Different models in managing the school clinic

2. Learning objectives Explain the conceptual framework of school health clinics. Describe the various models of school clinic in different countries including CDC comprehensive School Health Model Singapore School Health Model Canadian School Health Model Describe the Abu Dhabi Schools for Health Model and the different components.

3. Historical school health model From the late 1880s to late 1990s the school health programs were based on 3 elements

4. Overview of School Health Models There are many different school health models globally The most common model is the World Health Organization “Health Promoting Schools” which is the foundation of the WHO Global School Health Initiative that was launched in 1995. The common elements in the models we have reviewed are as follows:

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8. USA CDC Comprehensive School Model The coordinated school health, overseen by national and health promotion agencies, consists of eight components This model was proposed in 1987 by Allensworth and Kolbe.

9. A CSHP model consists of 8 interactive components: Health Education Physical Education Health Services Nutritional Services Healthy School Environment Health Promotion for Staff Counseling and Psychological Services Family/Community Involvement What is important is coordination between all the eight components

10. Singapore school health model The Ministry of Education, Ministry of Health and the Singapore Health Promotion Board work very closely on school health The MOE and HPB have run some successful joint projects For example: between 1992 – 2000 the “trim and fit” programme contributed to a 2% drop in the prevalence of obesity (16.6% to 14.6 %) amongst primary 6 students (11 – 12 years)

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12. WHO Health promoting schools model

13. Canadian School Health Model The Joint Consortium for School Health is a consortium of governments that bring together key health & education representatives responsible for school health in each province and territory

14. Health Promoting Schools - Canada

15. The new Schools for Health framework is based on global best practice HAAD has developed a comprehensive “Schools for Health” Program We work together with our partners from ADEC, SEHA School Health Services and private schools to implement the program in the 480 Abu Dhabi schools The model recognizes that healthcare in schools is not just health services but also the social and physical school environment, learning and capacity building through training; the involvement of family and community and supported by policy and partnerships. HAAD has developed a comprehensive “Schools for Health” Program We work together with our partners from ADEC, SEHA School Health Services and private schools to implement the program in the 480 Abu Dhabi schools The model recognizes that healthcare in schools is not just health services but also the social and physical school environment, learning and capacity building through training; the involvement of family and community and supported by policy and partnerships.

16. Schools for Health – 8 components

17. Why is coordination important? Coordinating all these parts / components in a systematic approach can enable schools to : Eliminate gaps and reduce redundancies across the many initiatives and funding streams. Build partnerships and teamwork among school health and education professionals in the school. Build collaboration and enhance communication among public health, school health, and other education and health professionals in the community. Focus efforts on helping students engage in protective, health-enhancing behaviors and avoid risk behaviors.

18. Coordination & School Health Goals Coordination among the components is important to achieve the school health goals : Improve health knowledge, attitudes, and skills; Improve health behaviors and health outcomes; Improve educational outcomes; Improve social outcomes

19. Strategies to achieve the goals Secure and maintain administrative support and commitment by Getting HAAD support at local level and principals support at school level; School administrators can support by: Incorporating health in the district’s or school’s vision and mission statements, including health goals in the school’s improvement plan Appointing someone to oversee school health Allocating resources Modeling healthy behaviors Regularly communicating the importance of wellness to students, staff, and parents

20. Strategies to achieve the goals Establish a school health council or team School Health Council The school health council should have representatives from all 8 components, parents, administrators, medical school health consultant, representatives from community, and from local health department. School Health Team Can you list down the members you require in the school health team?

21. Strategies to achieve the goals Identify a school health coordinator The school health coordinator helps maintain active school health councils and facilitate health programming in the district and school and between the school and community. The coordinator organizes eight components of school health and facilitates actions to achieve a successful, coordinated school health system, including policies, programs, activities, and resources.

22. Strategies to achieve the goals 4. Develop a plan Use a program planning process to achieve health promotion goals, keeping in mind all the stakeholders Steps include Defining priorities based on the students’ unique health needs Determining what resources are available Developing an action plan based on realistic goals and measurable objectives Establishing a timeline for implementation Evaluating whether the goals and objectives are met  plan would be incorporated into a school’s overall improvement plan to link health with learning outcomesplan would be incorporated into a school’s overall improvement plan to link health with learning outcomes

23. Strategies to achieve the goals Focus on students; Address priority health enhancing and health risk behaviors Provide professional development for staff.

24. Ecological Model of Health Behavior

25. Assumptions of the ecological model Health is influenced by multiple facets of the environment Environments themselves are multi-dimensional Human-environment interactions can be described at varying levels of aggregation There is feedback across different levels of environments and aggregates of persons

26. Intervention implications Factors within the control of individuals Individual level approach Individual education targeting increased knowledge about healthy eating Factors external to the control of individuals Environmental level structural approach Healthy food available in the canteen and tuck-shop

27. An evolved ecological model of CSHP The major differences between this model and CSHP is that it is intended to complement are found in the four concentric rings that surround the middle six components—the healthy school environment (inner ring), essential governance structures of a CSHP (second ring), local school system infrastructure within which a CSHP exists and functions (third ring), and family and community involvement (outer ring). The “chutes” running from the outer ring through the three adjacent rings to the inner circle are meant to convey coordination across all layers, as well as the concept that family members and a diverse, wide array of community organizations and agencies can be involved bidirectional in any and all other components and/or provide resources at any and all levels of the CSHP. The major differences between this model and CSHP is that it is intended to complement are found in the four concentric rings that surround the middle six components—the healthy school environment (inner ring), essential governance structures of a CSHP (second ring), local school system infrastructure within which a CSHP exists and functions (third ring), and family and community involvement (outer ring). The “chutes” running from the outer ring through the three adjacent rings to the inner circle are meant to convey coordination across all layers, as well as the concept that family members and a diverse, wide array of community organizations and agencies can be involved bidirectional in any and all other components and/or provide resources at any and all levels of the CSHP.

28. Essence of the ecological model Ecology refers to the complex interrelationship among intrapersonal factors, interpersonal processes and primary groups, institutional factors, community factors, and public policy.

29. Conclusion A School Health model is a framework that helps us understand the different aspects of health in schools There are many different models The Schools for Health Model is modeled on the 8 components of the CDC model

30. References Center for Disease Control. (2010). Healthy youth! Coordinated school health. Retrieved from http://www.cdc.gov/HealthyYouth/CSHP/ Fields, P., Harlan, T., & Anderson, L. (2010, June). School-based health centers and coordinated school health in West Virginia. Alternative Education Conference [PowerPoint slides]. West Virginia Department of Education.

31. Continuation… Lohrmann, D. K. (2008). A complementary ecological model of the coordinated school health program. Public Health Reports, 123(6), 695- 703. Tohrabi, M.R., & Yang, J. (2000). Comprehensive school health model: An integrated school health education and physical education program. ICPE 2000 Proceedings. Retrieved from http://www.ied.edu.hk/icpe2004/English%20Sample.pdf