behavior change.

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Review article

Chronic Obstructive Pulmonary Disease

2020, Clinics in Chest Medicine

Alberto Papi MD, ... Leonardo M. Fabbri MD

School-based interventions

School health programs could be an effective means of reducing risks in a large susceptible population,
the behavior of whom could determine future risk for chronic diseases such as COPD. These programs
include 4 basic components: health policies, education, supportive environments, and health services.
They make use of physical education, nutrition instruction and food services, health promotion among
school personnel, and community outreach. Many school health programs focus on preventing risk
factors associated with leading causes of death, disease, and disability, including tobacco and alcohol
use, as well as dietary practices, physical activity, and sexual behavior. The World Bank reported that
school health programs are highly cost-effective. For example, the annual cost of school health
programs was estimated to be US$0.03 and US$0.06 per capita in low-income and middle-income
countries, respectively, with a resulting 0.1% and 0.4% reduction of future disease burden.10,27

Review article

Non-profit organizations and public education: a compendium of resources for physicians

1998, Clinics in Dermatology

June K. Robinson MD, Robin L. Hornung MD

School-based projects are often seen as ideal opportunities to evaluate sun protection programs, which
move beyond short-lived brochures, bookmarks, and posters. Schools provide ready access to the
majority of children from diverse sociodemographic backgrounds. This creates the ideal environment to
reach large numbers of children with a skin cancer prevention project conducted within the framework
of a comprehensive school health program. The program could be coordinated with health and physical
education, health and nutrition services, school counseling, psychological and social services, and health
programs for faculty and staff. A comprehensive school health program could provide students with the
knowledge and skills to promote healthful lifestyle choices as outlined in the National Health Education
Standards.21 The school setting also provides an environment for appropriate infrastructure, i.e., a
setting where there are the services, motivation, and support necessary to develop and maintain
positive health practices. Subsequent integration of the school program with family and community
efforts provides reinforcement of the student’s knowledge, attitudes, and skills. Community
organizations such as the YMCA, the Girl Scouts and Boy Scouts of America, summer camps, and
organized sports programs offer unique opportunities to foster and reinforce sun safety behaviors that
children can learn in school.

Review article

Evidence-Based School Psychiatry

2012, Child and Adolescent Psychiatric Clinics of North America

Yifeng Wei Med, Stan Kutcher MD, FRCPC, FCAHS

Complexities of Addressing School Mental Health Globally

Health and education are inextricably related, and play a fundamental role in the development of
children and youth. Young people cannot learn effectively if their health is poor, so health literacy is
important in enhancing health, leading to a wide variety of school health programs being implemented
globally.

School health programs have evolved increasingly from physical health only to include mental health
interventions. Three distinct, overlapping phases have occurred. Phase 1 identified the important role of
schools in providing immunizations and health screening for selected health problems (eg, vision,
hearing, scoliosis), providing health essentials (eg, food programs, safe water and sanitation services),
and preventing of communicable diseases and injuries.1,2 Phase 2 evolved primarily over the past 20
years, as social and emotional health and well-being have been added. Specifically, the promotion of
safe and emotionally healthy school environments, life skills education, prevention of substance abuse
and violence/aggression, and detection of learning disabilities have been added.1,2 More recently,
mental health and mental illness are areas of intense focus in schools, including the importance of
promoting positive mental health through education, and the early identification/prevention of mental
disorders.2,3 This third phase of school health framework has become an important area of innovation
and research.4
Addressing mental health in schools varies substantially across the globe depending on diverse variables
such as social norms, accessibility of mental health care, socioeconomic status, religion, culture,
geographic location. In countries embroiled in war or where human rights and law enforcement are
weak or nonexistent, many schools may not function consistently, and basic needs such as safety,
shelter, and security may not be present. The impetus for initiating school-based health programs has
sometimes been to target a specific public health issue such as the prevention of communicable disease
(eg, HIV/AIDS in Zimbabwe and Thailand), or the prevention of teen pregnancy (eg, in Mexico and the
Caribbean). In some other regions, faith-based or religious education predominates, and how this
relates to school mental health programs has not been well studied. Moreover, even within a
jurisdiction substantive differences between various schools may make a single model approach to
school mental health unworkable, although common policy and evaluation frameworks may be
necessary to direct programs and activities.5

These realities all impact the conceptualization, development, and implementation of school mental
health initiatives and illustrate how local and contextual factors play important roles as school mental
health approaches are developed. What constitutes a school mental health priority in 1 area may be
vastly different from the priorities in another. This recognition of the global reality suggests that the
development of school mental health approaches should be driven by specific population needs,
contextualized to fit local realities, and link mental health to physical health and learning outcomes. All
stakeholders should be aware of these complexities so that they are able to develop and implement
appropriate, yet feasible, policies, plans and programs to respond to mental health priorities of children
and adolescents within the school setting.

Chapter

School Health Promotion

2008, International Encyclopedia of Public Health

O. Samdal

School Health Promotion

On the grounds present