There has been increased attention to the beliefs and attitudes of teachers regarding health & social issues. However, the beliefs and attitudes of other professionals such as nurses and police officers that work with and in schools are less examined thus far in the research.  An article in Issue #6, 2019 of Educational Psychology provides a tool that can measure professional commitment to social justice. The authors "demonstrate a method for answering this question empirically – cognitive diagnostic modelling (CDM). We used the four dimensions of the Social Issues Advocacy Scale (SIAS; Nilsson, Marszalek, Linnemeyer, Bahner, & Hanson Misialek, 2011 Nilsson, J. E., Marszalek, J. M., Linnemeyer, R. M., Bahner, A. E., & Hanson Misialek, L. (2011). Development and assessment of the Social Issues Advocacy Scale. Educational and Psychological Measurement, 71(1), 258–275. doi:10.1177/0013164410391581[Crossref], [Web of Science ®], , [Google Scholar]) as attributes of SJA, and fit SIAS responses to a CDM of 16 attribute mastery profiles. One-quarter of the sample had a profile suggesting SJA attitudes without action; one-fifth, a profile suggesting monitoring SJA in politics without participation; and one-eighth, a profile suggesting individuals rarely engage in action without SJA attitudes. We also found significant relationships between mastery profiles and degree pursued, degree field, and political affiliation. These results demonstrated the utility of CDM for training program assessment of SJA."  Read more...

 (From the ISHN Member information service)  An article in Issue #49, 2014 of Vaccines reports on a WHO led study on the growing trend among parents around the world. "Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite the availability of vaccination services. Different factors influence vaccine hesitancy and these are context-specific, varying across time and place and with different vaccines. Factors such as complacency, convenience and confidence are involved. Acceptance of vaccines may be decreasing and several explanations for this trend have been proposed." The WHO Strategic Advisory Group of Experts (SAGE) has developed an explanatory model that was tested and found useful in explaining the results of this interview-based study in Immunization Managers in several countries. "Even if there had been reports of vaccine hesitancy in their country, 11 of the 13 IMs considered that vaccine hesitancy was not common and that it did not have a significant impact on vaccine uptake in the routine immunization programmes. IMs from two countries indicated that mass immunization campaigns, rather than routine immunization programmes, were affected by vaccine hesitancy. Factors concerning convenience and ease of access were perceived to be important by nine of the IM's Convenience was a factor for sub-populations which did not use the health services provided and for hard-to-reach populations. However, two IMs stated that vaccine hesitancy was an important issue in their country." When IMs were asked about the percentage of non-vaccinated and under-vaccinated individuals in their country due to lack of confidence in vaccination, only six provided estimates ranging from less than 1% to 20%. Four IMs reported issues of complacency in their countries." Religious beliefs were often a causal factor in vaccine hesitancy (cited by nine IMs).Risk perceptions were identified by seven IMs as causal factors. This included concerns regarding vaccine safety, lack of perceived benefits of vaccination and lack of understanding of the burden of vaccine-preventable diseases. The new, basic understanding of vaccine hesitancy from this first study, which shows an apparent lack of urgency among Immunization Managers, runs counter to the many news stories of returning diseases such as measles in high income countries as well as renewed concerns about infectious diseases in low resource countries. Schools are a convenient site for vaccinations as well as a strong connection for educating parents. School policies about vaccination requirements are also key. More attention and action are warranted. Read more>>

(From the ISHN Member information service)  A Chicago-based organization, the Healthy Schools Campaign, has emerged on the national scene in the United States and is working hard to influence national policy decisions. Working from a background paper/initiative, Health in Mind, HSC has formed an  influential group of organizational and government leaders called the National Collaborative on Education and Health, with an impressive list of members  The NCEH has gained access to the US Surgeon General's Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (Prevention Advisory Group), which was created by the Affordable Care Act to bring a non-Federal perspective to the Strategy’s policy and program recommendations and to its implementation. 

On August 24, 2014, the NCEH hosted the first meeting of its Health Systems Working Group, an important step towards identifying strategies for redesigning health delivery systems to meet the health needs of students. The Health Systems Working Group members bring together over 25 health and education leaders who will work together over the next four months to identify strategies to increase collaboration between the health and education sectors to support the delivery of school health services and programs. Some of the key questions this group will address include:
• How can schools be incorporated into delivery system reforms; other new models of care emerging from the Affordable Care Act; and other innovations being tested for the delivery of physical and mental health services, health promotion and prevention?
• How can the health care system better support schools in creating the conditions of health for students?
• What new models of practice are needed in both the health sector and schools to support an integrated delivery of care model?
• What type of guidance needs to be shared with the health and education sectors to promote collaboration?

At the first meeting of the working group, participants discussed a brief discussion paper describing the opportunities presented by the Affordable Care Act that can be used to promote collaboration between the health and education sectors. The paper also discussed the need for a model that leverages these opportunities. These examples illustrated how preventive and primary care examples where hospitals/health care organizations from Portland, St. Paul, Madison, Grand Rapids, Deleware, Austin, Cincinnati and Kentucky are working closely with schools.

Commentary:
This is an exciting development within the United States. Coinciding with the release of the updated US school health promotion model from the Centers for Disease Control and Prevention and the educational leaders organization, ASCD, these policy level discussions could be connected to the renewed program and practitioner led efforts. They could also be built upon previous substantive work done on school health care services and centres in the US. Hopefully, these high level policy/advocate discussions will be connected firmly to the extensive history of programmic excellence.

Secondly, we hope that the discussions of this NCEH Working Group can be linked to broader discussions of how the health systems can support promotion and prevention policies and programs as well as preventive care through schools. As we know from the many different successful models of school health promotion in the US and elsewhere in the world, several aspects the public health functions of coordination, promotion, prevention, protection and surveillance can all be accomplished by working with and within school systems.  

As well, we hope that these policy/advocacy discussions on US health care-school programs can address the barriers and facilitators that health systems face when maintaining and sustaining long-term health promotion approaches such as school health. There is constant pressure on the health promotion sectors of health systems to respond to the latest health/social problem of the day. With scarce resources often drawn to treatment and emergency health, the health promotion sector is often forced to fund activities on a selected list of issues rather than on health overall. While this underlying problem of scarce resources will never disappear, there are systemic changes that can be made to structures, staffing and decision-making to ensure continuity and ongoing relationships/commitments to non-health sectors such as schools. A research agenda on such barriers and facilitators has already been proposed by a recent North American symposium of education and health leaders.  Another practical suggestion coming out of that symposium was greater and sustained investments in school nursing. If school nurses can be mandated to the full scope of their professional roles, then they can be be essential glue that keeps school health care connected to school health promotion and to the many specific prevention activities. 

A third hope for these high powered US discussions is that they take the time to truly understand the core mandates, concerns and constraints of school systems so that they can truly motivate and engage school systems in health promotion. Educators will happily accommodate health services in their schools. Indeed, this is often the first thing that school administrators ask for. Educators can provide all sorts of other health promoting support in their teaching, caring for children, working with parents and community leaders and more. But, as recent research is showing, they are reluctant to do that unless the health systems modify their approach to ensure that is it based on systemic, long-term strategies. ISHN and ASCD have gathered this recent research into a global discussion of how health (and other systems) need to integrate their programs within education systems. Insights and evidence-based and experience-tested ideas from the global discussion, including a consensus statement, a background paper and International Discussion Group are all sources that we hope American and other national leaders will not ignore.  

(From the ISHN Member information service)   The delivery of preventive health care services in schools is effective and cost-effective, as noted in several studies and reviews. But the key role of the school nurse in engaging school participants, which leads to other health promoting opportunities within the school, cannot be overlooked. An article in Issue #36, 2014 of Vaccines reports on a Nova Scotia, Canada study which concluded that having a nurse assigned to the school, engaging parents and teachers, was related to full adherence to a voluntary HPV vaccine program. The researchers report that "HPV vaccine initiation was significantly associated with Public Health Nurses providing reminder calls for: consent return (p = 0.017) and missed school clinic (p = 0.004); HPV education to teachers (p < 0.001), and a thank-you note to teachers (p < 0.001). Completion of the HPV series was associated with vaccine consents being returned to the students’ teacher (p = 0.003), and a Public Health Nurse being assigned to a school (p = 0.025). (Note: this posting is part of a series related to the important role and investment in school nurses in schools that will appear in this blog. Read More>>