Teacher, Administrator and Ed Faculty Understanding of Sustainable Development Impedes Adoption8/13/2014 (From the ISHN Member information service) As we learn more about how health and social programs can be better integrated within education systems, one of the new areas for discussion is how educator understandings, beliefs and professional identities will have an impact on their willingness to address such issues in their practice. Three articles in the July 2014 issue of Environmental Education Research provide insights on teacher, administrator/school leader and education faculty understanding of the concept of sustainable development plays out in their respective work assignments. One article shows that Swedish teachers differ in their understanding of the concept mostly according to their subject traditions. generally do not have a holistic understanding which is prescribed in the formal curriculum documents. The second article examines how a holistic, whole school approach and vision to ESD can be developed by school leaders in different ways. The third article examined how teacher educators were constrained from addressing ESD in their work due to pressing and competing priorities, even when they understood the concept. Read more>>
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(From the ISHN Member information service) The National Association of Chronic Disease Directors (NACDD) has just released an easy-to-read summary of a research article (Bradley & Greene, 2013) published in the May 2013 issue of the Journal of Adolescent Health. the relationship between health risk behaviors and academic achievement. This article, along with a recent Cochrane Review (Langford et al, 2014) of the effectiveness of multi-intervention approaches in school health promotion, has raised questions about what we know (and don't know) about such comprehensive approaches, their impact on on health and educational achievement and how new understandings based on ecological and systems-based thinking need to be taken into account as we move forward. This blog post provides a brief introduction to a discussion which ISHN will undertake this fall in cooperation with its International Discussion Group addressing healthy school models and frameworks.
As we noted in our ISHN members weekly report on news/research in May 2013, the connections between health status, risk/protective behaviours, health inequities and health promoting conditions and learning have been well-established by many studies and reviews. This 2013 review correlated risk behaviours such as violence, tobacco use, alcohol and other drug use, sexual behaviors contributing to unintended pregnancy and sexually transmitted diseases, inadequate physical activity and unhealthy dietary behaviors to various measures of academic achievement and found that for "all six health-risk behaviors, 96.6% of the studies reported statistically significant inverse relationships between health-risk behaviors and academic achievement.". In our view, the direct connection between health and learning is not really the issue for us to consider again today. The current question, already being discussed in several recent reviews and reports is whether multi-intervention approaches such as healthy schools affect educational achievement. The recent Cochrane Review (Langford et al, 2014) did not find sufficient evidence to support this claim but there have been several sources who suggest otherwise, at least in part, for health and social problems that have a direct impact on school attendance and participation. These sources include a review sponsored by WHO-Europe (Suhcrke $ de Paz Nieves, 2011), our ISHN analysis (McCall, 2010), a health inequities analysis (Basch, 2010), the Centers for Disease Control and Prevention (Web page summary, nd) and many others focused on specific health/social behaviours or conditions. A recent discussion paper from the intergovernmental consortium on school health in Canada (Hussain & Freeman, 2013) offers an interesting elaboration of the concept of "educational achievement" and starts a conversation about some indicators depicting some student and school outputs that can be jointly pursued by health and education systems. We need to sort out these claims and counter claims about whether and which types of multi-intervention approaches are most effective in promoting student achievement, student success, school and health, education and other system effectiveness. The Langford et al, 2014 review has also caused some decision-makers to question the value of school health promotion in general. Coming at a time when public health systems and authorities around the world are withdrawing from long-term commitments to school health promotion as their resources are reduced from the economic downturn, this is an alarming coincidence. Advocates for comprehensive school health approaches need to point out that the 2014 review essentially echos the findings of a similar review done for WHO in 2006 (Stewart-Brown, 2006) insofar as concluding that the evidence supporting the use of multi-intervention programs is limited to specific health issues and behaviours, and that there are several other systematic reviews with findings that contradict or clarify the Langford et al review. But we also develop and argue for a new paradigm for evaluating the impact of multi-intervention approaches that is truly based on ecological and systems-based evidence. Comprehensive school health programs in which school efforts are supported by school board and other agencies as well as by several ministries of government working together take several years to develop. They require holistic understandings of health rather than measures based on the absence of disease or specific health/social behaviours. We need to be measuring realistic outputs (basic health knowledge, generic and applied life skills, mindful self-understanding and realistic behavioural plans) that can be observed as students graduate from schools. The limitations of random controlled trials that often compare specific, artificially supported programs to existing programs without much clarity or understanding of the complexity of systems needs to be challenged. We need more multi-level models and analysis and systematic reviews that use mixed method studies as their basis. Our ISHN May 2013 weekly report also questioned the wishful thinking in the JAH article when it suggested that a "unified (health & education) system that addresses both health behavior and academic achievement would have reciprocal and synergistic effects on the health and academic achievement". In our view, establishing such a "unified system" runs counter to the reality of government structures. Instead, ISHN and other organizations have initiated an international discussion that suggests that health and other systems need to revise their approach so that health and social programs are integrated within the core mandates, constraints and concerns of education systems. ISHN, ASCD and other organizations have initiated an international discussion group that suggests that health and other systems need to revise their approach so that health and social programs are integrated within the core mandates, constraints and concerns of education systems. A global consensus statement has prompted and international dialogue in several regions of the world leading up to a forum with UN agencies in May, 2015. International school health symposiums have already been Asia and North America on the many aspects of this integration challenge. Watch for the announcements of our discussions in webinars and web meetings on the evidence and experience in multi-intervention approaches to school health promotion and development in the fall of 2014 on the ISHN webinars and conference schedules foubnd at the Wikipedia style web site at www.schools-for-all.org . (From the ISHN Member information service) The US Department of Education announced the winners of their research granting program on educational innovations this week. The focus of these large grants (1.5 million + for each) was on mental health issues, including resilience, social emotional learning, integrated mental health services and many more topics. The extent to which these grants are coordinated with the efforts of non-educational sectors will help to determine their ultimate impact on education and other systems. Read more>>
Social Control vs Helping a Child with Special Needs: The Dilemma Faced by Teachers & Schools7/11/2014 (From the UCLA Center on Mental Health in Schools) In the ASCD-ISHN sponsored discussions about integrating health and social programs more effectively within schools, we have identified a set of challenges associated with the contradictory or competing demands and constraints placed in teachers and schools by society. The UCLA Center on Mental Health in Schools has discussed one of these challenges in a recent paper on Helping and Socialization. The paper notes that a significant concern or dilemma arises when the teacher and the school are asked to both help the child displaying deviant behaviour while also serving the school's mandate to socialize children and to exercise the social controls necessary to ensure that other children can continue to learn. An example is presented in the paper as follows:
" One major reason for compulsory education is that society wants schools to act as socializing agencies. When a child misbehaves at school, the teacher's job is to bring the deviant and devious behavior under control. Interventions are designed to convince the child he should conform to the proscribed limits of the social setting. The child's parents valued the school's socializing agenda, but also wanted him to receive special help at school for what they saw as an emotionally based problem. The child, like most children did not appreciate the increasing efforts to control his behavior, especially since many of his actions were intended to enable him to escape such control. Under the circumstances , not only was there conflict among the involved parties, it is likely that the teacher's intervention efforts actually caused the child displaying deviant behaviour to experience negative emotional and behavior reactions (e.g., psychological reactance). It is commonplace for policy makers, practitioners, family members to be confronted with situations where socialization and helping agenda are in conflict. Some resolve the conflict by clearly defining themselves as socializing agents and in that role pursue socialization goals. In such a context, it is understood that helping is not the primary concern. Others resolve the conflict by viewing individuals as "clients" and pursuing interventions that can be defined as helping. In such cases, the goal is to work withthe consenting individual to resolve learning and behavior problems, including efforts designed to make environments more accommodative of individual differences. Some practitioners are unclear about their agenda or are forced by circumstances to try to pursue helping and socialization simultaneously, and this adds confusion to an already difficult situation." This role conflict or dilemma is not limited to children who are misbehaving. If teachers are asked to spend inordinately more time helping other children with special medical needs or to help children with social isolation or family stress issues, their time is taken away from the other students. In the "helping professions" such as nursing or social work, there is no conflict, because their priority is clearly with the more vulnerable child. However, educators are mandated to enable every child to reach their full potential, so the maxim is often to try to spend an equivalent amount of time and energy with each and every child, even if they have fewer health, social or even learning needs. To access the UCLA paper Read More>> (From the ISHN Member information service) An article in the June 21, 2014 issue of The Lancet calls for systems thinking from governments and Un agencies when they decide on the set of goals to replace the existing MDG goals. The authors assert that "Global priorities have progressed from the Millennium Development Goals (MDG) that will expire in 2015 to global sustainable development. Although there is not yet a consensus on the specific goals for the post-MDG era, the post-2015 investment agenda for health will probably emphasise social determinants of health, sustainable development, non-communicable diseases, health systems strengthening, universal health coverage, the health of women and children, and ageing." They then go on to make the case for "systems thinking". " The MDGs were undoubtedly successful in focusing international donor financing and domestic investments to achieve the targets set in these goals. Yet, undue emphasis on financing narrow disease programmes used to achieve disease-specific targets in the MDGs often missed opportunities to effectively strengthen health systems.1 Consequently, several low-income countries with weak health systems have struggled to reach the targets set in health-related MDGs and will not achieve them by 2015.2 An important lesson from the MDGs is that current and emerging global health challenges require action that embraces interdisciplinary and intersectoral approaches to development,3 which acknowledge the path-dependence and context-dependence of implementation."
A table in the article underlines the differences between "selective approaches" (linear thinking) focused on preventing specific problems and "systems thinking" In linear thinking, the program is developed from a blueprint, developed by trials in controlled circumstances, that are top-down in nature, often without considering local contexts or potential unintended consequences. In systems-based approaches, learning and context drive the action and selection of issues to be addressed as well as the programs. In linear thinking, the programs target disease-specific, quick-wins. Planners develop a specific program for a specific population and assess its ability to produce specific short-term outcomes. In systems-based approaches, the action is across various sectors, with key stakeholders involved from the beginning to develop and implement approaches across the relevant sectors. In selective thinking, there is a reliance on isolated, quantitative measures. Single snap shot data points are used by specialized experts to assess if the programs are meeting their objectives. In systems thinking, multiple interative measurements and synthesis as well as relationships are used to assess progress. Longitudinal, real-world data from multiple qualitative and quantitative sources are used to monitor relevant effects. Read more>> (From the ISHN Member information service) The Healthy Schools program in British Columbia, Canada is among the Canadian and international leaders in school-based and school-linked prevention of specific health problems and in promoting overall health. A visit to their content rich web site will reveal that the schools program is part of an overall settings-based approach and a "whole of government" strategy called Act Now BC. The province provides funding for a number of excellent initiatives and activities, all of which have used a long-term, systems-based strategy. Multi-intervention approaches are used regularly as the basis for strategies on physical activity, healthy eating, addictions and mental health. The province has mandatory health/personal planning as well as physical education curricula from kindergarten to senior high school grades. The province funds a network of over 150 schools per year as innovators and leaders in school prevention and promotion. Regular conferences bring the school health community together. Excellent learning resources are identified and promoted. The Healthy Schools program has funded the development of a number of generic school health resources that encourage good planning school self-assessments, the use of multiple interventions, effective teaching and student assessment practices and more. Indeed, the province has been both a pioneer and a leader.
However, like all other jurisdictions, British Columbia struggles to truly maintain a focus on improving the overall health of the school environment (policies, practices, social interactions, physical conditions, family problems and strengths, relationship with the community etc) rather than being fixated on a selected set of health or social behaviours or conditions. The list of priority topics on the BC education ministry web page for its healthy schools program is typical of most jurisdictions; healthy eating, physical activity, tobacco/drugs. If one reads the list of "generic" school health planning guides and tools from BC (and most other jurisdictions) one will find that the generic principles and practices are almost entirely focused on or applied to only these health problems or behaviours. We will struggle to find references to to child abuse, sexual health, poverty, indigenous students, LGBT students, violence, crime and many other issues confronting youth and families today in those planning documents. The BC Healthy Schools web site does maintain a list of educational and other resources addressing a broader list of issues. And it does list its 150+ school success stories according to this broader list of topics. But, again, if we examine these stories, we find almost no examples of schools trying to build their overall capacity to implement and maintain school health promotion programs (3/159) but we do find an overwhelming number of stories on healthy eating and physical activity. We also find very few stories from schools addressing topics like substance abuse, child abuse and other more difficult social issues. If we turn our attention to the current dominant thinking in the health sector these days, we will find out why so many of the "healthy schools" programs have actually become "school prevention" programs rather than "school health promotion" programs. As funding has been leeched from the health sector overall, we find that health authorities have retreated back to their protection and prevention functions and away from their health promotion function. The work done by health professionals in schools simply reflects this larger trend. Indeed, if one were to examine health ministries around the world and even the WHO, we would find that they are structured, staffed and funded more favourably around "non-communicable diseases" than around "health promotion". The danger in this trend to reduce the focus and fixate on a selected number of health issues means that the healthy schools programs become vulnerable when a new issue such as cyber-bullying emerges to capture the attention of the public, parents and decision-makers. Resources are quickly devoted to this new problem and if the healthy schools movement is not ready to address it, they will be by=passed. Or, if other multi-intervention approaches/programs such as safe schools or community schools are available and compete with each other for such new resources, then we will soon see new infrastructure, new documents, new research, new leaders emerge, often repeating or over-lapping with work that has already been done. We will also see educators and school systems having to yet again adjust to a new set of requests and demands from a new set of stakeholders, often without aligning with existing initiatives. This is what happened in BC and several other Canadian and western countries. New laws, new coordinators, new professional development activities and much more, all focused on bullying, cyber-bullying and to a lesser extent on LGBT students have been brought into BC (and other jurisdictions) in separate strategies If the healthy schools movement and its related government, agency and school level programs do not move towards a school health promotion rather than prevention approach, it may very well find itself bypassed by new initiatives focused on the topt topic of the day rather than a long term developmental, systems-based approach. This is not to say that the HS movement should try to compete with such specific emerging concerns. Indeed, that is the way the health system has always been funded, by disease, rather than health. But the proponents of healthy schools need to always include all of the many aspects of health, wellness, development and its connection to learning in its mandate, maintaining links with the advocates, experts and practitioners focused on these 25+ issues and concerns and being ready to work with them as attention is turned to their issue. This is also not to say that the healthy schools movement should try to be the primary or over-arching paradigm for addressing many of these issues. Instead, the healthy schools movement, linked most effectively to the health sector, and programs should be ready and willing to work with the many other multi-intervention approaches that work with other systems and sectors. These include the safe schools movement working with law enforcement, community schools working with social services and community development sectors, social/emotional learning and PBS models grounded in the school systems, the relief aid/emergencies in education movement working in countries facing disasters/conflict, school health & nutrition programs working in low income countries and many others. But if the healthy schools movement focuses too much on prevention and too little on promotion, it will not be able to either meet its mandate in addressing all aspects of health nor will it be able work effectively to work with other movements/sectoes in addressing the needs of the whole child. (From the ISHN Member information service) In the ASCD-ISHN global discussion of the need to better integrate health and social programs within education systems, it has been strongly suggested that authorities take a holisitc, whole child approach to education rather than trying to carve up children into specific health/social behaviours or conditions to to compete with the academic purposes of schooling. With the October 2013 release of its Education Renewal and Innovation Framework: Directions for Change, the Government of the Northwest Territories in Canada illustrates how this can be done from the ground up, while using a distinctly indigenous and rural set of values and principles. The news release announcing the framework identifies several challenges that require changes in the schools, the nature of which illustrate how the new directions see school as part of their respective social and economic contexts and communities. "The framework is one of several initiatives developed by the Government of the Northwest Territories to address challenges like poverty, mental health, addictions, early childhood development, safety, the legacy of residential schools and school attendance. Other challenges within the school system, like authentic learning, staff recruitment, training and retention and transitions to work or learning after high school will be met primarily through school programming and policies themselves, preparing children for a prosperous and healthy future." The foundations of the reforms are equally holistic in their approach to education. The executive summary of the document says it this way: "Thinking around teaching and learning is undergoing a major shift world-wide. The current education system is a model off a system similar to the factories of the Industrial Age. Subject areas are separated, students are sorted by age, and the end goal is a very specific set of skills and knowledge. Research now points to a more ecological understanding of the needs of learners and the factors that benefit learning." These foundational statements are intended to guide the initiative. These statements, especially the first few, are born of indigenous worldviews and experiences where relationships with the land, ecology, and identity are very powerful.
relationships", (2) "e that student wellness and the development of a positive sense of identity are promoted and embedded in school experiences, programming, and environments", (3) "ensure that educators have access to experiences and resources that enhance their wellness in order for them to focus on excellence in teaching" (5) "that the strengths and realities of small communities are recognized and built upon in order to ensure equitable, quality education in all NWT communities" and (9) "work with Aboriginal governments to be successful as they draw down jurisdiction over the education of their people". The document does include other directions that will be more familiar to those working in school systems based on competition, traditional rote style learning and even narrow, behavioural modification approaches to promote health. These include research-based curriculum, better data and use of those data in decision-making, and more monitoring/reporting to provide better accountability. However, these traditional, more industrial approaches to education are firmly based and and linked within this indigenous, holistic, whole child approach, that in turn, is rooted in a deep understanding the indigenous and rural, northern communities served by the schools in this system. To read more about the NWT education renewal, start at this web page. (From the ISHN Member information service) One of the major challenges in sustaining and integrating health and social programs within education systems is the tendency in government to create and maintain "silos" of programs, often delivered in isolation or even competition with each other. Most governments create committees to encourage coordination but they often fail, or they focus on only one problem at a time. The Manitoba Healthy Child Agency, a strategy established in law in 2007, is an exception to this rule. The slogan on Manitoba license plates tells the world about "Friendly Manitoba". More than just words, this slogan actually reflects a culture and customs in the province, one which was born in Canada's harshest winters and bred by generations of immigrants who had to rely on each other. So, perhaps, it is this culture of cooperation that enables Healthy Child Manitoba (HCM) to be as effective as an inter-ministry agency, coordinating several ministers and ministries, in a "whole of government" strategy. Other factors could include their requirement to report results every five years, its research, innovation and knowledge development capacity, and its combination of programs (as opposed to framework documents) that are delivered hands-on and delegated ways. As well, the Healthy Child inter-ministry program has its own legislation, entitled the Healthy Child Manitoba Act, thereby giving its coordination work legal authority and requirements to report every five years on progress.
The HCM web site describes its work as follows: " in 2000, the provincial government implemented the Healthy Child Manitoba (HCM) Strategy – a network of programs and supports for children, youth and families. This nationally recognized strategy was set in legislation under The Healthy Child Manitoba Act in 2007.Led by the Healthy Child Committee of Cabinet, Healthy Child Manitoba bridges departments and governments and, together with the community, works to improve the well-being of Manitoba's children and youth. HCM focuses on child-centred public policy through the integration of financial and community-based family supports.In addition to these cross-sectoral government structures, The HCM Act also continues the work of cross-sectoral community structures, including Parent-Child Coalitions and the Provincial Healthy Child Advisory Committee (PHCAC). HCM researches best practices and models and adapts these to Manitoba's unique situation. It strengthens provincial policies and programs for healthy child and adolescent development, from the prenatal period to adulthood. HCM then evaluates programs and services to find the most effective ways to achieve the best possible outcomes for Manitoba children, families, and communities." (From the ISHN Member information service) A recent article describing a growing trend in the United states to voluntarily delay entry into high school in order to strengthen students academically and socially reflects increased attention to various transition periods in a child's schooling. A report on grade retention done by UNESCO is primarily focused on involuntary cases but does include some students who have volunteered to wait a year. That UNESCO report concludes that “Grade repetition represents inefficiency and wastage of resources for society, but its voluntary forms may be beneficial to students in certain circumstances,”. In Ireland, a voluntary "transition" year has become so popular that the vast majority of students now make the choice to wait a year before proceeding. See our previous blof post on the Irish program here. In both of these cases and others, it may very well come down to the supports that are available to students as they make the transition. this is where effective, comprehensive health and social programs that are linked effectively within the school systems can be of the greatest service. Read more from the American news story.
(Identified by ASCD SmartBrief) A blog post identified by the ASCD Smart Brief service and published by Edutopia suggests that students should be taught to prepare their curricula vitae (which include personal and professional goals) rather then a simple resume (which simply lists assignments and accomplishments). This strategy for Career Education and Student Planning, one which the author calls preparing a "course for life", fits very well with health/personal/social development education, where effective teachers often use student journals and other reflection activities to help students learn more about themselves and their surroundings. As well, linking CV preparation with health journals and reflections is another way to achieve a better integration of health concerns within the core concerns of education systems. The author of the blog post discuses how difficult it can be for students to learn self-reflection techniques. But we all know that this process is essential if students are to develop personal behavioural and life plans. The article then outlines a five phases of preparing a CV, all of which are applicable to HPSD education as well as career education. Read more>>
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