(An item from the ISHN Member information service) An article in Volume 197, 2015 of Procedia - Social and Behavioral Sciences reports on a small qualitative study of teacher beliefs about school and classroom discipline. Although the study is small, the implications are significant, particularly, if, as we suspect, the views and beliefs of the teachers in this study do not differ greatly from teachers around the world. In the study, 20 teachers from primary and secondary schools were interviewed. Numerous concepts that teachers used to define the meaning of discipline were weighted according to the interviews. Among these concepts, the notions of "order" and "rules" were believed to be far more important to these teachers than other concepts such as ethics, compassion, determination, ability and an interactive process. In the middle ranking, but still far below the importance of order and rules, the concepts of volunteering, self-control, respect and adaptation to life were found. In other words, the traditional teacher beliefs and professional norms about student discipline appear to be well-reflected in this Turkish sample. Order and rules are paramount, the rest is much less important. Our only question is whether these views are consistemt with other teachers around the world. Read more>>
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(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>>
(An item from the ISHN Member information service) With debates about the purposes of schooling now underway in several countries such as England, the US and others, we note that several blogs are adding useful commentaries suggesting that a holistic education, aimed at developing the whole child, are also adding to those debates. Watch these pages for ongoing reporting of the education reform paper in England and the renewal of the Education Act in the US. Both countries are deciding whether health education will be part of their core subjects. 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>>
(An item from the ISHN Member information service) An article in Issue #2, 2015 of Journal of Development Effectiveness examines the uphill struggle of aid effectiveness caused by the proliferation and fragmentation of aid projects. The authors suggest that " Aid fragmentation is one of the hindrances to aid effectiveness. As a main contributing factor, proliferated aids from the donor side have been pointed out. In this regard, we first examine the main factors for the donors’ proliferation and its links with the recipients’ fragmentation, which have been asked in several studies, but are revisited again with a comprehensive up-to-date data set. We also examine whether a recipient country is indeed going to get worse off through fragmented aid or, more directly, by proliferated aid. The main findings are (1) donors tend to proliferate their aid disbursement as their aid budget increases; (2) the recipients’ fragmentation is mainly due to the donors’ proliferation, and this has been prevalent since the early stage of aid history; (3) non-monotonicity is shown between aid fragmentation and growth, given that economies of scale is dominant in the incipient stage of a recipient country’s growth, but turns out to affect negatively in the long run; (4) therefore, the donors’ proliferation will eventually harm the recipients’ growth. Read more>>
(An item from the ISHN Member information service) Three articles in June 2015 Issue of International Journal of Environmental Research and Public Health seek to make the case for "risky" outdoor play for all children. The first article reported on a "systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression". The second review article examined "the relationship between outdoor time and: (1) physical activity, (2) cardiorespiratory fitness, (3) musculoskeletal fitness, (4) sedentary behaviour; or (5) motor skill development in children aged 3–12 years. We identified 28 relevant studies that were assessed for quality using the GRADE framework. The systematic review revealed overall positive effects of outdoor time on physical activity, sedentary behaviour, and cardiorespiratory fitness, although causality could not be assumed due to a lack of RCTs". The third article was a position paper based on the two articles. Read More>>
(An item from the ISHN Member information service) We have noted items in this blog that report on teacher attitudes towards LGBT students and sexual orientation. This item reports on the apparently negligible impact of post-secondary training programs for psychologists, social workers and nurses. An article in Issue #6, 2015 of Journal of Homosexuality reports on the attitudes of healping professionals in Crete. "This study investigated the attitudes toward lesbians and gay men among social work, psychology, medical, and nursing students in Crete, Greece, using Herek’s ATLG scale. No respondents held completely heterosexist attitudes; only 1.6% held completely non-heterosexist attitudes. The 44.96 total ATLG score indicates a slightly positive attitude toward lesbians and gay men. Psychology students scored higher than all others on positive attitudes, followed by social work students, medical students, and nursing students. Gender, having lesbian or gay acquaintances or friends, and religiosity were significant factors influencing students’ attitudes, while no impact on attitudes due to the effects of higher education could be discerned." Read more>>
(An item from the ISHN Member information service) An article in Issue #5, 2015 of Journal of Developmental And Behavioural Pediatrics describes the impact of one student's disruptive behaviour on another student in the class. "Marcus is a 10-year-old boy who was followed by his pediatrician for several years. She knows him as a socially engaged, active athlete, playing soccer and baseball, out-going, and a good student. He has been in good health. At the beginning of this year, a new student was placed in Marcus's fourth grade class. This student is disruptive, impulsive, and abusive. He has frequent violent outbursts, yelling, kicking, and throwing objects, including recently throwing a desk across the room. The school has made efforts to manage this student. The teacher sets up behavior contracts, and the school has temporarily suspended the child; however, the school is unable to remove the child from the classroom. Many students, including Marcus, have been significantly affected by this disruption. Marcus describes the classroom environment as “tense.” He reports he is never sure what is going to make the student “so mad.” Over the last 3–4 months, Marcus developed nightmares, enuresis, and trichotillomania." Here is the dilemma confronting the teacher and the school. Do they continue to accept the disruptive student or do they suspend the student for the good of the others? Who is responsible for providing the support, both to the disruptive student and to other students affected by the situation? Read more>>
Note: This dilemma is one of the topics on the agenda of the ISHN-ASCD-EI dialogue on integrating health and social programs within the core mandates, constraints and concerns of education systems. For more on that dialogue, go to this web page. (An item from the ISHN Member information service) Two contradictory news stories this week underline the differences of opinion of well-respected authorities as they both tell parents what to do with their kids after school. Scroll trough the news reports in this week's update from ISHN to its members and you will find a Canadian study, followed by an editorial from a major newspaper, telling parents that they need to let their kids play outside freely. In the same week, we have a story from the UK, where the police are "slamming" parents for leaving their children at a swimming pool (presumably with qualified life guards) while they went shopping. In previous weeks, we tracked the stories of the Baltimore parents who had their children taken from them by Child Protection Services for letting them walk home from school without supervision. Consider all this disagreement in the context of the social/political norm that that parents know what is best for their children and that schools should respect their privacy and decisions. Read more>>
(An item from the ISHN Member information service) Formative evaluation results of eleven pilot schools participating in the ASCD Healthy Schools program (detailed planning and assessment guide, technical advice, networking) identifies "nine levers of change: principal as leader of the HSC efforts; active and engaged leadership; distributive team leadership; effective use of data for continuous school improvement; integration of the HSC process with the school improvement process; ongoing and embedded professional development; authentic and mutually beneficial community collaborations; stakeholder support of the local HSC effort; and creation or modification of school policy related to HSC that increased the likelihood that school improvement via health promotion would be pursued and sustained." The study was based on "Pre- and post-site visits along with in-depth interviews with school teams, teachers, students, administrators, community stakeholders and other involved individuals, school site report reviews, Healthy School Report Card results and school improvement plans were used for evaluation purposes. " The article concludes that "integration of health and education can become a sustainable and integral part of a school’s culture." Read more>>
(An item from the ISHN Member information service) As noted often in this blog, educators often encounter several different, often competing, multi-intervention models that are meant to act as planning and implementation frameworks. These include healthy schools, community schools, safe schools and many more. An article in Issue #2, 2015 of School Psychology Quarterly describes how two of these models, which have been developed for similar but yet different purposes, can be combined for greater effect. The authors note that "Positive Behavioral Interventions and Supports (PBIS) and Social Emotional Learning (SEL) are 2 of the most widely adopted, evidence-based approaches that have been advocated to address student mental health and externalizi8ng behaviour. These universal prevention approaches, however, stem from different theoretical camps and are often advocated and implemented apart from one another."..T"he purpose of this study was to examine the independent and combined effects of PBIS and SEL on student mental health outcomes. A quasi-randomized control design at the classroom level was used to make comparisons across 4 conditions: business-as-usual (BAU), PBIS alone, SEL alone, and COMBO condition with regard to their acceptability to teachers, integrity of program delivery, and student outcomes. As predicted, the COMBO condition produced significantly greater improvements in overall mental health and reductions in externalizing behaviors when compared to all other conditions. The results also indicated that the PBIS- and SEL-only conditions were both able to produce significant improvements in overall mental health functioning as compared with the BAU control." Now, if we can persuade the well-meaning mental health agencies to build on these existing models rather than develop yet another competing one based on "positive mental health" or on preventing specific mental health illnesses, school systems will be less distracted by competing frameworks. Read more>>
(An item from the ISHN Member information service) An article in June 2015 Issue of Journal of School Health examines school staff perspectives on the challenges and solutions to working with court-involved students. The article begins by noting that " Over 25% of children experience trauma, including physical, sexual, emotional abuse, and witnessing substance abuse or violence within their household.[2] Among court-involved students, exposure to trauma is even more substantial,". The background is not surprising "Not surprisingly, court-involved youth may encounter more academic challenges than other students. For example, foster youth are assigned to special education services more often than non-foster youth,and almost 50% demonstrate behavioral or emotional problems. Youth in the juvenile justice system exhibit much higher rates of behavioral and emotional disorders and are more likely to experience school discipline, suspensions, and expulsions,requiring teachers to focus on socioemotional and behavioral issues in the classroom that impede learning.Although schools should acknowledge student capabilities and needs,targeted school services and resources are lacking." The authors suggest that teacher perceptions may be critical. " Teacher perception of student behavior can impact student success. Cox et al[28] reported that teachers who worked in a juvenile residential school facility perceived students as apathetic about class work. However, court-involved students may be too distracted by previous trauma to be attentive in the classroom, and school personnel can misinterpret this behavior as oppositional or reflecting mental health disorders.This may contribute to higher rates of school suspensions and expulsions...Exploring perceptions of teachers and school staff, addressing training gaps, and providing needed resources to school personnel may be key to making this happen." Read more>>
(An item from the ISHN Member information service) An article in Issue #1, 2015 of Education as Change reports on teachers’ responses to sexual and gender diversity in the Free State, South Africa. "Emotions are central to social justice work in education but receive scant research attention in South Africa. Our study explores the role of emotions in teachers’ approaches to teaching about sexual and gender diversity in schools in the Free State. Using in-depth interviews, we found that teachers experienced discomfort with the topic, had inherited bitter knowledge about non-normative sexual and gender identities, and experienced strong negative affect when discussing the topic. In many ways, participants unconsciously and unreflexively perpetuated heterosexism and homophobia in their classroom teaching and school settings. We conclude that the growing emphasis in educational policy in South Africa on the rights of lesbian, gay, bisexual, transgender and intersex (LGBTI) learners requires a greater awareness among educators of the role of emotions in enabling or hindering this form of social justice work in education." Read more>>
(An item from the ISHN Member information service) The articles in Issue #2, 2015 of European Journal of Education form a special issue on one of the pillars used by UNESCO and many countries to frame the purposes and goals of education and school systems. The title of the issue asks "Learning to Be — Idealism or Core Business?". As many will know, the 1996 Delors report to UNESCO introduced four pillars around which education and learning should be organized: learning to know; learning to do; learning to live together; and learning to be. ‘ The earlier UNESCO report, the Faure report, had been focused on "learning to be" and expressed grave concerns that educational purpose may end up being subject to technical, vocational and economic interests rather than a liberating force for universal progress and humanism. This special issue takes us back to this debate. Many of the articles in the issue address this question directly and through examples of various national education systems in Latin America, Germany, Canada, England. "Do Our Education Systems Do Enough to Enable Learners to Flourish as Independent, Autonomous and Well-Balanced Individuals? For those who wish to gain a deeper understanding of the forces and debates shaping school systems as we seek to integrate health and social programs more firmly within education systems, this issue is a must read. Read more>>
(An item from the ISHN Member information service) As part of our global dialogue on integrating health & social programs within education systems, we have been urging that non-educational sectors strive to better understand schools and educators. An article in Volume 187, 2015 of Procedia - Social and Behavioral Sciences provides us with some valuable insights based on small scale examination of the values of older (more than 20 yrs teaching) and younger primary school teachers (less than 15 yrs teaching. The authors note that "Teachers, including primary education teachers are not only transmitters of (didactically processed) knowledge but also one of the many factors of axiological influence for the younger generations. Primary education teachers, be they aware of it or not, convey – implicitly or explicitly – their system of values onto their pupils. The study aims to reveal the main values of a group of primary education teachers in Prahova County, Romania, listing values in which they believe and which they instill in their little pupils". Some of the inter-generational differences among this small sample of teachers are noted in this commentary:
(An item from the ISHN Member information service) A high profile case of cyber bullying in Canada led to a series of in-depth interviews with police officers about their views and professional norms regarding bullying. An article in Issue #2, 2015 of Journal of School Violence reports on this study. "Increasing public awareness of cyberbullying, coupled with several highly publicized youth suicides linked to electronic bullying, have led lawmakers and politicians to consider new criminal legislation specifically related to cyberbullying. However, little is known about how the police currently respond to cyberbullying, and it is not clear whether new laws are necessary. In this article, the authors draw upon in-depth interviews with Canadian street patrol officers and school resource officers to explore police perspectives on policing cyberbullying. In contrast to the reactive hard-line approach proposed in much legislation and public discussion, police officers prefer to take a preventative approach by educating youth and raising awareness about the dangers of digital communications. Although there are instances when criminal charges must be laid, these incidents transcend “bullying,” a term that has little legal meaning for police officers." Read more>>
(An item from the ISHN Member information service) Two articles in Issue #6, 2013 of Health Education Journal explore teacher views and ideas about health and health education. The first article compared teacher views about health in several European and African countries. The researchers found that women, older teachers, better educated, elementary and language teachers were more apt to hold positive views about health, with significant differences existing between countries. The second article examined the ideas of over 100 Italian teachers, exploring "the relationships among teachers’ health representations, their ideas about health promotion, their working conditions and their involvement in health-promotion activities at school. The results show that teachers have ambiguous health representations; however, the traditional idea of health as absence of illness was prevalent among the teachers surveyed. Regarding health-promotion activities, the teachers seemed to prefer health education programmes based on informative techniques. Some representations of health were connected to the importance that teachers attributed to health promotion and to teachers’ participation in health-promotion activities. Teachers’ working conditions appear not to be related to their involvement in health promotion." Read more>>
(From the ISHN Member information service) ISHN has started two international discussion groups focused on new approaches to school health promotion and development. (www.schools-for-all.org - Select Discussion Groups) Our Implementation/Capacity group has included the concepts of senior leadership and shared vision as part of the capacities need to implement and sustain comprehensive SH approaches. The Integration within Education group has started a global dialogue with global educator organizations to emphasize that health programs need to work within the core mandates, constraints and concerns of school systems. It is heartening to see research that confirms such topics that are included in the knowledge development agendas of these two ISHN initiatives. An article in Issue #2, 2015 of Health Education Journal reports on a small study in Nova Scotia that examined the variance of implementation in nine schools. "The results revealed that schools assembled into three sequential categories based on the functioning of theoretical components. Higher level visioning and school-level leadership were critical in sustaining the adoption and implementation of HPS across schools and appeared to enable and integrate organisational processes, such as distributed leadership and a collaborative school culture, to enhance HPS implementation at school level. This study confirmed other reports that it is imperative to integrate HPS work with educational values so as to enable partnerships in both the health and education sectors, thereby promoting both health and prosperity among students." Read more>>
(From the ISHN Member information service) Teachers' perspectives of supporting pupils with long-term health conditions in mainstream schools are reported in an articles in Issue #2, 2015 of Health & Social Care in the Community. The narrative review of the literature found that " teachers receive little formal training relevant to long-term condition management and are fearful of the risks involved in teaching children and young people with long-term conditions. Communication between families, school and health and social care services appears to be poor. Educational programmes developed in conjunction with and/or delivered by healthcare professionals seem to have the potential to increase teachers' knowledge and confidence. This review suggests that healthcare professionals have an important role to play in supporting teachers in identifying and meeting the needs of pupils with long-term conditions. It is vital that pupils with long-term conditions receive appropriate care and support in schools to ensure their safety and help them to integrate with their peers and achieve their academic potential. Limitations in the current evidence are highlighted and implications for future research are identified." Read more>>
(From the ISHN Member information service) An excellent illustration of a procedure to select evidence-based interventions to promote health is described in Issue #1, 2015 of Environmental Health Review. ISHN recommends the use of this type of planning tool but also suggests that, despite the rigour within this procedure used to select relevant research on better practices, other steps need to be taken to test our underlying assumptions before we begin as well as use our common sense in assessing the fit between the planned intervention and our local context, especially in regards to likely barriers that may be prevalent in our local communities, states or countries.
The illustration used in the journal article is focused on an urban setting, wherein the public health practitioners are looking for urban planning interventions to increase physical activity among children and adults in the community in response to rising obesity rates. The article takes the reader through several planning steps to identify such urban planning tools, eventually pointing to a credible research review published by the CDC in the United States that suggest that "Community-scale urban design and land-use regulations, policies, and practices" such as zoning regulations and building codes, and environmental changes brought about by government policies or builders’ practices. The latter include policies encouraging transit-oriented development, and policies addressing street layouts, the density of development, the location of more stores, jobs and schools within walking distance of where people live as well as "street-scale urban design and land use approaches" in small geographic areas, generally limited to a few blocks, such as improved street lighting or infrastructure projects that increase the ease and safety of street crossing, ensure sidewalk continuity, introduce or enhance traffic calming such as center islands or raised crosswalks, or enhance the aesthetics of the street area, such as landscaping can improve levels of physical activity. Once these two types of interventions are identified in the procedure, the remaining steps suggest the involvement of stakeholders, program development and building in evaluation and feedback mechanisms. One section of the procedure suggests "Assessing Applicability and Transferability of Evidence" but the focus in that section is on how the knowledge about the intervention can be transferred successfully to policy-makers and practitioners and mentions real-barriers related to feasibility such as costs, resources and other practical factors only briefly. We suggest here that this excellent illustration of a procedure to select an intervention to address a problem needs to be accompanied by at least three other processes. The first of these is to test our assumptions about the type of outcome we are seeking. The illustration in this article, where the fictional planners decide in advance that increased physical activity can prevent or reduce obesity and overweight is actually reflective of many real-life planners, who have done the same. The trouble is that there is increasing evidence, including from sources such as the CDC and the centre which has published this guide to selecting interventions, that increased physical activity alone, will have little impact on body weight unless it is very intense, well beyond the scope of the average person. The second process we suggest is a real hard look at the resources available in the community or organization. The research reviews identified in the article did note these barriers in their study. The barriers to community scale interventions include "1) changing how cities are built given that the urban landscape changes relatively slowly, 2) zoning regulations that preclude mixed-use neighborhoods, 3) cost of remodeling/retrofitting existing communities, 4) lack of effective communication between different professional groups (i.e., urban planners, architects, transportation engineers, public health professionals, etc.), and 5) changing behavioral norms directed towards urban design, lifestyle, and physical activity patterns" The real world barriers to street scale changes include: "the expense of changing existing streetscapes. In addition, street-scale urban design an land use policies require careful planning and coordination between urban planners, architects, engineers, developers, and public health professionals. Success is greatly enhanced by community buy-in, which can take time and effort to achieve. Inadequate resources and lack of incentives for improving pedestrian-friendliness may affect how completely and appropriately interventions are implemented and evaluated". The article suggests that the local context is an established urban setting. In most established cities, it is very difficult to make major changes in existing neighbourhoods, especially in these days where priority concerns might very well be crime, traffic and aging infrastructure. This real world observation leads us to the third major consideration that should be used in conjunction with this procedure to select evidence-based interventions. The third consideration needs to be an in-depth understanding of the core mandates, constraints and current concerns of the system that will carry the major part of the burden in implementing the intervention. In this case, it is the municipality. There are lots of examples of how such systems analysis can be done, but we close this ISHN Commentary with an appropriate example, also found by the same centre that has created this procedure for identifying evidence-based interventions. This systems planning guide that they suggest is from the province of Alberta, which suggests that program planners consider the characterisitcs of the system that will will host the intervention. These include the leadership, organization "slack" in committed vs available resources, staffing, time for implementation and more. In school health promotion, ISHN is pleased to be pat of a global dialogue being led by educators in regards to how health and social programs can be better integrated within education systems. We suggest that before we select an intervention from the research, we seek to truly understand the system that will carry the intervention over the long term. We also suggest we look closely ar practical barriers and that we check our assumptions. Read more>> (From the ISHN Member information service) There are few studies that focus on teachers of health, personal and social development (HPSD)but, of the few, it can be said that there is remarkable number of new teachers assigned to teach HPSD who quickly seek a transfer to a different subject or leave the profession entirely. As part of a series of articles in Issue #1, 2015 of the Asia-Pacific Journal of Teacher Education one author focuses on the experiences of new teachers who are assigned out of the field in which they were trained. "The lived experiences of novice teachers in out-of-field positions influence future career decisions and impact on their journey towards being competent and experienced practitioners, conversely their “life-world” is often misunderstood. The purpose of this article is to investigate the lived experiences of these teachers, how principals’ understanding and leadership styles influence the lived experiences of these teachers. The article argues that the strategies implemented by school leaders based on their understanding of novice out-of-field teachers’ lived experience greatly influence the development of these teachers. It draws on Gadamer’s theories to investigate the lived experiences and perceptions of four principals and four novice out-of-field teachers through the different lenses of these participants. It concludes with a discussion on the interrelationships between school leaders’ understanding and novice teachers’ lived experience. Participants’ interpretation of specific lived experiences connected to out-of-field teaching shapes meaning in their attempt to understand and to “belong,” for example, confidence issues, self-esteem concerns, and disconnectedness." Since very few education faculties offer specialized training or courses in HPSD, it would appear that the majority of these teachers will be left alone in their "out of field"assignments. In a profession that experiences high rates of turnover for all new teachers, this is particularly significant. Read more>>
(From the ISHN Member information service) One of the themes being discussed in the ISHN International Discussion Group on Integration of Health/Social Programs Within School Systems focuses on the political, normative and practical constraints on schools in doing this work. A special issue of Health Education (#1, 2015) illustrates these constraints as several articles discuss the nature and delivery of sexual education in several countries. The editorial introducing this special issue makes note of these powerful differences imposed by the national, state or local contexts. "The papers highlight contrasts, tensions, potentials and barriers embedded in the ways sexuality education is delivered to children and young people internationally. Examples are drawn from Russia, Wales, China and the USA; they identify historical and structural issues related to the implementation of comprehensive progressive approaches. Topics discussed include the importance of appropriate content, theoretical/conceptual frameworks, modes of delivery, timing, attitudes from key stakeholders and the need for comprehensive evaluation of innovative approaches to the delivery of sexual education." . These constraints are especially true for sex education but other, less sensitive issues can also be contentious. These include compulsory vaccinations, the use of alcohol, gender equity, child abuse and neglect, and more. Even actions taken to promote huealthier school lunches can be politicized (eg the recent debates in the US) or cause controversy when letters are sent to parents asking them to prepare healthier lunches or that their child is overweight.
(From the ISHN Member information service) An article in Issue #1, 2015 of Public Health Reports discusses how governments can implement a Health in All Policies (HiAP) approach to inter-sectorial cooperation by using their legislative, regulatory leadership and funding levers. The article makes several practical suggestions on how governments can use the law to prescribe, authorize, structure and fund inter-sectorial cooperation. The article provide several state and local agency examples for each of these suggestions. Most of these cited legally required cooperative actions in the article are focused on responses to specific health issues rather than long-term inter-ministry or intra-ministry cooperation or long term approaches such as school health programs. However, the article can be used as a litmus test of government commitments to requiring and supporting their health ministries to work within other ministries and sectors who deliver their programs in settings such as schools, municipalities, workplaces etc.
In this ISHN comment, we extract the suggestions from the article to determine if there is a commitment to the inter-sectorial approach that we call school health promotion. The article reviews the HiAP approach: "The U.S. Centers for Disease Control and Prevention, Institute of Medicine (IOM), European Union, and World Health Organization all recognize the potential of HiAP to address the social determinantsof health, and through them, upstream contributions to morbidity and mortality.Sometimes called “healthy public policy”14 or described as a component of “horizontal government,” “joint-up government,” or “whole-of-government,”15 HiAP is an approach that integrates health considerations into non-health sectors; it recognizes that “corporate boardrooms, legislatures, and executive branches” make choices that profoundly affect health.11 Additional research is critical to determine whether HiAP leads to decisions that are more likely to consider health16 and, ultimately, improve it.Nonetheless, HiAP is a promising approach consistent with solving complex social problems through the “collective impact” of multiple sectors collaborating around a common agenda.19 These sectors include transportation, agriculture, housing, employment, planning, business, education, and energy, and in federal, state, and local government, they are often connected to agencies charged with regulating or facilitating their work." The article goes onto suggest that legislation is a good way to implement HiAP. " But how do governments implement HiAP? Consistent with law’s contributions to improving the public’s health,law can be “an important tool for institutionalizing an infrastructure for HiAP and for requiring agencies to ensure that the policies they pursue serve . . . health.” Governments use law to integrate health into other sectors.They also use legal mechanisms to further cross-sector collaboration around health, which is a critical component of HiAP. Since an effective HiAP strategy will require practical applications to inter-sectorial work, we suggest strongly that any introduction of an HiAP strategy will require the health sector to go to the venues or settings where the other sectors actually deliver their services and programs such as workplaces, municipalities, schools and other places. In other words, the health sector will need to return to a settings-based health promotion strategy if it expects ongoing cooperation from the other sectors. Otherwise the HiAP strategy runs the risk of being perceived as the health sector dumping its work onto the other sectors and they will resist, delay or simply not cooperate. The articles suggests that government levers can be used in several ways. Let's take a quick look at how many of these strategies are used to promote intersectorial cooperation through comprehensive, whole of government approaches to school health promotion.
(From the ISHN Member information service) An analysis of three school-based initiatives in AIDS/HIV education based on a rights-based approach suggests that we are left with some unfinished business. The article prompting this discussion appears in Issue #1, 2015 of Sex Education: Sexuality, Society and Learning. The authors suggest that "Over the past 25 years, there has been growing investment in concepts of rights in the areas of HIV prevention, care and treatment, including HIV- and AIDS-related education delivered in schools. Despite this increasing commitment to the notion of rights, few efforts appear to have been made to understand the varying conceptions of rights that underpin different kinds of initiatives. Engaging with a multi-disciplinary body of literature on the issue of rights, and through a focus on three rights-informed HIV- and AIDS-related initiatives, this paper seeks to address this gap in the current literature. In so doing, it also examines a central tension within human rights discourse, namely between the construal of rights as shared and universally applicable to all human beings, while being created in and limited by the location in which they were elaborated, as well as by the language used to formulate them. More explicit engagement with the diversity of approaches made possible through a commitment to human rights may facilitate forms of HIV- and AIDS-related education that are more meaningful to young people." Or, in our view, a rights-based approach may create political and social barriers to the expansion and improvement of sex education in schools where the understandings about human rights differ from those articulated by experts and UN agencies. Read more>>
(From the ISHN Member information service) As with many other health issues, mental health advocates often focus on teachers as the key agent in school-based and school-linked mental health promotion. Their "mental health literacy", their willingness to care for their students and their roles in identifying, referring, managing students with problems, which are often presented as disruptive classroom behaviours, are added to their responsibilities to teach all students about mental health, social and emotional learning skills as well as promote mindfulness and resilience, encourage or discourage student friendships and inform, involve ,educate and support parents as well as involve community partners and work with self-help groups. An article in Issue #1, 2015 of Advances in School Mental Health investigated teacher perceptions about their roles and self-efficacy. The researchers note that "Interviews were conducted with 21 teachers from Canberra, Australia. Teachers viewed supporting student mental health as part of their role, though perceived a lack of knowledge and skills in mental health-related areas. They clearly emphasized the need to work within a well-coordinated pastoral care (or secular care) system". The researchers suggest that "Additional training in mental health and clear role delineation within the school may assist teachers to feel better prepared to effectively and appropriately support student mental health." Read more>>
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