How States Can Support Coordinated School Health

State education and health agencies play important roles in supporting coordinated school health.

The following is a list of priority actions that state departments of health and education can take to support a coordinated, systematic approach to school health at the local level.

1. Monitor critical health-related behaviors among young people, and assess the effectiveness of school health policies and programs in promoting healthy behaviors and reducing risky ones.
   
   
   To obtain continuous, high-quality, comparable data, states can

   • Conduct a Youth Risk Behavior Survey (YRBS) every 2 years among representative samples of 9th through 12th grade students.
   • Supplement state YRBS data with data from the Youth Tobacco Survey or other surveys that assess health-related behaviors and their determinants among students.
   • Evaluate the effectiveness of school health policies and programs every 2 years by surveying representative samples of middle/junior high and senior high schools through the School Health Profiles survey.
   • Participate in national surveys that measure health-risk behaviors among young people, such as the national YRBS, or that measure the status of school health policies and programs, such as the national School Health Policies and Practices Study (SHPPS). These surveys provide national data that can be compared with state-level data.
      
2. Establish and maintain dedicated program management and administrative-support systems.
   
   
   The state education and state health agency should build an infrastructure within their respective agency that supports

   • Personnel and organizational involvement
   • Authorization and funding
   • Technical assistance and resources
   • Communication and linkages
      
3. Build partnerships among state-level government agencies and nongovernmental organizations to coordinate efforts and maximize use of resources.
   
   
   Improving the health of young people and their families is a complex effort that requires cooperation and collaboration among many organizations and professionals. To foster these necessary partnerships, states can

   • Develop structures within state agencies. States can build coordination and planning among multiple categorical programs. For example, a designated director of school health programs can bring together all federal- and state-funded school health related programs to share data and resources, improve communication, and develop a statewide plan. This is necessary because school health related programs are typically not placed together, but are located in different divisions and units throughout each agency.
   • Promote collaboration among state agencies. States can establish a school health interagency program committee to coordinate management and implementation of various school health-related programs across state agencies including education, health, transportation, social services, juvenile justice, and governor’s office.
   • Establish a state school health coordinating council. A state school health coordinating council can develop statewide consensus on key issues related to school health programs and policies. This council should include representatives from health and education leadership organizations, the state school boards association, nongovernmental organizations such as the American Cancer Society and state chapters of national professional school health organizations, health care providers, universities, businesses, community health coalitions, parents, and students.
      
4. Establish policies to help schools implement and coordinate their school health efforts.
    
   • Form school health councils at the district level and healthy school teams at the school level with diverse representation.
   • Place school health coordinators at the district level to coordinate all school health activities (e.g., lead the school health council, communicate student health needs, present data, assess programs and polices, advocate for improvement, and acquire resources).
   • Implement school health guidelines and programs.
   • Provide model policies to local school districts that are developed in cooperation with the state's board of education and association of school boards.
   • Develop curriculum frameworks and standards to guide instruction and curricula content.
   • Establish and enforce strong nutrition standards.
   • Establish and enforce tobacco-free school policies.
   • Appropriate funding to school health programs.
      
5. Establish a technical assistance and resource plan to support school districts in their CSH efforts.
    
   • Provide school districts with the information and tools they need to implement school health policies.
   • Establish criteria to help school districts develop, assess, and select effective health education and physical education curricula.
   • Develop and disseminate guidelines and resources to help school districts establish school health councils.
   • Identify and promote the use of resources for developing school health policies and for assessing and planning school health programs.
   • Identify community resource personnel and programs to foster community-school partnerships.
   • Identify national standards and guidelines for CSH components and disseminate to school districts.
   • Communicate findings from the Community Guide to Preventive Services about the effectiveness of different school health interventions.
   • Identify a contact person in every school district to receive regular school communications and resources.
   • Foster communication and networking among school health coordinators.
      
6. Communicate the role and benefits of coordinated school health to key audiences.
    
   • Inform decision makers and the public about the role of coordinated school health efforts in promoting health and academic success among young people.
   • Promote the value of coordinated school health efforts among legislators, state government policy makers, (including health and education leaders), local school leaders, business leaders, parents, students, and other community members.
   • Foster communication among state-level partners to improve coordinated school health efforts and increase the flow of information and resources between the state and local levels.
      
7. Develop a professional development plan for school officials and others responsible for implementing CSH and school health initiatives.
    
   • Develop a statewide professional development plan for school officials and others responsible for establishing, supporting, coordinating, and implementing school health policies, services, and initiatives.
   • Implement policies, identify funding, and designate staff to develop the plan and to ensure that it is implemented at the state and school-district levels.
   • Develop a cadre of trainers who can provide and model interactive professional development on how to establish and sustain a school health council, or use the School Health Index to assess school health policies and programs and create a plan.
   • Use multiple delivery systems for professional development, such as skill-building workshops, instructional materials and resource centers, Web sites, national and state conferences, online courses, and university courses.
   • Promote professional development opportunities to encourage participation.
      
8. Establish a system for evaluation to improve state and local school health policies and programs.
    
   • Develop clear plans, inclusive partnerships, and feedback systems that foster learning and ongoing improvement.
   • Develop procedures for measuring program goals, objectives, and implementation plans to assess the following:
     • Development and implementation of health-related education policies.
     • Provision of professional development activities for decision makers and education and public health agency staff.
     • Development and implementation of effective curricula and programs for students.
     • Establishment of sufficient capacity to develop and implement program activities and collaborate with other organizations.

These actions are described in more detail in Building a Healthier Future Through School Health Programs [pdf 400K] from Promising Practices in Chronic Disease Prevention and Control.

Additional reading: "The State Role in Coordinated School Health Programs," a chapter in Health Is Academic: A Guide to Coordinated School Health Programs, Marx E, Wooley SF, Northrop D. New York: Teachers College Press; 1998.