Featuring a Comprehensive Approach to Serving Disadvantaged Communities

The feature article this month is the basis of our sixth annual conference being held in at the Ramada Plaza Hotel Dartmouth, April 21-23, 2010. The article identifies the issues that are more relevant to low income, geographically or culturally isolated communities as well as students facing significant disadvantage because or race, language, gender or other forms of discrimination.

The conference will address these issues for the first time in a comprehensive manner. CASH is pleased to be cooperating with the Canadian Association for Community Education and education, health and law enforcement officials across Canada to develop a program that includes hands-on workshops as well as keynote speakers such as:

• Chris Jones, Executive Director, International Centre on Community Schools, Wales, UK
• James Shelton, Assistant Deputy Secretary, Department of Education, United States
• Annie Kidder, People for Education, Ontario
• Doug Gleddes, EverActive Schools, Alberta
• Nova Scotia School Health teams from Chignecto, Acadian Schools and Mi’kmaw Kina’matnewey
• Lorna McCue, on behalf of a national Healthy Communities program addressing disadvantage

The concurrent workshops will be led by proven programs and cover topics such as school meal programs, restorative justice, parent resource centres, schools as community centres, supporting transitions from pre-school headstart programs, university student service learning programs, working with street youth and more. Go to http://www.safehealthyschools.org/shconferences/ for full details.

There is a reduced conference registration fee for organizational members of of the Canadian School Health Knowledge Network. Conference Go to the CSH Knowledge Network page to see all of the benfits and to join/rejoin as an organizational member.

Conference registration also includes access to webinars that will link the discussions at this Canadian conference with a similar international symposium being held in Geneva in July 2010.

Scroll down to the article on issues and programs for schools serving disadvantaged communities. Also, please go to the online version to add your comments, suggestions and even edits to the paper at:
http://www.canadianschoolhealth.ca/page/Issues+and+Programs+for+Disadvantaged+Schools

Canadian School Health Knowledge Network News

Canadian Media Reports for February 2010

Schools for All. A National Conference on Alleviating Disadvantage. April 21-23, Halifax, NS See the Preliminary Program and Registration page. Registration is $325 for SH Knowledge Network Members, $475 for non members. The registration fee includes access to four webinars held jointly with an international SH Symposium in Geneva in July. Our Indigenous School Health Framework, a document developed in consultation with and led by Canada's aboriginal communities, has been noticed world-wide, with presentations by CoP Chair Shirley Tagalik at the November 2009 American School Health Conference and the July international school health symposium in Geneva. Leadership is also being demonstrated by another Chair of one of our Communities of Practice (CoP). Mary McKenna, from UNB and Chair of the School Nutrition CoP, was instrumental in initiating a recent national meeting of government officials on school nutrition policies. Our School Mental Health CoP Co-Chair, Gloria Wells, has engaged in a cross-border conversation with a similar CoP on SMH in the United States. Watch for further news very soon. CASH is working with nine other national organizations to develop a Consensus Statement on School Mental Health. This statement will be used to influence the development of youth mental health framework as well as the overall national MH strategy being developed by the Mental Health Commission of Canada. As well, the statement will be the basis of input into a similar initiative developing a mental health component of the national Healthy Living Strategy. All comments and suggested changes are welcome. Visit the web page and use the wiki tools to make a comment or edit the document online. CASH is also collaborating with the 50+ members of the Canadian School Health NGO Network to find ways to use web 2.0 (social networking tools) more effectively. Potential activities include shared access to a Twitter account that "follows" health and education feeds from a wide variety of organizations, joint posting on the "CSH Tweets" that are also posted on this web site and posting updates directly onto our School Health Blog. This process is starting to work, with three recent postings coming directly from other organizations into the School Health Blog. The CSH Knowledge Network list of SH contacts has grown to over 2500 people. We are continuing to transfer the email contacts lists over to the professional networking web site at www.canadianschoolhealth.ca. Agencies, organizations and individuals will be able to control the email they receive from this wiki-based web site through their own profiles. (This occurs by "watching" or "unwatching" selected pages). As well, they will be able to use the tools on the web site to interact with others and receive RSS feeds from the daily blog of SH news. The Fall/Winter (2009) issue of the CTF-CASH Health and Learning Magazine is currently being distributed by email to school boards and schools across Canada. The back issues of this magazine will be posted on this web site. CASH is now asking the SH Contacts in all 500 school boards to either agree to forward email alerts of new issues or to pass along their email lists. All of these requests have been granted so far by these wornderful people. To receive an email alert whenever the new electronic tri-annual publication is published, please contact dmccall@cash-aces.ca

News Story (Feb 26-10) Montreal Health Dept ban use of green cleaning products in schools http://is.gd/9zpzp News Story (Feb 27-10) Toronto City Council Considers cancelling Daycare in Schools http://is.gd/9yX0o News release (Feb 22-10) Students Commission/Health Canada looking for youth to be part of Youth Action and Young Adult Advisory Committees! Act Fast! www.tgmag.ca News Comment (Feb 22-10) Anti-bullying programs: ignored and insufficient http://is.gd/9207f News Story (Feb 18-10) All-day learning for Ontario's 4- and 5-year-olds is a step closer http://is.gd/91YmH News Story (Feb 23-10) Federal Senate report Recommends Child care Plan http://is.gd/91VAx News Story (Feb 12-10) Nunavut unrolls youth safe sex campaign http://is.gd/8CHoo News Story (Feb 19-10) Ontario cracks down on bullying http://is.gd/8KbaW News Release (Feb 16-10) Mindyourmind Youth Volunteers Create Sexual Health Promotion Tool Adventures in Sex City http://is.gd/8Kkey News Story (Feb 17-10) Nearly 4.6M Canadians have hypertension: Study http://is.gd/8AAHZ News Story (Feb 16-10) No Opt-Out for Gay Topics in Ontario School System? http://is.gd/8ACTL News Story (Feb 15-10) Lawsuit could see schools on hook for bullying http://is.gd/8ACYw News Story (Feb 10-10) Candy, fried foods to slide off Ontario school menus http://is.gd/8gl7w News Story (Feb 4-10) New ontario bully law takes effect to mixed reviews http://is.gd/8gu8m News Story (Feb 6-10) Ontario is the first province in Canada to require all staff to report serious student incidents http://is.gd/8gpAH News Story (Feb 12-10) Aboriginal infection linked to residential school trauma: Study http://is.gd/8ghJr News Story (Feb 10-10) Gay, bisexual teens at risk for eating disorders http://is.gd/8ghmn News Story (Feb 10-10) Gay teens 'terrorized' in Canada's schools http://is.gd/8gh9R News Story (Feb 12-10) Gay teenagers more likely to think about suicide: Study http://is.gd/8ggdc News Story (Feb 4-10) School intruders not always reported, Canadian school murder trial hears http://is.gd/7HY03 News Story (Feb 3-10) Morning workout at Etobicoke school helps kids focus http://is.gd/7HZCB News Story (Feb 2-10) Abstinence-only programs – minus religion – can delay teen sex http://is.gd/7AuoV News Story (Feb 2-10) Liberals would boost child care despite deficit http://is.gd/7AuJN

Canadian Research, Reports and Resources from the February School Health Blog Postings

Our blog also tracks Canadian research studies, reports and new planning/educational resources announcements. Here are the ones posted for February, 2010:

• Canadian Study on School differences in adolescent health and wellbeing:
  An analysis of the data from the 2006 Canadian Health Behaviour in School-aged children (HBSC) study shows that healthier students learn more easily. It also correlated some "school" factors such as the wealth of the community and number of discipline problems in the school. The findings also confirmed earlier studies showing that the characteristics of the individual student, family, school and neighbourhood interact in complex ways to create health, social and educational outcomes.
  

• The Current State of Canadian Family Finances Vanier Institute 2009
  This is an annual report which monitors trends in family income, expenditures, savings and debt. The analysis relates to the period 1990 to 2009, with emphasis on the time period that is labelled “so far this decade” or on the latest year available, depending on the data series. The year 1990 was chosen as the beginning year in order to highlight longer term changes. Almost all of the background data comes from Statistics Canada.
  

• A Canadian Economic Case for Financing the Social Determinants of Health
  In April 2007, the Canadian Policy Research Network, on behalf of the Public Health Agency of Canada (PHAC), convened a roundtable of national and international experts to explore the economic case for financing the social determinants of health, building on the 2006 CPRN paper Economic Arguments for Action on the Social Determinants of Health, by David Hay. In this report, Developing a Canadian Economic Case for Financing the Social Determinants of Health: Report on the April 2007 Roundtable, David Hay provides a synopsis of the available research and the roundtable discussion.
  

• Study of Regional and Cultural Differences in Chronic Disease in Canada's North
  This study examines data from the Canadian Community Health Survey and compared the changes between 2000 and 2005. Results indicating deterioration in aboriginal but not in non-aboriginal populations. Published in the January issue of Preventing Chronic Disease.
  

• Canadian Study on "Orchid Children"
  Jelena Obradović, Nicole R. Bush, Juliet Stamperdahl, Nancy E. Adler, W. Thomas Boyce (2010) Biological Sensitivity to Context: The Interactive Effects of Stress Reactivity and Family Adversity on Socioemotional Behavior and School Readiness January/February Issue of Child Development
  

• Canadian Study: Discrimination in Placement of Aboriginal Children
  John D. Fluke, Martin Chabot, Barbara Fallon, Bruce MacLaurin, Cindy Blackstock (2010) Placement decisions and disparities among aboriginal groups: An application of the decision making ecology through multi-level analysis in the January 2010 Issue of Child Abuse & Neglect (From a Special Issue on Convention on the Rights of the Child)
  

Feature Article: Issues and Programs for Schools Serving Disadvantaged Communities and Populations

In June 2007, the World Health Organization convened a meeting to discuss future directions in school health promotion. One of the themes discussed at that meeting was how to correlate school-based and school-linked programs more closely with the local community contexts in which schools operate. These contexts included schools in low income countries, schools in communities that have been disrupted by war, disasters and epidemics, aboriginal communities and schools serving low income communities within high or medium income countries.

Subsequent to that meeting, the Canadian Association for Community Education, the Canadian Association for School Health and the International School Health Network established a Community of Practice on Schools in Disadvantaged Communities. In order to focus the discussion, the following summary statement has been developed. Readers of this article are encouraged to either comment on the draft below by going to the online version at:
http://www.canadianschoolhealth.ca/page/Issues+and+Programs+for+Disadvantaged+Schools

Schools in Disadvantaged Communities: An Initial Identification of the Issues and Programs

The following selection of issues and related school-based or school-linked programs is presented to stimulate discussion about the policy/program options that schools, communities and governments can realistically consider in order to alleviate the impact of disadvantage through schools. This is an important first step, since these issues and programs are usually addressed in isolation from each other by different sectors such as health, education, welfare and law enforcement.

We have attempted to identify practical program options that schools can implement to reduce the impact of poverty, geographical isolation, cultural, religious and linguistic barriers, discrimination based on gender, sexual orientation, physical or intellectual abilities or race rather than seek to eliminate them through school programs. The reduction of poverty and other disparities is something that must be addressed by fundamental changes to public services, to wealth redistribution mechanisms/taxation and other aspects of society that are beyond the scope of schools to change directly. Further, these specific issues/programs discussed here should be considered within their community contexts because those local situations will create constraints and opportunities within which schools must work.

We have tried to identify a cluster of issues that are likely to be more relevant to the context of low-income communities. Economic disparity is often a common denominator among other forms of disadvantage, so we have used poverty or social determinants as our focal point.

The Issues Most Relevant to Disadvantaged Communities

Some of the health, economic and social issues that are likely more relevant to the school communities in this context include:

• Students arriving in school hungry and families not having sufficient food, clothes or financial resources

• Parents who are not able to access public services easily due to geographical, linguistic, cultural or other barriers and who often have a distrust of schools and other services

• High levels of poverty, unemployment and crime (eg. Gangs & guns would likely be more of concern than less violent anti-social behaviours such as vandalism or bullying)

• Run-down school buildings and infestations of lice and other parasites as well as poor quality of water, air, heating and facilities. These relate to other studies and GIS applications about infrastructure/cohesion in rural and urban communities.

• A lack of recreation and informal learning services and spaces in the community as well as disorganized communities and unsafe or inadequate public transportation

• Health problems related to early childhood ailments, hearing and vision problems, oral health/dental problems, genetic problems, FASD and similar problems

• A lack of basic literacy and health literacy among parents, the community and students

• Higher levels of early school leaving and dropouts/pushouts

• Higher levels of tobacco and alcohol use as well as illicit drugs

• etc

Multiple Frameworks for Action: Community Schools working with Healthy Schools, Safe Schools and Others

There are many frameworks, models and multi-intervention approaches, programs and strategies that have been developed by various sectors, working with schools, to promote different aspects of human development. Community schools, healthy schools and safe schools are just three examples. There are several more, many of which include a focus on schools in disadvantaged communities. It is suggested here that the pursuit of a detailed common framework to mesh all of these models together is less useful than simply noting what is common or compatible, identifying where expertise and experience resides from among the various sectors/models and then encouraging jurisdictions and local communities to select the programs and interventions that they see as being most relevant to them.

The International School Health Network, in its consensus statement, has identified several broad implementation strategies that are common to almost all school-based and school-linked programs. They include:

• addressing the needs of the whole child to identify clusters of strengths, problems and conditions and the corresponding synergistic combination of programs and policies to address them
• recognizing the limits of school-based and school-linked programs while still maximizing the potential for improvements in and for young people as they leave they primary and secondary schooling
• a focus on disadvantaged and more vulnerable children, youth and families
• striving for comprehensive approaches, coordinated programs and whole school strategies
• using multiple, coordinated interventions, including school, agency and health authorities policy, instruction, health, social and other services, different forms of social support (such as parent involvement, youth engagement, community participation) and changes to the physical environment to improve student knowledge and skills, alter risk and protective factors and influence pr alleviate social and economic determinants
• selecting evidence-based programs, policies and practices
• using evidence-based implementation strategies that identify local mechanisms and drivers of change and work towards systems change
• building capacity for sustainable programs, policies and practices
• seeking congruence with the educational mandate and constraints of the school systems
• deepening understanding of the complex, ecological factors that are the reality of the multiple, open, loosely-coupled and bureaucratic systems that work with and within schools

Common Arenas for Action

School-based and school-linked programs can be implemented in several arenas. By clarifying the levels of action and the systems/agencies/personnel involved, we can be clearer about intended outputs. The arenas of levels of action for school-related programs include:

• the transition from early childhood programs and the home into primary school is a time of vulnerability and potential continued strength as young children leave from various pre-school programs
• classroom level instruction only interventions whose intended outputs are in the students’ knowledge, attitudes, normative beliefs, awareness of services and how to access them locally, skills such as social skills, self-knowledge and behavioural intentions (Note Most instructional programs produce minimal behaviour change but changes in knowledge, attitudes, skills etc may be a pre-requisite for change)
• whole school strategies that can address address broadly based issues such as preventing dropouts
• coordinated agency-community-school based/linked programs
• comprehensive approaches (multi-level, multi-system, multi-issue) include changes at the ministry level, school board/agency/health authority/police service level and the school-neighbourhood level. They include synergistic programs that address aspects of other issues such as addiction, violence, crime, and others. The focus at this level should be on system capacity and change.

Systematic Change; One Step or Program at a Time

Some of the programs that are described briefly in this overview paper address many of those factors and conditions. These programs, policies, services and practices can be brought together in a multi-intervention approach, program or strategy. These policies, programs and services include interventions in these five domains as listed below:

Policy

• cooperation with day care and pre-school programs
• emphasis on early literacy programs
• cooperation with vocational training and youth employment programs to assist in transitions to work and training
• cooperation with post-secondary institutions to encourage PSE access
• use of comprehensive (community policing, community-development, rural development etc), agency-school (community schools, healthy schools, safe schools) or whole school models (SEL, EBS) and frameworks

Instruction

• head start or head start continuation programs
• school dropout prevention programs
• focused efforts on basic literacy and health literacy for all
• emphasis on vocational programs (eg. Teaching assistants and nurse practitioners in education/health/caring professions can be used as a stepping stone to further employment and careers)
• additional assistance to facilitate access to post secondary education

Health, Social and Other Services

• school meal programs
• parent resource centres/family-school programs
• after school programs
• crime prevention and youth justice programs that emphasize diversion and restorative justice that are linked to community policing strategies
• delivery of basic health services such as dental, vaccinations, vision screening, etc
• support for special populations such as those with FASD, emotional-behavioutr disorders etc

Increased Social Support

• parent education and training programs
• family violence/neglect prevention programs
• cooperation with child protection services
• cooperation with housing authorities
• cooperation with local businesses, community groups, advocacy groups
• cooperation with youth employment programs and local employers
• school activities to reflect cultural makeup of the community
• working with elders and respected members of minority communities

Changes to the Physical Environment & Practical Resources

• school and community restoration and renovation programs (clean water, parasites, lead pipes, asbestos, moulds etc)
• improved security measures for schools in high crime neighbourhoods
• organization of safe, active transportation routes to school
• cooperation with community libraries

These multiple programs can be combined in coordinated delivery models that are suitable to the local neighbourhood, community, region or provincial/territorial context.

Help to Build a Toolbox of Resources, Reports and Research
An initial collection of research references, reports and resources has been started by the International School Health Network from a previous Canadian project. Visitors to this wiki-based web site are welcome to add references (using the Easy Edit" tool found at the top of the page or commenting on the collection by using the "thread" tool found at the bottom of the page. Here are just a few examples from that ever-growing list of web-linked materials.

• Education and poverty: a critical review of theory, policy and practice There is widespread agreement that poverty and poor educational outcomes are related but there are competing explanations as to why this should be. This study identifies the thinking behind different approaches and the implications for policy.
• The extra mile: how schools succeed in raising aspirations in deprived communities This DCSF project examined the teaching and learning practices of fifty schools in the most deprived wards in England that were judged to be high attaining or showing significant sustained improvement over several years in terms of pupil outcomes.
• Barlow, J., Parsons, J. (2005). Group-based Parent-training Programmes for Improving Emotional and Behavioural Adjustment in 0-3 Year Old Children. Cochrane Review approved November 22, 2002
• Warren-Adamson, Chris. (2006). Family centres: A review of the literature. Child and Family Social Work, 11(2).
• Moran, P., Ghate, D., van der Merwe, A. (2004). What Works in Parenting Support? A Review of the International Evidence. London, England: Department of Education and Skills.
• Bhattacharya J, Currie J, Haider S. Evaluating the impact of school nutrition programs. Washington, DC: Food Assistance and Nutrition Research Programs, USDA. 2004
• Kristjansson EA, Robinson V, Petticrew M, MacDonald B, Krasevec J, Janzen L, Greenhalgh T, Wells G, MacGowan J, Farmer A, Shea BJ, Mayhew A, Tugwell P (2007) School feeding for improving the physical and psychosocial health of disadvantaged elementary school children. Cambell and Cochrane Collaboration