“Building the Case for Coordinated School Health”: The Cuyahoga County Board of Health Coordinated School Health Initi

1. “Building the Case for Coordinated School Health”:The Cuyahoga County Board of Health Coordinated School Health Initiative Presented by: Martha Halko, MS, RD, LD Carol Inniss, BSN, RN

2. Cuyahoga County Demographics • The population in the health district served by the Cuyahoga County Board of Health (CCBH), is the largest in the state of Ohio. • The City of Cleveland, Shaker Heights and Lakewood have their own health departments. • The county population is ~1.3 million. • It is a diverse, multi-cultured, urban county. • There are 31 Public School districts in Cuyahoga County & 343 school buildings.

3. CCBH at a Glance Our Mission…Prevent Disease and Injury, Promote Positive Health Outcomes and Provide Critical Services to Improve the Health Status of the Community.

4. Health Commissioner Terrance Allan, R.S., M.P.H The 4 service areas are: Community Health Nursing Environmental Health Epidemiology and Surveillance

5. Building the Case for Coordinated School Health • The CCBH identified the need for a Coordinated School Health (CSH) initiative. • The CCBH programs which address the needs of schools and school districts include: • School health services • Tobacco avoidance & cessation • Teen pregnancy prevention • School environmental health services • Cardiovascular Health • Child & Family Health Services – Wellness Policy Technical Assistance Program

6. CSH Strategic Priority • The CCBH programs which provide interventions in the schools were not coordinated. • To better serve the local school districts: • CCBH set a strategic priority to “Broaden the Scope of the Comprehensive School Health Program.” • The CCBH Performance Goals are: 1. Establish a School Health Council 2. Host a Comprehensive School Health Conference.

7. CSH Best Practices • Utilize the Eight Component Coordinated School Health Model (Allensworth and Kolbe, 1987) • Utilize a Best Practices Model • Institute policy and environmental changes to enable the use of a population-based approach. • Healthy People 2010 objectives

8. CSH Resources • “School Health Index for Physical Activity, Healthy Eating & a Tobacco-Free Lifestyle”; A self assessment & planning Guide. • February 2000, U.S. Department of Health & Human Services, Centers for Disease Control & Prevention. • Healthy Ohioans- Buckeye Best Healthy School Awards Program • Goal: To achieve positive school-based environmental and policy changes. • Focuses on tobacco, nutrition and physical activity.

9. Identifying the Foundations for Coordinated School Health • The CCBH School Health Program: • Contracts with 10 public school districts • Contracts with14 private school system • Serves more than 60,000 students annually. • The School Health Nurses play an integral role in the development & implementation of a (CSH) program.

10. Existing Support for CSH • The CCBH Cardiovascular Health Grant • Administered by the Ohio Department of Health • Focus on Coordinated School Health. • The CCBH Child & Family Health Services Grant has a focus on wellness policy. • Community Partners supported the need for a Coordinated School Health Initiative.

11. Supporting Data Local childhood obesity rates and tobacco usage data provided a strong basis for promoting a healthy school environment. • Local survey revealed that 35%, or 1 in 3 of the children enrolled in kindergarten were overweight or obese. • A 2004 Youth tobacco Survey revealed that 28% of students report current use of some type of tobacco product. More students report current use of cigars, cigarillos, and little cigars, than cigarettes.

12. Fostering Collaboration • Coordination & collaboration among CCBH service areas and programs. • Utilize the Ohio Department of Health CVH project consultant as a resource and a “team member.” • Build on existing partnerships with Cleveland Department of Public Health, Children’s Hunger Alliance, American Cancer Society & other’s. • Coordinate with Ohio Action For Healthy Kids. • Form new partnerships to assure that there is representation on the council from all branches of the coordinated school health model.

13. Steps in the Planning Process • CCBH school advisory committee formed. • A county-wide AFHK advisory council formed. • American Cancer Society recommended merging the two committees. • The new Coordinated School Health Council formed a planning committee to plan & present a CSH conference.

14. Steps in the Planning Process • During the conference planning process the CSH council was expanded. • The council met for the first time on May 3rd prior to the May 25th CSH conference. • Both the council meeting & conference were used to introduce coordinated school health to the county.

15. CSH Funding Sources • CCBH in-kind contributions • Cardiovascular Health Grant • 4 year cycle, began Jan. 05 • United Parcel Service Mini-Grant, administered by Children’s Hunger Alliance • American Cancer Society • Child & Family Health Services Grant • 5 year cycle, began July 05 • Seeking additional funding

16. Mission: The Cuyahoga County Coordinated School Health Council will work in partnership with the school districts of Cuyahoga County to promote healthy lifestyle choices in a healthy school environment. Goal: To assist school districts with creating a healthy school environment which gives students & staff consistent, reliable health information and ample opportunity to use it. Coordinated School Health Implementation Plan

17. Implementation Plan • Develop communications plan which will include: • Developing a countywide newsletter and brochure. • CSH speakers bureau to present the CSH model. • Partner with the Youth Tobacco Survey to gather baseline data.

18. Academics + Health = A Winning Combination • May 25th, 2005Conference objectives: • To develop an action plan to improve student health, leading to increased academic proficiency. • To develop an action plan to create wellness policies & environmental conditions in the school & community • Providing technical assistance to school districts represented at the CSH conference.

19. Outcomes/Successes • CSH conference was successful! • 84 attendees • 16 school districts represented. • Great collaboration with ODH and community partners. • The CSH council has grown from ~15 members to 32 since its inception.

20. Challenges • Serving all public and private schools in the county. • Incorporating the school districts which are not in the CCBH health jurisdiction. • Short and long term funding. • Forming relationships with school administrators. • Coordinating programs and services within CCBH & within a large urban community.

21. Next Steps….. • Next CSH meeting scheduled for September. • Establishing council overall goals and objectives. • Creating active subcommittees for newsletter/brochure development, wellness policy implementation and marketing. • Create a CSH link on the CCBH web site.

22. Contact Information Deborah Weisbarth, BSN, RN Supervisor, School Health Program Chair, Coordinated School Health Program (216) 201-2001 x1304 dweisbarth@ccbh.net Martha Halko, MS, RD, LD Program Manager, Cardiovascular Health Grant (216) 201-2001 x1535 mhalko@ccbh.net Carol Inniss, BSN, RN Program Manager, School Health Program (216) 201-2001 x1309 cinniss@ccbh.net