Knowledge Matters September 2010This is a featured page

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Canada's monthly school health report from the Canadian Association for School Health
Volume 5 Issue 1 (September 2010)
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(Download to print version)

Featuring the Links between Student Health, School Health Promotion, Educational Achievement and School Effectiveness

The feature article for the first month of the school year could not be more appropriate. We have borrowed from the ongoing collection or research articles, reports and news stories being collected by the School Health Insider, the new information service being developed by the International School Health Network for its members. Over 150 documents are included on that list. The article in this issue of Knowledge Matters provides a preliminary analysis in an attempt to go beyond the simplistic argument that "healthy kids learn better" to examine issues such as which health issues and which programs have more impact on student learning.


Canadian School Health Knowledge Network NewsCanadian Media Reports for September 2010

  • Alas Summer is Over. CASH activities came to a relaxing stop over the summer, as Doug McCall was engaged in contract and conference work in Asia and Europe and then relaxed on the beach on Vancouver Island.
  • Toot Your Horn by Tweeting! Do you have SH news you want to share with 2500 other Canadian SH practitioners. Then feel free to post your news on the shared "CSH Tweets" account on Twitter. Simply go to www.twitter.com/cshtweets, sign in as user "cshtweets`, password `cash-aces and post your news. Those tweets and other items are subsequently posted on the CSH web site through posting updates directly onto our School Health Blog and will also be included in this monthly emailing to over 2500 people. This “self-serve” process is starting to work, with three recent postings coming directly from other organizations into the School Health Blog.
  • New Features on www.canadianschoolhealth.ca
    In our continuing effort to use technology effectively, we have added a couple of features to the web site. These include:
    • Enabling the chairs of our Communities of Practice to communicate with CoP members through designated “friends” lists within the membership of the web site
    • Adding Instant Message boxes onto a “Drop-In - Office Hours” page in the web site. During next school year, we will designate times, topics and resource people that will be available to answer questions through private or public IM messages or to drop into an informal “web meeting” using our webinar platform. And, yes, we will also be available by telephone during those “office hours”. Indeed, the page also includes links to a VOIP-based telephone system where anyone can call us free from anywhere in Canada.
    • Designated Twitter account tracking a topic. In cooperation with the International School Health Network, we have established a web page within the Mental Health CoP section of the web site that posts the very latest research on schools & mental health. If you would like to access the information more frequently than that, you can follow the ISHN Twitter Newsfeed on School Mental Health from your own Twitter account.
    • Search for Canadian SH news using our Google customized search engine for Canadian newspapers
  • Sign Up & Sign In: We are continuing to transfer the email contacts lists over to our 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.

News Story (Sep 30-10) No chocolate milk ban in Ontario schools http://is.gd/iouxP

News Story (Sep 30-10) Most Canadians did not take H1N1 shot: StatsCan http://is.gd/fClrD


News Release (Sep 29-10) Canada's commitment to maternal, newborn and child health worldwide http://is.gd/fChdQ


News Story (Sep 28-10) Fewer crimes reported to police: Statscan http://is.gd/fxBdH


News Story (Sep 28-10) Federal tobacco strategy turns from scary labels to stopping contraband http://is.gd/fxB1S


News Story (Sep 18-10) Edmonton’s archbishop forbids Catholic schools to use casino money http://is.gd/ioxGy

News Story (Sep 27-10) Massive teacher turnover, band politics can bring chaos to classrooms http://is.gd/ioxjM

News Story (Sep 27-10) Ottawa seeks backup source of pandemic vaccine http://is.gd/fxAN6


News Story (Sep 26-10) Delta, B.C., in shock after deadly daytime attack on teenage girl http://is.gd/fxAlf


News Release (Sep 24-10) Canada's Ministers of Education Meeting Advances their Priorities http://is.gd/frmRB

Web Page Canada Report on Millennieum Development Goals http://is.gd/fpbY1


News Story (Sep 23-10) Sixty per cent of Canadian adults are overweight, 24 per cent are obese: OECD report http://is.gd/foXYy

News Story (Sep 23-10) Americans, Mexicans, Brits, Australians, New Zealanders & Canadians are fattest: OECD report http://is.gd/foXYy


News Release (Sep 23-10) First Nations call for justice and equity in education funding for their children http://is.gd/foXji


News Release (Sep 21-10) Canada's Statement at World Summit on Millennium Development Goals http://is.gd/fnPkq

News Story (Sep 20-10) Chiefs say First Nations schools need $2B more in funding http://is.gd/ioxqm

News Release (Sep 17-10) Student safety and wellbeing highlighted in wake of ‘rave’ incident in Maple ridge BC http://is.gd/fkpOF


News Release (Sep 16-10) Three schools destroyed in January's Haiti earthquake will be rebuilt by Ontario. http://is.gd/fkpSH


News Release (Sep 17-10) Health groups commend health ministers for commitment to address childhood obesity http://is.gd/fjxRy


News Story (Sep 16-10) Canadian schools make it into world's best http://is.gd/ioxxl

Policy Doc Curbing Childhood Obesity: Federal, Provincial Territorial Framework to Promote Healthy Weight (Canada, 2010) http://is.gd/fjxqP


News Release (Sep 14-10) Health Ministers Agree on Ways to Strengthen the Health of Canadians http://is.gd/fjxjo


Policy Doc A Declaration on Prevention and Promotion from Canada’s Ministers of Health/Health Promotion/Healthy Living http://is.gd/fjxdy


News Story (Sep 15-10) Health ministers weigh in on childhood obesity - Healthy Living School Actions Included http://is.gd/fbV1q


News Story (Sep 14-10) Health ministers wrap up meetings in St. John’s http://is.gd/fbUF9


News Release (Sep 13-10) Federal-Provincial Health Ministers to Discuss School Health as part of Healthy Living Plan http://is.gd/f9bZT


News Story (Sep 11-10) Bigger children, tougher play causes spike in basketball concussions http://is.gd/fbTLd


News Story (Sep 10-10) Overweight and obese people make up majority in Ontario http://is.gd/fbTOZ


News Story (Sep 10-10) Newfoundland Mount Pearl school aims to stop hazing http://is.gd/fbSmM


News Story (Sep 10-10) Two London Ontario schools are in lockdown http://is.gd/fbTsY


News Story (Sep 9-10) Study urges mental health follow up in school shootings http://is.gd/fbREF


News Story (Sep 8-10) School cheaters often exhibit personality disorder traits: UBC study http://is.gd/fbTE8


News Story (Sep 4-10) Alberta Build Schools without Playgrounds http://is.gd/f5NrS


News Story (Sep 7-10) Seismic insecurity shakes faith in private schools http://is.gd/fbSr3


News Story (Sep 4-10) Asthma 'spike' looms as school year nears http://is.gd/fbRyu


News Story (Sep 3-10) Canadian Police Trained to Work with Schools http://is.gd/f5Mpf


News Release Annual Report Mental Health Commission of Canada http://is.gd/f1ro5


News Release for Parents (Sep 1-10) School Lunches That Make the Grade interior Health BC http://is.gd/eQsWz


News Story (Sep 1-10) School food under fire as Calgary cafeterias face health violations http://is.gd/fbTyJ

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

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

Articles in the September 2010 Issue of Canadian Journal of School Psychology
  • Living up to Expectations: The Strengths and Challenges Experienced by Chinese Canadian Students
  • A Review of Psychometric Assessment and Reporting Practices: An Examination of Measurement-Oriented Versus Non-Measurement-Oriented Domains
  • Adolescents’ Willingness to Access School-Based Support for Nonsuicidal Self-Injury
  • Cognitive Proficiency Index for the Canadian Edition of the Wechsler Intelligence Scale for Children-Fourth Edition
Articles in September 2010 Paediatrics & Child Health
  • Childhood overweight and obesity management: A national perspective of primary health care providers? views, practices, perceived barriers and needs
  • CPS Position Statement: Inhalant abuse
  • CPS Position Statement: Fetal alcohol spectrum disorder: Diagnostic update
  • Has the Alberta daily physical activity initiative been successfully implemented in Calgary schools?
Resources from Canada on Sexual Health Promotion in Schools



Articles in the September Supplementary Issue of Canadian Journal of Public Health (Theme is School Nutrition & Physical Activity)
  • Comprehensive School Health in Canada
  • Facilitating Health and Education Sector Collaboration in Support of Comprehensive School Health
  • Diet and Physical Activity in Schools: Perspectives from the Implementation of the WHO Global Strategy on Diet, Physical Activity and Health
  • Policy Options to Support Physical Activity in Schools
  • Policy Options to Support Healthy Eating in Schools
  • Stakeholder Engagement for Improved School Policy: Development and Implementation
  • Monitoring and Evaluating School Nutrition and Physical Activity Policies

Reza Nakhaie, Robert Arnold (2010) A four year (1996–2000) analysis of social capital and health status of Canadians: The difference that love makes Social Science & Medicine Volume 71, Issue 5

Svetlana Ristovski-Slijepcevic, Kirsten Bell, Gwen E Chapman, Brenda L Beagan (2010) Being ‘thick’ indicates you are eating, you are healthy and you have an attractive body shape: Perspectives on fatness and food choice amongst Black and White men and women in Canada, Health Sociology Review Vol 19, No 3

Policy Doc Safe Schools, Student Conduct (Trillium SB, Ontario, Canada) http://is.gd/fafXd


Web Site Alberta School Resource Officers Association http://is.gd/fafQD


Planning Guide Walk to School Guide (Canada) http://is.gd/fbVqx

Articles in the September 2010 Issue of Chronic Disease in Canada
  • Preface to the Canadian Health Measures Survey results - Oral health statistics, 2007–2009
  • Canadian Health Measures Survey results – Oral health statistics, 2007-2009
  • The public health implications of assisted reproductive technologies
  • Executive Summary – Meals and snacks consumed by young Quebecers
  • Book review – Culture and Health: Applying Medical Anthropology

Feature Article: The Links between Student Health, School Health Promotion, Educational Achievement and School Effectiveness: A Preliminary Summary By Doug McCall, Executive Director, International School Health Network

Introduction

The effect of school health programs on student educational achievement has long been a basic argument advanced to persuade practitioners and decision-makers, primarily those in the education system, of the value of investing in such programs. While few can argue against the notion that “healthy kids learn better”, it is time that we examined this claim more critically and then developed a more forceful and specific case. This article is a step towards that goal. It provides a listing of research articles, reviews and reports on the links between student health (including safety & social development), school health, student academic achievement and overall school effectiveness.

The cautious findings of Murray et al(2007), who conducted a systematic review of the impact of coordinated school health programs on student learning, reminds us of the work that needs to be done in understanding this linkage. They found that strong evidence existed only for asthma programs and limited evidence for nutrition, mental health and health services. A 2009 review done for the Department of Education in Washington State (Dilley, 2009) found several promising studies but also strongly suggested that more evidence was needed to make a more compelling case. As well, the evaluations of the national Healthy Schools program (Healey, 2004) reported mixed results in regards whether healthier schools consistently supported better academic achievement.

This examination of this preliminary listing of case studies, reports and reviews suggests that we need to break this broad issue of linking school health programs to academic achievement into different parts as well as broaden the definition of ”health” to include social development and safety. The component parts of the issue might include these aspects, as well as these confounding factors:

  • Health status and health behaviours obviously have an impact on a student’s ability to learn. However, are there aspects of health or social development that are more powerful, urgent or relevant to the child’s ability to learn that we should focus on? For example, overweight or obese children may not be learning as effectively as they could but hungry children definitely will not.
  • School health programs have long been unfairly expected to modify life-long health behaviours and decision-makers often look for significant behavioural results after only one or two years of program delivery. Will we now expect that those short term programs will also affect the student’s health sufficient to impact their academic grades?
  • If there are difficulties to be expected in measuring learning improvement for all students, should we focus more on students who are clearly facing higher hurdles in their learning because of their health? For example, should we focus on students who will miss more school days because of asthma, disabilities, family violence, teen pregnancy etc?
  • Does the delivery of school health and similar programs in a comprehensive manner (linking several interventions so that the efforts of the whole school, local agency programs and ministry policies are coordinated) have an impact on the nature of the school and the relationships that are formed within the school?
  • If we are to look for multi-level changes to the complex, adaptive environments of the school, should we be using different research methods other than solely random controlled trials that are better suited for examining specific interventions aimed at specific outcomes?
  • Are there different components within the comprehensive, coordinated or whole school delivery models that are more relevant to academic successor school effectiveness? Should we focus more on health and social services or changes to the physical environment rather than instructional programs? .

This report also suggests that we need to look more closely at different community and country contexts because they interact with the different interventions. For example, the potential for educational benefits of health, safety and social development programs in disadvantaged communities will be far greater because they have farther to go. Should we construct an agenda of health and social problems for these types of communities and address them first? This would be consistent with stronger evidence coming from studies of the educational impact of health and development programs in developing countries and from countries which have been significantly disrupted by war, disease or disaster (these studies are not included in this listing.)

This listing of research, reports and resources stories comes from the School Health Insider, an information service provided by the International School Health Network to its members. If you would like more information about this service and ISHN membership, click here. Please note that this list has not been developed by a searching of the regular research databases and consequently, we have likely missed some relevant articles or revi8ews. We suggest that such a review using the specific questions shown immediately below would be a good next step.

A. An Overview and History of Health & Education Linkages

The importance of the health-learning connection has been of ongoing concern to those who wish to promote health, safety and social development through schools. A WHO Expert Committee on Comprehensive School Health Education and Promotion (1997) summed up the relationship as follows:
  1. Health Status Affects the Capacity to Learn. Health is a key factor in school entry, school success and productivity throughout life. nutritional deficiencies, physical and mental disabilities and problems associated with premature sexual activity, tobacco/alcohol/drug use, injury, bullying and violence and other health/social issues can inhibit or prevent academic success.

  2. Educational Attainment Affects Health Status. A lack of basic academic, literary and numeracy skills prevents a person’s capacity to participate fully in personal, family and community life. As well, formal academic status is directly liked to economic status.

  3. Formal learning environments such as pre-schools, schools, colleges, universities and training programs, as well as informal learning in playgrounds, youth programs, recreational activities, religious organizations and other venues can influence health.

  4. Formal and informal health care and social services delivery centres are also excellent vehicles for ongoing learning about life and well as health. Patient education, senior citizen centres, parent resource centres, guidance counsellors offices, visits with social workers are all potential points where individuals can learn or be encouraged to learn more.

  5. Purposeful combinations of health and learning interventions can influence short-term and long-term health status as well as improve learning educational achievement. Research on integrated approaches to early childhood development, school-based health promotion, workplace programs and community-based programs all demonstrate the value of coordinating health and learning programs, services and activities as much as possible.

The Centres for Disease Control and Prevention (nd) has summarized the relationship between health and academic achievement as follows:

“Scientific reviews have documented that school health programs can have positive impacts on educational outcomes, as well as health-risk behaviors and health outcomes. Programs that are primarily designed to improve academic performance are increasingly being recognized as important public health interventions.”

Similarly, a 2009 review done for the Departments of Health & Education in Washington State (Dilley, 2009) concluded that:

  • Health and Education Are Linked. For students in middle and high school, health risks and academic risks affect each other. Students who do poorly in school may have more health risks, which adversely affect their achievement and in turn contribute to health risks. Data from the Healthy Youth Survey in Washington State provide a new way of looking at the relationship between health risk and academic achievement. The report examines 13 key physical and mental health risk factors and analyzes the relationship between these specific health factors and the grades students report getting in school.
  • Every Health Risk Can Affect Academic Success. The more health risks students have, the less likely they will succeed in school or graduate on time. Each health risk that can be removed has the potential to positively influence academic behaviors. Improvement of even a single health factor may help improve academic achievement.
  • Interventions Can Narrow Disparities. Lack of equal chances for success—the result of poverty, discrimination, unequal access to services, and other factors—affects a person’s health. These patterns of socioeconomic disparities are often the same for disparities in academic achievement. It may be unrealistic to expect to close the achievement gap for disadvantaged youth without addressing wellness, readiness to learn, and the conditions affecting the health of the community.
  • Health Interventions Can Improve Learning and Health. There are many proven interventions that have a positive impact on students’ health and academic achievement. This report examines how delivering supportive health policies, instruction, and services comprehensively may be more effective than offering single health interventions. The Washington State report offers school leaders six key ingredients for success that are supported by research and are consistent with the Coordinated School Health approach from the Centers for Disease Control and Prevention (CDC).

The list of reports, resources and research studies noted immediately below show that this ongoing interest in the connection between human health and educational achievement has been part of the school health promotion movement since its beginnings in the 1980’s.

Reports/Resources Research

Ian Warwick, Ann Mooney and Chris Oliver (2009) National Healthy Schools Programme: Developing the Evidence Base
Thomas Coram Research Unit, Institute of Education University of London

Julia Dilley (2009) Research Review: School-based Health Interventions and Academic Achievement, Washington State Board of Health, Washington State Office of Superintendent of Public Instruction

Report Student Health and Academic Achievement (CDC, 2010) http://is.gd/isj6U

Powney J, Malcolm H, Lowden K (2000) Health and attainment: a brief review of recent literature. Glasgow: SCRE Centre, University of Glasgow
Web Site Effective & Healthy Schools (Great Schools) Funded by Gates Foundation http://is.gd/fCdz5

Report OECD Education Ministerial MeetingInvesting in Human and Social Capital: New Challenges http://is.gd/gT1qO

Report THE IMPACT OF POOR HEALTH ON EDUCATION:NEW EVIDENCE USING GENETIC MARKERS (Queens University, Canada, 2007) http://is.gd/it31P

Presentation Health and academics: survey of educator perceptions (American Public Health Association, Nov 2010) http://is.gd/it44m

Dunkle MC, Nash MA. Beyond the Health Room. Washington, DC: Council of Chief State School Officers, Resource Center on Educational Equity; 1991

E-book. The Well-Balanced Teacher (ASCD, USA) http://is.gd/fChKD

American Association of School Administrators. AASA position statements.* [pdf 106k] Position statement 3: Getting children ready for success in school, July 2006; Position statement 18: Providing a safe and nurturing environment for students, July 2007

The Society of State Directors of Health, Physical Education
and Recreation and the Association of State and Territorial Health Officials. (2002). Making the Connection: Health and Student Achievement. Reston,VA.

Council of Chief State School Officers. Assuring school success for students at risk: A policy statement of the Council of Chief State School Officers.* November 1987

Presentation. Society of State Directors of Health, Physical Education and Recreation. Making the connection: Health and student achievement.* [ppt 5.2MB].

Bodgen, James F. Fit, Healthy and Ready to Learn: A School Health Policy Guide. Alexandria, VA: National Association of State Boards of Education, 2000, pE-3.

Healy, K. (2004) Linking Children’s Health and Education. Progress and Challenges in London. London: Kings Fund.

Green, J., Howes, F., Waters, E., Maher, E. and Oberklaid, F. (2005) Promoting the social and emotional health of primary school aged children: Reviewing the evidence base for school-based interventions. International Journal of Mental Health Promotion, 7(2):30-36.

Nancy G. Murray DrPH, Barbara J. Low DrPH, Christine Hollis MPH, MPS, CHES, Alan W. Cross MD, Sally M. Davis PhD (2007) Coordinated School Health Programs and Academic Achievement: A Systematic Review of the Literature Journal of School Health 77 (9) , 589–600

B. Correlation of Student Health Status, Health & Social Behaviours and Student Learning

Research often lags behind the common sense of practitioners. Early research studies also often begin with identifying correlations between things rather than any cause-effect relationships. Consequently, it is not surprising to find that the first conclusion reached in a variety of studies is that health status and health behaviours are correlated with higher levels of education and educational achievement. These correlations are found with negative health conditions and behaviours and with positive behaviours as well as with accumulations of health problems adding up to more difficulty in learning.

The US Centre for Disease Control & Prevention has summarized the negative association between health-risk behaviors and academic achievement among high school students after controlling for sex, race/ ethnicity, and grade level. This means that students with higher grades are less likely to engage in health-risk behaviors than their classmates with lower grades, and students who do not engage in health-risk behaviors receive higher grades than their classmates who do engage in health-risk behaviors. These associations do not prove causation. Further research is needed to determine whether low grades lead to health-risk behaviors, health-risk behaviors lead to low grades, or some other factors lead to both of these problems. (The CDC web site then goes on to present fact sheets and slide presentations based on the data from the 2009 national YRBS on the association between health-risk behaviours and academic grades)

A similar review done for the Scottish Council for Research in Education (Powney et al, 2000) found similar negative correlations between risky health and social behaviours and student success at school. A more recent review of the research (Warwock et al, 2009) done as part of an evaluation of the Healthy School program in England concluded that:

A number of studies have shown there to be a close association between health and academic attainment, with academic attainment influencing, and being influenced by, health status (Healy, 2004; World Health Organisation, 1996). There is a substantial body of evidence showing that poor health can inhibit learning (Healy, 2004; St Leger and Nutbeam, 2000; Feinstein et al, 2008). Moreover, drawing on a meta-analysis of studies focusing on health and educational outcomes, St Leger and Nutbeam (2000) conclude that good health is associated with positive educational outcomes. Their analysis reveals a strong association between health and education-related outcomes such as exam grades, classroom performance, and students’ behaviour and attitudes. Moreover, a review of the literature focusing on the links between health and school attainment found that ‘… in the longer-term the research consistently points to adverse effects of ill health on attainment’ (Powney et al., 2000: 7).

Positive health behaviours are also correlated with better success at school. The Centre for Disease Control has also described some of these positive behaviours and health conditions. A review of the research on physical activity (Centre for Disease Control & Prevention, 2010) , noted that physical activity may help improve academic performance including academic achievement (e.g., grades, standardized test scores); academic behavior (e.g., on-task behavior, attendance); and factors that can positively influence academic achievement (e.g. concentration, attention, improved classroom behavior). This literature review examined 23 years of research and includes 50 studies. The majority of the studies in this review report that physical activity was positively related to academic performance. Most importantly, adding time during the school day for physical activity does not appear to take away from academic performance. Several studies (Finestein, 2008, Michelle et al 2008) have noted the correlation between a healthy diet and academic performance. Taras & Potts-Datema (2005) have noted similar correlations of poor academic achievement with obesity.

The review done for the Health Department in Washington State (Dilley, 2009) found that the effect of various health risks was cumulative. The more health risks students had, the more likely it was that they also were at academic risk. The rate of increase in academic risk was very consistent—each extra health risk added a similar difference, whether going from one to two risks or seven to eight risks. Fewer than 10 percent of students with no health risk factors reported being at academic risk (having mostly Cs, Ds, or Fs). About half of students with six health risk factors, and two-thirds or more of students with at least nine health risk factors were at academic risk. On the positive side, this also suggests that each health risk that can be removed has the potential to positively influence academic behaviors.

Reports/Resources Research

Swingle CA. (1999) The relationship between the health of school-age children and learning: implications for schools. Lansing, MI: Michigan Department of Community Health; 1997

Fact Sheet Academic Success and Physical Fitness http://is.gd/iso6R

Henry KL (2010) Academic Achievement and Adolescent Drug Use: An Examination of Reciprocal Effects and Correlated Growth Trajectories Journal of School Health Volume 80, Issue 1, pages 38–43, January 2010


Feinstein, L., Sabates, R., Sorhaindo, A., Herrick, D., Northstone, K. & Emmett, P. (2008) Dietary patterns related to attainment in school: the importance of early eating patterns. Journal of Epidemiology and Community Health, 62(8):734-9

Michelle D. Florence MSc, PDt, Mark Asbridge PhD, Paul J. Veugelers PhD (2008) Diet Quality and Academic Performance Journal of School Health 78 (4) , 209–215 doi:10.1111/j.1746-1561.2008.00288.x

Hanson TL, Austin G, Bayha, JL. (2004) How are Student Health Risks & Resilience Related to the Academic Progress of Schools. San Francisco: West Education. 2004.

Danice K. Eaton PhD, Nancy Brener PhD, Laura K. Kann PhD (2008) Associations of Health Risk Behaviors With School Absenteeism. Does Having Permission for the Absence Make a Difference? Journal of School Health 78 (4) , 223–229 doi:10.1111/j.1746-1561.2008.00290.x

Taras, H. (2005). Nutrition and student performance at school. Journal of School Health, 75(6), 1746-1761

Taras H.
Physical activity and student performance at school. Journal of School Health 2005;75(6):214–218.

Coe DP, Pivornik JM, Womack CJ, Reeves MJ, Malina RM.(2006) Effect of Physical Education & Activity Levels on Academic Achievement in Children. Medicine & Science in Sports & Exercise. 2006. www.acsm-msse.org


Taras H, Potts-Datema W. (2005) Chronic health conditions and student performance at school. Journal of School Health 2005;75(7):255–266

Taras H, Potts-Datema W.
Obesity and student performance at school. Journal of School Health 2005;75(8):291–295.

Taras H, Potts-Datema W.
Sleep and student performance at school. Journal of School Health 2005;75(7):248–254

Sharon Judge PhD, Lisa Jahns PhD, RD (2007) Association of Overweight With Academic Performance and Social and Behavioral Problems: An Update From the Early Childhood Longitudinal Study

Journal of School Health 77 (10) , 672–678

Katharina Widenhorn-Müller, PhDa, Katrin Hille, PhDa, Jochen Klenk, MPHb and Ulrike Weiland (2008) Influence of Having Breakfast on Cognitive Performance and Mood in 13- to 20-Year-Old High School Students: Results of a Crossover Trial. Pediatrics, August
Journal of School Health 74 9 347 352

Christi A. Bergin and David A. Bergin (2009) Sleep: The E-ZZZ Intervention Educational Leadership December 2009/January 2010 Vol 67: 4

Christi A. Bergin and David A. Bergin (2009) Sleep: The E-ZZZ Intervention Educational Leadership December 2009/January 2010 Vol 67:4

Jerusha Conner, Denise Pope and Mollie Galloway (2009) Success with Less Stress

Inga Dóra Sigfúsdóttir,,Álfgeir Logi Kristjánsson,John P. Allegrante (2007) Health behaviour and academic achievement in Icelandic school children Health Educ. Res. (2007) 22 (1): 70-80.

Shephard RJ. (1996) Habitual physical activity and academic performance. Nutrition Reviews 1996;54(4 Pt 2):S32–S36

Vaisman N, Voet H, Akivis A, Vakil E. Effect of breakfast timing on the cognitive functions of elementary school students. Archives Pediatric Adolescent Medicine. 1996; 150: 1989-1092.
Educational Leadership December 2009/January 2010 Vol 67: 4

Conners CK, Blouin AG.(1982)
Nutritional effects on behavior of children. Journal Psychiatric Research. 1982/83: 17: 193-201.

Libbey, Heather P. Measuring Student Relationships to School: Attachment Bonding, Connectedness and Engagement. Journal of School Health. 2004:74(7):274-283.


Zill, N. (1990)
Child health and school readiness:Background paper on a national educational goal. Washington, DC: Child Trends

C. Health & Social Problems and Behaviours with Significantly More Impact on Learning

It would also appear that some health, safety, social or economic risks as well as some physical conditions in the school have more of an impact on learning. These risks or problems may be more significant because they have an impact on attendance, creating prolonged or repeated absence from school. Other risks may be more significant because they have a significant impact on the social attachment/relationships of the student to peers, educators or other significant adults normally found in the school. Indeed, based on what we have found thus far, it may be safer and more evidence-based if we modified our slogan from “healthy kids learn better” to “impoverished, hungry, pregnant, abused, neglected, asthmatic, bullied and addicted students have difficulty in schools”.
Based on the reports and research articles noted below, it would appear that these problems may have a stronger correlation with student learning:
· asthma
· tooth decay
· severe emotional or mental health problems
· hunger
· teen pregnancy
· repeated bullying or harassment of some students
· child abuse or neglect

The research evaluating various promotion, prevention and assistance programs to reduce the health or social impact of these problems consistently and clearly shows that multiple intervention programs are more effective but more costly or complicated to deliver and maintain. Consequently, if we are hoping to persuade educators of the value of school health and social development programs, it is likely that we will need to include attention to these health & social problems that have a more profound impact on student learning.

Reports/Resources Research
Harden, A., Brunton, G., Fletcher, A., Oakley, A., Burchett, H. and Baackhans, M. (2006) Young people, pregnancy and social exclusion: a systematic synthesis of research evidence to identify effective, appropriate and promising approaches for prevention and support. London: EPPI Centre, Institute of Education, University of London

Taras, H., Potts-Datema, W. (2005). Childhood asthma and student performance at school. Journal of School Health, 75(8), 296-312.

Sheniz Moonie PhD, David A. Sterling PhD, CIH, Larry W. Figgs PhD, MPH, Mario Castro MD, MPH (2008) The Relationship Between School Absence, Academic Performance, and Asthma Status Journal of School Health 78 (3) , 140–148

Maryellen Guinan, Maryanne McGuckin, Yusef Ali The effect of a comprehensive handwashing program on absenteeism in elementary schools Am J Infect Control. 2002 Jun ;30 (4):217-20 12032496

B Hammond, Y Ali, E Fendler, M Dolan, S Donovan (2000) Effect of hand sanitizer use on elementary school absenteeism Am J Infect Control. 2000 Oct ;28 (5):340-6 11029132 (P,S,E,B)

Kathryn Rose Puskar,Lisa Marie Bernardo (2007) Mental Health and Academic Achievement: Role of School Nurses
Journal for Specialists in Pediatric Nursing Volume 12, Issue 4, pages 215–223, October 2007

Gwen M. Glew, Ming-Yu Fan, Wayne Katon, Frederick P. Rivara, Mary A. Kernic, (2005) Bullying, Psychosocial Adjustment, and Academic Performance in Elementary School Arch Pediatr Adolesc Med.2005;159:1026-1031.

Maria E. Eisenberg, Dianne Neumark-Sztainer, Cheryl L. Perry (2003) Peer Harassment, School Connectedness, and Academic Achievement

Tanya N. Berana;Ginger Hughesa;Judy Lupartb (2008) A model of achievement and bullying: analyses of the Canadian National Longitudinal Survey of Children and Youth data Educational Research Vol 50, No 1, 25-39
Journal of School HealthVolume 73, Issue 8, pages 311–316, October 2003

Jaana Juvonen , Jaana Juvonen , Guadalupe Espinoza (2010)

Bullying Experiences and Compromised Academic Performance Across Middle School Grades
Journal of Early Adoelscence September, 2010

Dewey JD. (1999 (Reviewing the relationship between school factors and substance use for elementary, middle, and high school students. Journal of Primary Prevention 1999;19(3):177–225

Mandell DJ, Hill SL, Carter L, Brandon RN.
The impact of substance use and violence/ delinquency on academic achievement for groups of middle and high school students in Washington. Seattle, WA: Washington Kids Count, Human Services Policy Center, Evans School of Public Affairs, University of Washington; 2002.

Brown L, Pollitt E.(1996) Malnutrition, poverty and intellectual development. Scientific American. 1996; 274(2):38-43.

American School Food Service Association (ASFSA). Impact of hunger and malnutrition on student achievement. School Board Food Service Research Review. 1989: (1, Spring):17-21.


Schoenthaler, S. Abstracts of early papers on the effects of vitamin-mineral supplementation on IQ and behavior. Personality and Individual Differences. 1991: 12(4):343.


Alaimo K, Olson CM, Frongillo Jr, EA.
Food insufficiency and American school-aged children’s cognitive, academic, and psychosocial development. Pediatrics. July 2001:108(1):44-53.

D. Effect of Interventions aimed to serve the needs of students at Elevated Risk/Burden of Selected Health Conditions

In a similar way, researchers are identifying categories of students who may be more susceptible to health and social problems and consequently face greater risks of learning problems. These include:
· aboriginal students
· ethnic minority students who face discrimination or language/culture related problems
· incarcerated youth or youth living in care/group homes
· students with intellectual or physical disabilities
· students with genetic problems, including vision, hearing and similar problesm
· students with FASD
· autistic students
· student with ADHD
· students with emotional or behavioural disorders
· students with chronic diseases causing repeated absence from school

As in the previous section, there are research reviews which indicate a multi-intervention approach to support these students is more effective.

Reports/Resources Research

Report Aboriginal children’s health: Leaving no child behind http://is.gd/hXHdf

Schinke, S.P., Cole, K.C., and Roulin, S.R. (2000). Enhancing
the educational achievement of at-risk youth. Prevention Science
, 1, pp. 51–60. In J. Sonia, and S. Estes (Eds.), Raising academic achievement: A study of 20 successful programs. Washington, DC:American Youth Policy Forum

Presentation (Nov 23-10) Schooling for Incarcerated Youths: The Link Between Education and Rehabilitation http://is.gd/hXGtM

News Story (Nov 23-10) Teachers improve educational outcomes for youth in care http://is.gd/hXFS3

News Story (Jul 28-10) ADHD teens more likely to drop out http://is.gd/e2vJe





Lynch EW, Lewis RB, Murphy DS. Educational services for children with chronic illnesses: Perspectives of educators and families. Exceptional Children. 1999;59:210-220.

Sexson S. Madan-Swain A.
School re-entry for the child with chronic illness. Journal Learning Disabilities 1993:26:115-125,137.

Kliebenstein MA, Broome ME. (2000)
School re-entry for the child with chronic illness: parent and school personnel perceptions Pediatric Nurs Nov-Dec;26(6):579-82.

KM Thies. (1999)
Identifying the educational implications of chronic illness in school children. Journal of School Health. 1999:69 (10), 392-397.

Valdes K, Williamson C. Wanger M. (1990)
Thenational longitudinal transition study (NLTS) of special education students. Statistical Almanac Volume 9: Youth Categorized as Other Health Impaired. Washington, DC. US Department of Education: 1990.

Dworkin PH. (1989)
School failure. Pediatric Review. 1989:88(4):610-617



E. Effect of Comprehensive Approaches, Coordinated Agency-School Programs and Whole School Strategies on Student Learning or School Effectiveness

In this section, we examine the possibility that multi-intervention programs can raise the general educational effectiveness of the school or have an impact on all students (rather than students facing more severe problems). Although there are several promising studies and several positive reports as well as many cogent arguments, the research evidence on this question is muted and somewhat mixed.

Murray et al (2007 noted that scientifically rigorous evaluation of school health programs is challenging to conduct due to issues related to sample size, recruitment, random assignment to condition, implementation fidelity, costs, and adequate follow-up time. Measuring the impact on learning is even more difficult because we are looking at secondary effects on a population level (the overall health of all of the students has to improve and then the impact on their learning will have to take hold). However, Murray et al still state that school health programs hold promise for improving academic outcomes for children.

The list of reports, reviews and studies indentified thus far in our tracking of the research indicates that several models of comprehensive approaches (multi-issue, multi-system and multi-level), coordinated agency-school programs (single issue, multi-agency) and whole school (educator only models) can make the claim that their model has academic benefits. These include:
· community schools, particularly those serving disadvantaged communities
· social and emotional learning multi-intervention programs
· safe & caring school models
· healthy schools
· green or environmentally sustainable schools

The Community Schools Coalition in the United States has identified several case studies reporting that community schools have significantly positive impacts on student academic performance, dropout rates and student behaviour in schools. Academic Performance. For example, Communities in Schools (CIS), the largest nationwide model of community schools, reported that schools that fully implement the CIS Model of integrated student services have higher percentages of students achieving math and reading proficiency than did students in other schools. In a 2009 study comparing Children’s Aid Society (CAS) community schools to other New York City schools, CAS schools’ students scored significantly higher on math tests than students in other city schools. All CAS middle schools but one (IS 166) outperformed peer and city-wide schools in making one year of progress, with MS 319 and MS 324 at 100 percent, and CAS middle schools academically outperformed peer schools in math progress for the lowest 1/3 of students. In data collected in late 2009, there were 55% fewer incidences of chronic absenteeism among participants in Providence Full Service Community Schools’ (FSCS) programs than in the general school population.


Green et al (2005) reviewed eight analysis of 322 studies measuring the impact of social and emotionaol learning programs and found that, although the studies were of limited duration, had methodological problems and often did not control for social context, school effectiveness was increased if schools focused on promoting overall mental health, self-esteem and coping skills rather than preventing specific mental health problems or disorders. Payton et al (2008) examined three systematic reviews and found that SEL programs improved students’ social-emotional skills, attitudes about self and others, connection to school, positive social behavior and academic performance; they also reduced students’ conduct problems and emotional distress.

In health, Sinnot (2005) examined a representative sample of 2,314 schools in 16 LEAs in England to investigate any association between the healthy schools strategy and a rise in standards. The rates of progress were higher for schools having achieved healthy schools status over one year (3.6) and over two years (3.8). This shows that schools having achieved the healthy status had an average improvement last year of 1.5 compared to those not in the project – the equivalent of 0.5% increase in each of the three subjects at KS2. The study also shows that for schools that have joined the healthy schools project progress was also greater than for those not in the project but not as great as for those who have already achieved the status.

Further, there may be particular combinations of interventions drawing from these models that would have a greater effect on student achievement or school effectiveness. These are explored further in the final two sections of this report. For example, there is good evidence that the physical environment of the school (air quality, natural light, access to fresh water etc) improve learning for all. Staff wellness programs reduce staff absenteeism and performance. Efforts to support social attachments between students and mentors, peers, teachers and parents also have educational impacts. Drawing from the safe, healthy, community or green school models noted above to create a hybrid model that maximizes educational impact may be the best way to sustain educator interest.

Reports/Resources Research

Report Benefits of Social-Emotional Learning. Meta-analyses.(Syntheses of SEL Research Study Findings (CASEL, nd) http://is.gd/it1N9

Bireda S (2009) Look at Community Schools Center for American Progress


Martin J. Blank, Atelia Melaville, and Bela P. Shah, “
Making the Difference: Research and Practice in Community Schools” (Washington, D.C.: Coalition for Community Schools, 2003).


Cummings C, Dyson A, Muijs D, PappsI, Pearson D, Raffo C, Tiplady L,Todd L (2007) , “
Evaluation of the Full Service Extended SchoolsInitiative: Final Report” Department Of Education & Skills, United Kingdom: University of Newcastle, University of Manchester: 2007).

OFSTED (2006) Healthy schools, healthy children? The contribution of education to pupils’ health and well-being. London: Ofsted

Anne T. Henderson and Karen Mapp, “A New Wave of Evidence: The Impact of School, Family, and Community Connections on Student Achievement” (Austin, TX: Southwest Educational Development Laboratory: 2002).

Sinnot, J. (2005) Healthy Schools and Improvement in Standards. www.wiredforhealth.gov.uk/Word/improved_standards_05.doc Accessed April 2009

Miranda Thurston (2006) The National Healthy Schools Programme: a vehiclefor school improvement?
Case studies from Cheshire
, Centre for Public Health Research

Thesis Effect of a Comprehensive School Health Model on Improving Academic Achievement (OISE, 2007) http://is.gd/it3In

Thurston, M. (2006) The National Healthy Schools Programme: a vehicle for school improvement? Case studies from Cheshire. Chester, Centre for Public Health Research

Planning Guide Inclusive Education UNESCO 2006 http://is.gd/gwRcZ

Planning Guide Community Schools (USA)
http://is.gd/e2vyt

Research Report: Rationale for Community Schools http://is.gd/e2vv7

Thorpe, G., Kirk, S., Whitcombe, D. (2002) The impact of the National Healthy School Standard on school effectiveness and improvement. Research Brief RBX09-02, London: DfES

Planning Guide Starting a Community School (US National Center for Community Schools) http://is.gd/ekaRB

Murray NG, Low BJ, Hollis C, Cross AW, Davis SM. (2007) Coordinated school health programs and academic achievement: A systematic review of the literature. Journal of School Health 2007;77(9):589–600

Rosas S, Case J, Tholstrup L A Retrospective Examination of the Relationship Between Implementation Quality of the Coordinated School Health Program Model and School-Level Academic Indicators Over Time. Journal of School Health Volume 79, Issue 3, pages 108–115, March 2009

Frances M. Vinciullo Beverly J. Bradley (2009) A Correlational Study of the Relationship Between a Coordinated School Health Program and School Achievement: A Case for School Health Journal of School Nursing, Vol. 25, No. 6, 453-465

National Research Council. (2006). Review and Assessment of the Health and Productivity Benefits of Green Schools: An Interim Report. Washington, DC: National Academy Press

Schagen, S. Blenkinsop, S. Schagen, I., Scott, E., Eggers, M., Warwick, I., Chase, E. & Aggleton, P. (2005) Evaluating the impact of the National Healthy School Standard: using national datasets. Health Education Research, 20(6): 688-696

Payton J, Weissberg RP, Durlak JA, Dymnicki AB, Taylor RD, Schellinger KB and Pachan M (2008) The Positive Impact of Social and Emotional Learning for Kindergarten to Eighth-Grade Students. Findings from Three Scientific Reviews. Collaborative for Social, Emotional and Academic Learning

Elias, M.J., & Arnold, H (2006) The connections between academics and social-emotional learning. In The educator’s guide to emotional intelligence and academic achievement: Social-emotional learning in the classroom. CA: Corwin Press.

Zins, J.E., Bloodworth, M.R., Weissberg, R.P., and Walberg, H. (2004)
The scientific base linking social and emotional learning to school success.in J. Zins, R.P. Weissberg, M. Wang and H.J. Walberg, (Eds.), Building academic success on social and emotional learning: What the research says. New York: Teachers College Press.

Zins, J.E., Payton, J.W., Weissberg, R.P., & O'Brien, M.U. (2007) Social and emotional leaning and successful school performance In G. Matthews, M. Zeidner, & R. D. Roberts (Eds.), The science of emotional intelligence: Knowns and unknowns. New York: Oxford University Press

Zins Joseph E, Bloodworth MR, Weissberg Roger P and Walberg, Herbert J. The scientific base linking social and emotional learning to school success. In Building Academic Success on Social and Emotional Learning: What Does the Research Say? Joseph E. Zins, Roger P Weissberg, Margaret C Wang, and Herbert Walberg (Eds.).New York. Teachers College Press. 2004.

State Education and Environment Roundtable. (2005). California student assessment project: The effects of environment-based education on student achievement. California Department of Education

Dryfoos, J. (2000). Evaluation of community schools: Findings to date.Washington, DC: Coalition for Community Schools.


F. Effect of Individual Components/Elements or Interventions within Comprehensive, Coordinated, Whole School Programs on Student Learning

This section examines the impact of the broad components of a school health, safety or social development approach (physical environment, social support strategies, staff wellness, health services, health, personal/social development and physical education ) as well as several individual i8nterventions or programs such as handwashing programs, immunization, oral health, and peer helping.

School facilities and physical attributes of schools, facilities and school grounds

There is growing evidence (Berry, 2002; Schneider, 2002:, National Research Council, 2006) that the physical environment of the school has a significant impact on student learning. Air quality, natural light, comfortable classrooms, access to clean water, sanitation, school grounds that encourage active play and that reduce stress, temperature and humidity are all factors.

Social environment and relationships

A summary prepared by the Centers for Disease Control & Prevention states that students who feel connected to school believe that adults and peers in the school care about their learning as well as about them as individuals. When students feel connected to school, they are less likely to engage in a variety of risk behaviors, including tobacco use, alcohol and drug use, violence and gang involvement, and early sexual initiation. Connected students are also more likely to have higher grades and test scores, have better school attendance, and stay in school longer.

However, it is important to note that the students are connected by relationships with people at school through programs such mentoring, peer helper programs, after school programs, parent involvement programs, technology clubs, artistic projects, eco-projects, student homeroom and advisor programs, creating youth friendly spaces in the school, individualized and alternative educational study programs and more and not by general attempts to improve the social climate or student discipline in the school.

Accessible, Convenient, Youth Friendly Health Services

Several reports, studies and reviews have been listed below that report that school-based health centres are effective supports for students in attending and staying in school.

Staff Wellness Programs

Schools that implement a school site health promotion program will also realize educational benefits for students. These will include reduced absenteeism, which saves money and increases productivity as well as improved instruction as students’ primary teachers are not replaced by temporary substitutes. Teachers who participate in worksite health promotion programs are more energetic and can use this extra energy within their classrooms.

Cognitive and social skills instruction

The review done for Washington State identified a large number of specific curricula or programs that have been shown to improve a wide variety of student health behaviors through cognitive functioning and social skills training. These included programs that teach decision-making skills, conflict management, goal setting, and peer pressure resistance. Some of these skill-building trainings included segments for family involvement and community service. Content varied according to the health risks being addressed and also the age group of the intended audience. For example, the Guide to Community Preventive Services recommends school-based violence prevention programs that use cognitive skills training for students in the elementary and middle school age range. Training then shifts to social skills and development of behavioral skills47 for students in middle to high school ages.

Comprehensive School Guidance Programs

Comprehensive school guidance programs combine academic and personal counselling activities with an active professional coordination and advocacy role for school counsellors.

Specific Interventions that have educational benefits


Several or the reports, studies and reviews noted in the list below have identified specific interventions that have positive benefits for student educational achievement or overall school effectiveness. These include:
· handwashing programs to reduce student and staff absenteeism
· School-based programs to reduce youth violence•
· Youth development behavioral interventions, coordinated with community service to reduce • sexual risk behaviors in adolescents
· School-based instructional programs for reducing alcohol-impaired driving•
· School-based or linked dental sealant delivery programs•
· Enhanced school-based physical education•
· Person-to-person interventions to improve caregivers’ parenting skills.•
· Parent/teacher communication skills training
· Increased physical activity in regular classrooms and school day
· Chronic disease management training
· Group Counselling and Guidance
· Public health participation in and support for school dropout programs
· Academic support and remediation programs
· School-based or school-linked Dental Health services
· Positive behaviour support programs
· Mentoring programs
· Preventing teen pregnancy and support programs for young parents

Reports/Resources Research

Center for Mental Health in Schools. (2000). A sampling of outcome findings from interventions relevant to addressing
barriers to learning
. Los Angeles, CA:Author (at UCLA).

Center for Mental Health in Schools. (1999). Expanding education reform to address barriers to learning: Restructuring
student support services and enhancing school-community
partnerships.



Carnegie Council of Adolescent Development. (1989).
Turning points: Preparing American youth for the 21st
century. Report of the Task Force on Education of Young Adolescents
.Washington, DC:Author.

Fact Sheet School Success & Health Services
http://is.gd/isnpn

Van Cura M (2010) The Relationship Between School-Based Health Centers, Rates of Early Dismissal From School, and Loss of Seat Time Journal of School Health Volume 80, Issue 8, pages 371–377, August 2010

Fact Sheet Academic Success & Nutrition Services through Schools http://is.gd/isnQc
Fact Sheet Health Education and Academic Achievement http://is.gd/isozt
Fact Sheet School Counseling, Social Services and Academic Achievement http://is.gd/isoWp
Fact Sheet Academic Success through Family Involvement in Schools http://is.gd/isppe
Fact Sheet Academic Success through Staff Wellness http://is.gd/ispFq

Sinnot, J. (2005) Healthy Schools and Improvement in Standards. www.wiredforhealth.gov.uk/Word/improved_standards_05.doc Accessed April 2009

Research Report (2007) Physical Education, Physical Activity and Academic Performance Active Living Research Robert Johnson Foundation

Brown D, Trust J (2005)
School Counselors, Comprehensive School Counseling Programs,and Academic Achievement:
Are School Counselors Promising
More Than They Can Deliver?
American School Counseling Association


Web Page California Department of Education (nd)
Research on School Counseling Effectiveness

Department of Education and Skills (nd) How the National Healthy School Standard contributes to School Improvement, Healthy Schools Program, England

Berry, M. (2002). Healthy School Environment and Enhanced Educational Performance. The Case of Charles Young Elementary School, Washington, DC.

Marti Rice PhD, RN, Duck-Hee Kang PhD, RN, FAAN, Michael Weaver PhD, RN, FAAN, Carol C. Howell PhD, RN (2008) Relationship of Anger, Stress, and Coping With School Connectedness in Fourth-Grade Children Journal of School Health 78 (3) , 149–156

Schneider M (2002) Do School Facilities Affect Academic Outcomes? Washington, DC, National Clearinghouse for Educational Facilities

Web Pages Improved Academic Performance & Indoor Air Quality in Schools (EPA, USA) http://is.gd/g8uqm

Report Indoor Air Quality Affects Student Learning (EPA, USA, 2010) http://is.gd/g8u1q

Centers for Disease Control & Prevention (2009) SCHOOL
CONNECTEDNESS STRATEGIES FOR INCREASING PROTECTIVE
FACTORS AMONG YOUTH
, Atlanta, GA, Author

US General Accounting Office. School-Linked Human Services. A Comprehensive Strategy for Aiding Students At Risk for School Failure. GAO/HRD-94-21, Washington DC. US General Accounting Office, 1993.

American School Counselors Association. Position statement: comprehensive school counseling program. Alexandria, VA: ASCA; 2005

U.S. General Accounting Office. School-Linked Human Services: A Comprehensive Strategy for Aiding Students At Risk for School Failure. GAO/HRD-94-21, Washington, DC: U.S. General Accounting Office, 1993.

Policy Doc (USA, 2010) Family Engagement in Education: Seven Principles for Success http://is.gd/e2I5Z

Havlinova, M., & Kolar, M. (2005) Is the Social Climate More Secure in Health Promoting Schools? A Comparative Research Study. Chapter 22 pp 409-422 in Clift, S. and Jensen, B.B. (eds) The Health Promoting School: International Advances in Theory, Evaluation and Practice. Copenhagen: Danish University of Education Press.

Sherry Everett Jones, Robert Axelrad, Wendy A Wattigney (2007) Healthy and Safe School Environment, Part II, Physical School Environment:

Peterson Geierstanger, S., Amaral, G., Mansour, M., Walters, S.R (2004) School-based health centers and academic performance: Research, challenges, and recommendations

Trost SG, Mars H (2009) Why We Should Not Cut PE Educational Leadership December 2009/January 2010 Vol 67: 4

Fox CK, Barr-Anderson D, Neumark-Sztainer D, Wall M (2010) Physical Activity and Sports Team Participation: Associations With Academic Outcomes in Middle School and High School Students Journal of School HealthVolume 80, Issue 1, pages 31–37, January 2010

Shepard RJ, Volle M, Lavallee M, LaBarre R, Jequier JC, Rajic M. Required physical activity and academic grades: A controlled longitudinal study. IN: Limarinen and Valimake, editors. Children and Sport. Berlin: Springer Verlag; 1984.58-63.

Results From the School Health Policies and Programs Study 2006 J Sch Health. 2007 Oct ;77 (8):544-56 17908107

Shepard, RJ. (1997) Curricular physical activity and academic performance. Pediatric Exercise Science. 1997: 9:113-126.

Strolin-Goltzman J (2010) The Relationship Between School-Based Health Centers and the Learning Environment Journal of School Health Volume 80, Issue 3, pages 153–159, March 2010

Baskin, Thomas W.; Slaten, Christopher D.; Sorenson, Carey; Glover-Russell, Jaquaye; Merson, David N Does youth psychotherapy improve academically related outcomes? A meta-analysis Journal of Counseling Psychology, Vol 57(3), Jul 2010, 290-296.

Monsma M, Day R, St. Arnaud S. (1992) Hand washing makes a difference. Journal of School Health. 1992:62(3):109-111.

McCord, MD. Et al . (1993) School-based clinic use and school performance. Journal of Adolescent Health. 1993:14:91-98

Eggert LL, Thompson EA, Herting JR, Nicholas LJ, Dicker BG.(1994) Preventing adolescent drug abuse and high school dropout through an intensive school-based social network development program. Am J Health Promot. 1994; 8(3): 202-215.


Brigman G, Campbell C. (2003)
Helping students improve academic achievement and school success behavior. Professional School Counseling Dec 2003.

Lee RS. (1993)
Effects of classroom guidance on student achievement. Elementary School Guidance and Counseling. 1993; 27: 163-171.

Carns AW, Carns MR. (1991)
Teaching studyskills, cognitive strategies, and meta- cognitive skills through self-diagnosed learning styles. The School Counselor. 1991; 38:341-346.

Lapan RT, Gysbers NC, Sun Y. (1997) The impact of more fully implemented guidance programs on the school experiences of high school students: a statewide evaluation study. Journal of Counseling and Development. 1997 (March/April).


Hawkins J, Catalano R, Kosterman R, Abbott R, Hill K. (1999)
Preventing adolescent health-risk behaviors by strengthening protection during childhood. Archives of Pediatric Adolescent Medicine. 1999; 153: 226-234.

Marks, HM. (2000)
Student engagement in instructional activity: patterns in the elementary, middle and high school years. American Education Research Journal. 2000: 37(1):153-184.

Goodenow C. (1993)
Classroom belonging among early adolescent students: Relationships to motivation and achievement. Journal of Early Adolescents. 1993: 13 (1): 21-43.

Klem Adena M, Connell James P. (2004)
Relationships matter: Linking teacher support to student engagement and achievement. Journal of School Health. 2004:74(7):262-273.

Croninger RG, Lee VE,. (2001)
Social capital and dropping out of high schools: Benefits to at-risk students of teachers’ support and guidance. Teachers College Record. 2001: 103(4):548-581.

Catalano RF, et al . (2004)
The importance of bonding to school for healthy development: findings from the Social Development Research Group. Journal of School Health. 2004:74(7):252-261.

Hawkins, JD et al. (2001)
Long-term effects of the Seattle social Development intervention of school bonding trajectories. Applied Developmental Science. 2001:5:225-236.

Miedel WT & Reynolds AJ. (1999)
Parent involvement in early intervention for disadvantaged children does it matter? Journal of School Psychology. 1999; 37(4):379-402. EJ607658.

Vincent ML, Clearie AF, Schuluchter MD.(1987)
Reducing adolescent pregnancy through school and community-based education. JAMA. 1987; 257 (24), 3382-3386.

Blair, S et al (1986)
Health Promotion for educators: Impact on absenteeism. Preventive Medicine, 1986. 15,166-175.

Schneider M (2002)
Do School Facilities Affect Academic Outcomes?http://www.edfacilities.org/pubs/outcomes.pdf Washington, DC, National Clearinghouse for Educational Facilities

Berry, M. (2002).
Healthy School Environment and Enhanced Educational Performance. The Case of Charles Young Elementary School, Washington, DC.

National Research Council. (2006).
Review and Assessment of the Health and Productivity Benefits of Green Schools: An Interim Report. Washington, DC: National Academy Press


G. Effect of Interventions or Comprehensive Approaches on Students or Schools in Disadvantaged Communities

This final section examines interventions that address disparities or alleviate disadvantages. The International School Health Network, in cooperation with several other organizations has developed a consensus statement describing the issues and programs that are more relevant to schools serving communities that are disadvantaged by economic, cultural or geographical factors. Not surprisingly, the 2009 review (Dilley, 2009) done for Washington State found that the patterns for disparities in academic risk are similar to patterns observed for disparities in health. Of interest here is which health disparities are most influential in reducing educational potential and opportunity.

Charles Basch has identified several health inequalities that have more of an effect on student learning outcomes and school success in a report on the missing link in school reform: health. :
He used three criteria to identify health inequalities that were most relevant to educational achievement.
· prevalence and the extent of the health disparities,
· evidence of causal effects on educational outcomes, and
· feasibility of implementing proven or promising school-based programs and policies.

Based on these criteria, the following educationally relevant health disparities were selected as priorities:
(1) vision,
(2) asthma,
(3) teen pregnancy,
(4) aggression and violence,
(5) physical activity,
(6) breakfast, and
(7) inattention and hyperactivity.


Basch notes that the omission of other health topics should not be taken to suggest that they are unimportant. Tobacco, alcohol and drug use, dental problems, ear infections, obesity, accidental injuries,
among others, are pervasive problems affecting youth and depending on the local context also warrant consideration. Indeed, all of these problems are rightly priorities of the U.S. Public Health Service. The seven specified priorities are intended to illustrate the effect that addressing particular health disparities can have on educational opportunity and the achievement gap. They illustrate a reasonable set of “starting points” through which school policies and programs might influence the achievement gap among urban minority youth. Schools in different social and economic contexts will have lesser or greater propensity to include various health factors as a priority; this is not problematic as long as problems are addressed with proven or promising approaches, are selected strategically, and are addressed through an effectively coordinated effort.
Reports/Resources Research
Overview

Howley, D.B., and Bickel, R. (2000, February). School size,
poverty and student achievement
. The Rural School and Community Trust.

Charles E. Basch (2010) Healthier Students Are Better Learners: A Missing Link in School Reforms to Close the Achievement Gap. A Research Initiative of the Campaign for Educational Equity, Teachers College, Columbia University

Report low-income students do better in affluent schools (ASCD, 2010) http://is.gd/g9RSm

Carnegie Council of Adolescent Development. (1989).Turning points: Preparing American youth for the 21st
century. Report of the Task Force on Education of Young Adolescents
.Washington, DC:Author.



Paul E. Barton and Richard J. Coley (2009) Those Persistent Gaps Educational Leadership December 2009/January 2010 Vol 67: 4
Student Meal Programs

Minnesota Department of Children, Families and Learning. School Breakfast Programs Energizing the Classroom. Minnesota Department of Children, Family and Learning. Roseville, Minnesota. 1998.

News Story (Nov 23-10) School lunch programs might break poverty cycle http://is.gd/hXLnU



Peter Hinrichs (2010) The Effects of the National School Lunch Program on Education and Health." . Journal of Policy Analysis and Management; Published Online: June 3, 2010

Meyers AF, Sampson, AE, Weitzman M, Rogers BL and Kayne H. School breakfast program and school performance. American Journal of Diseases of Children. 1989; 143:1234-9.


Powell CA, Walker SP, Grantham-Mc Gregor SM.(1998(
Nutrition and education: A randomized trial of the effects of breakfast in rural primary school children. American Journal Clinical Nutrition. 1998;68:873- 879.


Oral Health Programs

Parent Resource Centres

Parent Support and Training Programs

Policy Doc (USA, 2010) Family Engagement in Education: Seven Principles for Success http://is.gd/e2I5Z

Dropout Prevention Programs and Strategies

Planning Guide School Dropout Prevention Working with State Agencies US Dept of Education

Report GRADE RETENTION ACHIEVEMENT AND MENTAL HEALTH OUTCOMES (Nat Association of School Psychologists, nd) http://is.gd/it5ar

Freudenberg N, Ruglis J. Reframing school dropout as a public health issue. Prev Chronic Dis 2007;4(4). http://www.cdc.gov/pcd/issues/2007/oct/07_0063.htm. Accessed [date].

Research Report (USA, 2009) Dropout Prevention http://is.gd/e2I1V

Geoff Bowlby (2008) Provincial Drop-out rates - Trends and Consequences Statistics Canada



Freudenberg N, Ruglis J. Reframing school dropout as a public health issue. Preventing Chronic Disease 2007;4(4):A107.

Service Learning Programs with University Students

Policy Doc The Role of Colleges and Universities in Alleviating Disadvantageshttp://is.gd/e2EBy
Mentoring Programs
After School Programs
Cultural Support Programs/Immigrant Services

Policy Doc (2010) Helping immigrant and refugee students succeed http://is.gd/e2I9Y
Head Start Programs
Spernak SM Schottenbauer MA, , Sharon L. Ramey and Craig T. Ramey (2006) Child health & academic achievement among former head start children Children & Youth Services Review Volume 28, Issue 10, October 2006, Pages 1251-1261
Head Lice & Attendance Policies

Policy Doc AAP New Recommendation: Allow Kids with Head Lice in School http://is.gd/e2tZX






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