Coordinated School Health FAQs

Basic Information about Coordinated School Health

How did the concept of coordinated school health (CSH) originate?

The concept of comprehensive school health was introduced in the late 1980s by Kolbe and Allensworth to promote the optimal physical, emotional, social, and educational development of students.¹ The concept expanded from a traditional three-component school health model (school health services, school health education, and school health environment) to eight components, which include

• Health education
• Physical education
• Health services
• Nutrition services
• Counseling, psychological, and social services
• Staff health promotion
• Family and community involvement
• Healthy environment

In 1995, an Institute of Medicine committee reviewed previous health models and definitions and suggested the term “coordinated school health program” to better describe the interdisciplinary and interagency collaboration required. In response to recommendations from a 2007 expert panel, CDC began using “coordinated school health” to better describe the systematic approach needed to coordinate the policies, practices, and components.

Is there a definition for CSH?

Several definitions are found in the literature or used by CDC, states, or local school districts to describe and promote CSH. There is no single best definition of CSH because programs must be tailored to meet each state's, school's, and community’s needs.

• CDC
  CSH is a systematic approach to improving the health and well-being of all students so they can fully participate and be successful in school. The process involves bringing together school administrators, teachers, other staff, students, families, and community members to assess health needs; set priorities; and plan, implement, and evaluate all health-related activities. CSH typically integrates health promotion efforts across eight interrelated components that already exist to some extent in most schools. These components include health education, physical education, health services, nutrition services, counseling, psychological and social services, healthy and safe school environments, staff wellness, and family and community involvement. (CDC. School Health Programs: Improving the Health of Our Nation's Youth—At A Glance 2011, Atlanta: CDC; 2011.)
   
• Health is Academic: A Guide to Coordinated School Health Programs
  “A coordinated school health program (CSHP) is a planned, organized set of health-related programs, policies, and services coordinated at both the district and individual school levels to meet the health and safety needs of K-12 students.” (Marx E, Wooley SF, Northrop D, editors. Health Is Academic: A Guide to Coordinated School Health Programs. New York: Teachers College Press; 1998.)
   
• Institute of Medicine
  “A (comprehensive) school health program is an integrated set of planned, sequential, school-affiliated strategies, activities, and services designed to promote the optimal physical, emotional, social, and educational development of students. The program involves and is supportive of families and is determined by the local community based on community needs, resources, standards, and requirements. It is coordinated by a multidisciplinary team and accountable to the community for program quality and effectiveness.” (Institute of Medicine. Schools and Health: Our Nation’s Investment. Washington, DC: National Academy Press; 1997.)

Are there other models of school health in addition to the eight-component model recommended by CDC?

Yes. Some states, such as Maine, and school districts have adopted models with more components, and other states, such as Wisconsin, have adopted models with fewer components.

How is CSH different from student support services?

CSH and student support services are closely related and have similar goals. Student support services, also known as student services or pupil services, include prevention, intervention, transition, and follow-up services for students and families, especially for students who are experiencing problems that create barriers to learning. CSH often includes the support services provided to students experiencing problems, but also comprises the health-related policies and practices necessary to meet the health and safety needs of all K–12 students.

Implementing Coordinated School Health

Is there a CSH program available for purchase?

No. CDC recommends a coordinated, systematic approach to planning and organizing all school health-related activities, including initiatives, components, policies, and partnerships to continuously improve the health and learning of all students. CSH is not available as a discrete program for purchase.

If our community, district, or school wants to implement a coordinated approach to school health, are there resources to help us get started?

Yes, multiple resources are available here.

The following resources describe CSH programs and relevant policies:

• Program Success Stories illustrate the exemplary work that partners undertake.
• Making It Happen! School Nutrition Success Stories includes stories of schools and school districts that have implemented innovative strategies to improve the nutritional quality of foods and beverages sold outside of federal meal programs.
• Building Healthier Schools describes local collaborations in 13 county health departments and school districts to promote physical activity and nutrition.
• Promising District Practices offers stories of local school district successes.

How can our school district obtain technical assistance and updates if our state is not funded by CDC to implement a coordinated approach to school health to improve physical activity, nutrition, and tobacco use prevention?

Although your state might not have CDC funding for CSH, it might have other resources that can help you.

• Check with your state education and health agencies to see if they offer any grants or technical assistance.
• Join a state or national listserv such as the Comprehensive Health Education Network (CHEN), administered by the American School Health Association, to stay abreast of new developments and learn about national, state, or regional trainings.
• Join a professional organization devoted to CSH so you can network with other school health coordinators. For example, the American School Health Association has a Section specifically for school health coordinators.

Our superintendent designated someone to be the school health coordinator. Where can our new school health coordinator obtain training and information on responsibilities?

Many states offer school health leadership training based on the American Cancer Society’s National School Health Coordinator Leadership Institute. Check with your state education agency. In addition, school health professional associations offer pre- or post-conference training sessions as well as individual conference sessions that address school health leadership. Building Competencies for Managers and Staff of Coordinated School Health Programs [doc 235K] PDF [583K] identifies nine school health program professional responsibilities and includes a competency self-assessment tool.

Resources for Coordinated School Health

Our superintendent and school board are focused on improving academic achievement. What resources are available to help us make the case for CSH?

The academic success of America’s youth is strongly linked with their overall health. Scientific reviews have documented that school health programs can have positive impacts on educational outcomes, health-risk behaviors, and health outcomes. Science-based resources for making the case for CSH are available here.

Funding for Coordinated School Health

Is funding available to implement CSH?

Yes, competitive funding is available from several federal agencies and some state and local agencies.

CDC provides competitive funding for state health and education departments so they can work together to help build the capacity of school districts to implement a coordinated approach to school health. All states and territories that meet certain criteria can apply for funding from CDC every 5 years.

CDC also provides competitive funding for national nongovernmental organizations (NGOs) to build the capacity of schools to address specified health-risk behaviors and conditions. All NGOs that meet certain criteria can apply for funding from CDC every 5 years.

Some states provide grants to help schools use CDC’s School Health Index or similar tools to assess the CSH components and develop a plan for improvement or implementation. Check with your state or local education or health agency.

Other federal initiatives related to CSH include the following:

• U.S. Department of Agriculture. Provides funding for school meal programs, including the school lunch and breakfast programs and the fresh fruit and vegetable program.
• Office of Safe and Drug-Free Schools, U.S. Department of Education. Offers grants for physical education programs, elementary and secondary school counseling programs, integration of schools and mental health systems, drug and violence prevention, safe schools/healthy students, and character and civic education.
• U.S. Environmental Protection Agency. Provides resources for sun safety and school chemical cleanup campaign
• Safe Routes to School Program, U.S Department of Transportation states improve the ability of primary and middle school students to walk and bicycle to school safely
• Health Resources and Services Administration Administers programs that provide access to health care services for uninsured, isolated, or medically vulnerable people
• Safe Schools/Healthy Students, Substance Abuse and Mental Health Services Administration Offers initiatives to prevent violence and substance abuse among youth in schools and communities
• Children’s Health Insurance Program, Centers for Medicare and Medicaid Services In some states, school-based or school-linked health centers are allowed to bill Medicaid/Children’s Health Insurance Program for reimbursement of medical services provided to eligible students
   

Which states are currently funded to implement CSH?

Twenty-two states and one tribal government receive CDC funding to promote physical activity, nutrition, and tobacco-use prevention through a CSH approach.

Evaluation and Laws

What evaluation has been done on CSH?

Only a few studies have examined coordination of all eight components of CSH. Some studies provide credible evidence of efficacy of the components included in the CSH framework. Currently, DASH is working with three school districts on a multisite evaluation designed to better understand and operationalize well-coordinated and integrated approaches to CSH.

What laws and policies cover child and adolescent health in schools?

The February 2008 issue of the Journal of School Health published the report "A CDC Review of School Laws and Policies Concerning Child and Adolescent Health," which describes the breadth of health-related federal, state, and local laws and policies under which school operate.

The NASBE State School Health Policy Database is a comprehensive set of laws and policies from 50 states on more than 40 school health topics, including coordination, school health councils, and school health coordinators.