(An item from the ISHN Member information service)  An analysis of coordination the Dutch Healthy School Approach (HSA) is reported in the July 2015 Issue of BMC Public Health. "HSA targets demand-driven practices based on the epidemiological data, a prioritization of needs, an assessment of important/modifiable determinants, the drafting and implementation of a multi-year plan, and its evaluation. All this is done jointly with multiple stakeholders. At school level, implementation is assisted by a ‘HPS advisor’, who represents various public services and providers in individual contacts with schools. At local and regional levels, the public health services (PHSs) function as a coordinator between the education, health and other services stakeholders. Their coordinating role derives from a legal responsibility for the implementation of local public health policy and youth health care financed by the municipality". The study "reports on the longitudinal quantitative and qualitative data resulting from a two-year trajectory (2008–2011) based on the DIagnosis of Sustainable Collaboration (DISC) model. This trajectory aimed to support regional coordinators of comprehensive school health promotion (CSHP) in systematically developing change management and project management to establish intersectoral collaboration. Multilevel analyses of quantitative data on the determinants of collaborations according to the DISC model were done, with 90 respondents (response 57 %) at pretest and 69 respondents (52 %) at posttest. Quantitative data showed major improvements in change management and project management. There were also improvements in consensus development, commitment formation, formalization of the CSHP, and alignment of policies, although organizational problems within the collaboration increased. Content analyses of qualitative data identified five main management styles. Read more>>

(An item from the ISHN Member information service)  An education ministry funded evaluation of the effectiveness of the Taiwan Health Promoting Schools Network, the mechanism used to implement school health in that country since 2001 was summarized in the July 2015 issue of the Journal of School Health. The survey of 800 randomly selected schools found that "Respondents were most satisfied with consultants and schools' recognition of responsibilities and rules and their interactions with HPSSN administrators. They were least satisfied with the extent of their HPSSN consultant interaction and believed HPSSN provided insufficient resources to establish HPS. Respondents' consultant partnerships and satisfaction with HPSSN administration significantly predicted HPS implementation. Additionally, the predictive values of healthy policies and school-community relationships were greater than the other 6 HPS components." In other words, capacity and relationships were critical. Read more>>

(An item from the ISHN Member information service) A number of experts were asked to refine the concept of integrated public health policy in order to move towards better ways of measuring and monitoring this idea that is central to the recent health sector attempts to promote health in all policies and the ISHN-ASCD-EI initiative on integrating health and social programs within education systems. The authors note "While expectations of integrated public health policy (IPHP) are high, assessment is hampered by the concept's ambiguity. This paper aims to clarify IPHP as first step in further measurement development. We invited 237 Dutch experts, 62 of whom generated statements on characteristics of IPHP. Next, 100 experts were invited, 24 of whom sorted the statements into piles according to their perceived similarity and rated the statements on relevance and measurability. The concept map consisted of 97 statements, grouped into 11 clusters and five themes. Core themes were ‘integration’, concerning ‘policy coherence’ and ‘organizing connections’, and ‘health’, concerning ‘positioning health’ and ‘addressing determinants’. Peripheral themes were ‘generic aspects’, ‘capacities’, and ‘goals and setting’, which respectively addressed general notions of integrated policy making, conditions for IPHP, and the variety in manifestations of IPHP. Measurability ratings were low compared to relevance." While this article is an important first step and knowing that it is always risky to comment based only on an abstract, this article raised a flag in that the issues of capacity and setting were relegated to a peripheral status. This dismissal of the real world capacities and powerful conditions based on context seems to run counter other complexity literature suggesting that working within complex environments will always require both capacity and a firm understanding of the circumstances. Read more>>

(From the ISHN Member information service)  An article in Issue #2, 2015 of Psychological Bulletin describes how any multiple intervention program such as school health promotion will need to determine how many health issues need to be addressed in their context, how many interventions will likely achieve an optimal affect and which issues being addressed are more relevant/proximal to the population being served. The " meta-analysis of 150 research reports summarizing the results of multiple behavior domain interventions examined theoretical predictions about the effects of the included number of recommendations on behavioral and clinical change in the domains of smoking, diet, and physical activity. The meta-analysis yielded 3 main conclusions. First, there is a curvilinear relation between the number of behavioral recommendations and improvements in behavioral and clinical measures, with a moderate number of recommendations producing the highest level of change. A moderate number of recommendations is likely to be associated with stronger effects because the intervention ensures the necessary level of motivation to implement the recommended changes, thereby increasing compliance with the goals set by the intervention, without making the intervention excessively demanding. Second, this curve was more pronounced when samples were likely to have low motivation to change, such as when interventions were delivered to nonpatient (vs. patient) populations, were implemented in nonclinic (vs. clinic) settings, used lay community (vs. expert) facilitators, and involved group (vs. individual) delivery formats. Finally, change in behavioral outcomes mediated the effects of number of recommended behaviors on clinical change. These findings provide important insights that can help guide the design of effective multiple behavior domain interventions". Read More>>

(From the ISHN Member information service) SHPPS is a national survey periodically conducted to assess school health policies and practices at the state, district, school, and classroom levels. The 2012 study collected data at the state and district levels
only. School-and classroom-level data collection will take place in 2014. This report is on school health coordination activities. 66.0% of states had a person, such as a state school health coordinator, responsible for overseeing or coordinating all
of the state’s school health and safety policies and activities. 53.7% of districts had a district-level school health coordinator who oversees the district’s health and safety policies and activities. 68.8% of states had one or more than one group (e.g., a committee, council, or team) of people formally charged with coordinating state-level school health-related activities. 65.4% of districts had one or more than one group (e.g., a school health council, committee, or team) at the district level that offered guidance on the development of policies or coordinated activities that are health-related. Read more>>

(An item from the ISHN Member information service) An article in Issue #5, 2013 of Journal of School Nursing advocates for four key skills or competencies that have been identified by several nursing associations in the US that focus on inter-professional collaboration. The Expert Panel identified and described four specific competency domains (Interprofessional Education Collaborative Expert panel, 2011): Values/Ethics, Roles/Responsibilities, Communication and Teams and Teamwork. For the full text of the article, go to this web page. To access the full report cited in the article, go to this web page. 

(An item from the ISHN Member information service) A review of the research on multi-intervention approaches to school health promotion reported in the July 2013 issue of the Journal of School Health suggests that effective approaches included stronger consideration of integration within the school system. the local context, building capacity for sustained implementation and ensuring coordination. The authors report that "Findings indicated that, for adequate implementation, an intervention should be integrated in pre-existent school settings, fine-tuned to its target population or environment, involve family and the community, and be led by the school itself, with there being a “healthy school coordinator” to coordinate the program." Read more>>

(An item from ISHN Member information service) Working across multiple systems to prevent a problem or promote health is not easy, even with collaboration mandated from above. An article in Issue #1, 2013 of Critical Public Health describes some of those challenges in an analysis of alcohol abuse prevention partnerships in England. The authors report that: "Tackling alcohol-related harms crosses agency and professional boundaries, requiring collaboration between health, criminal justice, education and social welfare institutions. It is a key component of most multi-component programmes in the United States, Australia and Europe. The findings are based on a mix of open discussion interviews with key informants and on semi-structured telephone interviews with 90 professionals with roles in local alcohol partnerships. Interviewees reported the challenges of working within a complex network of interlinked partnerships, often within hierarchies under an umbrella partnership, some of them having a formal duty of partnership. The new alcohol strategy has emerged at a time of extensive reorganisation within health, social care and criminal justice structures. Further development of a partnership model for policy implementation would benefit from consideration of the incompatibility arising from required collaboration and from tensions between institutional and professional cultures. A clearer analysis of which aspects of partnership working provide ‘added value’ is needed. Read more>