(An item from the ISHN Member information service)  A July 15, 2015 news release from the Office for Standards in Education (Ofsted) in England has announced that it will monitor the joint delivery of support services to children and youth. "Joint Targeted Area Inspections (JTAI) are to be introduced from autumn this year by Ofsted, the Care Quality Commission, Her Majesty’s Inspectorate of Constabulary and Her Majesty’s Inspectorate of Probation. They will specifically examine how well local authorities, health, police and probation services work together in a particular area to safeguard children. The new inspections aim to shine a light on both good and poor practice, identifying examples from which others can learn and helping local agencies to improve. The proposals, set out in a consultation launched today (Wednesday 15 July), will give inspectorates more flexibility and the ability to be responsive to certain areas of interest or concern. Each inspection is to include a ‘deep dive’ element, with the first 6 set to focus on children at risk of sexual exploitation and those missing from home, school or care. Further inspections will look at other issues by theme. The experiences of children and young people are at the heart of the proposed model. Inspectors from across all 4 inspectorates will work in small multi-disciplinary teams jointly tracking and sampling cases to assess the progress and outcomes for children and young people at risk of harm. This will complement the single agency inspections and provide a joined up evaluation of how well the agencies work together to protect children. Under the proposals the final report will include a narrative judgement that clearly sets out how the local partnership and the agencies who are part of it are performing and what they need to do to improve.". Read more>>

(From the ISHN Member information service)  An article in the March 2015 issue of Journal of Adolescent Health reports that school-based health centresd can effectively promote sexual health among their clients. The researchers report that "Reproductive health indicators among students at four urban high schools in a single building with an SHC in 2009 were compared with students in a school without an SHC, using a quasi-experimental research design (N = 2,076 students, 1,365 from SHC and 711 from comparison school). The SHC provided comprehensive reproductive health education and services, including on-site provision of hormonal contraception. Students in the SHC were more likely to report receipt of health care provider counseling and classroom education about reproductive health and a willingness to use an SHC for reproductive health services. Use of hormonal contraception measured at various time points (first sex, last sex, and ever used) was greater among students in the SHC. Most 10th–12th graders using contraception in the SHC reported receiving contraception through the SHC. Comparing students in the nonintervention school to SHC nonusers to SHC users, we found stepwise increases in receipt of education and provider counseling, willingness to use the SHC, and contraceptive use. Read More>>

(From the UCLA School Mental Health Project)  A part of the ASCD-ISHN global dialogue on integrating health & social programs more effectively within education systems has focused on the need for better coordinated among the various student support services. A recent UCLA planning guide takes this coordination a major step forward and connects it to student learning and success. The guide suggests that "New directions for student and learning supports are key to systemically addressing barriers to learning and teaching. The aim is to unify and then develop a comprehensive and equitable system of student/learning supports at every school.This guide incorporates years of research and prototype development and a variety of examples from trailblazing efforts at local, district, regional, and state levels. The prototypes and examples can be adopted/adapted to design and plan ways to transform the role schools play." 

The UCLA analysis of the causes of this fragmentation is revealing. They suggest that "  While the range of student and learning supports at schools varies; some have few, some have many. In some instances, community services (e.g.,health and social services, after-school programs) are connected to a school. However, given their sparsity, agencies endeavoring to bring community services to schools usually must limit their activities to enhancing supports at a couple of school campuses in a neighborhood. Moreover, there often is not a good connection between community services and the work of the many school and district-based student support staff whose roles include preventing, intervening early, and treating students with learning, behavior, and emotional problems. Such school employed personnel include psychologists, counselors, social workers, nurses, dropout/graduation support staff, special educators, and others. When school and community efforts are poorly connected, community and school personnel tend to work
with the same students and families with little shared planning or ongoing communication. Ironically, some education policy makers have developed the false impression that community resources are ready and able to meet all the support needs of students and their families. This impression already has contributed to serious cuts related to student supports (e.g ., districts laying off student support personnel) in the struggle to balance tight school budgets.An outgrowth of all this has been increased fragmentation, as well ascounterproductive competition for sparse resources related to student and learning supports. Underlying the fragmentation is a fundamental policy problem. That problem is the long-standing and continuing marginalization in school improvement policy and practice of most efforts to directly use student and learning supports to address barriers to learning and teaching and re-engage disconnected students. "

The UCLA research and planning guide calls for a transformative change student support services that is based on these four principles:
1) Expand the policy framework for school improvement to fully integrate, as primary and essential, a component that brings together the supports for addressing barriers to learning and teaching and re-engaging disconnected students.
(2) Reframe student and learning support interventions to create a unified and comprehensive system of learning supports in classrooms and school-wide.
(3) Rework the operational infrastructure to ensure effective daily implementation and ongoing development of a unified and comprehensive system for addressing barriers to learning and teaching.
(4) Enhance approaches for systemic change in ways that ensure effective implementation, replication toscale, and sustainability

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(An item from the ISHN Member information service) In 2004, Canada's federal government and all provinces & territories agreed to an accord that would reform the health system in Canada. Billions of dollars for health funding, primarily for health care, were committed by the federal government as a strategy to buy long lasting change and reform the system. A small part of that accord included some promises on health promotion, primarily with regard to immunization, coordinated responses to outbreaks of infectious diseases and the creation of a Public Health Agency of Canada. As well, first Ministers agreed that "  In addition, governments commit to accelerate work on a pan-Canadian Public Health Strategy. For the first time, governments will set goals and targets for improving the health status of Canadians through a collaborative process with experts. The Strategy will include efforts to address common risk factors, such as physical inactivity, and integrated disease strategies. First Ministers commit to working across sectors through initiatives such as Healthy Schools." (The Accord was signed as Canadian governments also agreed to establish and intergovernmental consortium on school health promotion.)
A review of progress after ten years was part of the accord and the Health Council of Canada was created and mandated to prepare it, along with other regular reporting.  The full report notes that the progress has been dismal and recommends a totally new approach based on a systems approach and with an emphasis on equity. What is even more disappointing, along with the poor results achieved in Canadian's health and the health care system, is the absence of any attention, even in this mandatory decade review, of any real understanding that health care does not produce any improvements in health. If we are to improve the health of Canadians, we will need major new investments in health promotion. And, of course, as noted in the Ministers' promises, we need to do that through inter-sectorial action through settings such as schools.    

(An item from ISHN Member information service) Several articles in Issue #3, 2012 of Children & Schools call for and then start to develop a comprehensive model of school-based and school-linked social work. The editorial provides a rationale for the creation of a national school social work model, followed by an initial conceptualization of a model and recent and future steps to refine the model using an iterative process. Anogther of the articles replicates the efforts of a mixed-method investigation designed to identify barriers and facilitators to school social work practice within different geographic locations. Time constraints and caseloads were found to be the most commonly cited barriers to practice, and respondents from urban locations reported the highest number of barriers when compared with those from suburban and rural settings. As a single category, school staff collaboration, communication, cooperation, and attitudes was cited as the most common facilitator and the highest ranked facilitator of practice. A third article provides an argument for and implications of school social workers as uniquely qualified to develop, lead, and facilitate interdisciplinary, community–university collaboration to increase meaningful family involvement and support children's success in schools through school-linked services. Read more. 

(An item from ISHN Member information service) An article in Issue #6, 2012 of Child, Care, Heallth & Development freview the impact of child vision screening and found benefits as well as more questions about which form is most effective for different types of vision problems. The aim of this review was to determine: (1) the effectiveness of children's vision screening programmes; (2) at what age children should attend vision screening; and (3) what form vision screening programmes should take to be most effective. Screening of children 18 months to 5 years, and subsequent early treatment, led to improved visual outcomes. The benefit was primarily through treatment of amblyopia, with improved visual acuity of the amblyopic eye. However, the overall quality of the evidence was low. The authors conclude that " Screening and treating children with uncorrected refractive error can improve educational outcomes. Evidence suggested that screening occur in the preschool years. Orthoptists were favoured as screening personnel; however, nurses could achieve high sensitivity and specificity with appropriate training. Further research is required to assess the effectiveness of neonatal screening. Most studies suggested that children's vision screening was beneficial, although programme components varied widely (e.g. tests used, screening personnel and age at testing). Research is required to clearly define any improvements to quality of life and any related economic benefits resulting from childhood vision screening". Read more. 

(An item from ISHN Member information service) An article in the November 2012 issue of the Journal of Adolescent Health reports on the validity of a questionnaire designed to assess the youth-friendliness of primary and preventive health services. this criteria underlying the effectiveness of health services delivered to teens is one of the important parts of a comprehensive approach to school health promotion. The tool can be used to assess school-linked services such as local clinics and physicians offices as well as school based health centres. Read more.