The school health service team includes community health nurses and other mental health and wellbeing; loss and grief; problems at home; relationships. School health services can be a rich source of data for studying the relation between . have a backup relationship with a licensed physician in the community. A community health centre is publicly funded and offers a range of health services to local residents.
Some schools have even developed large catering operations for public events. As early as the s, major teacher training institutions established a curriculum in school foodservice.
When the National School Lunch Act was passed in and school foodservice and nutrition emerged as a profession, dietitians and home economists were the early leaders Frank et al.
At the present time, USDA has no specific requirements for school foodservice and nutrition program directors or managers. According to SHPPS, few states or local school districts have established standards for school foodservice directors, and only 2. If nutrition screening, assessments, and counseling are provided by the school, consulting dietitians, nurses, or public health staff are often used.
There is consensus today that school nutrition and foodservices are important to learning readiness, health promotion, and disease prevention National Research Council, ; U.
School health services
Department of Health and Human Services, The Healthy People goals call for at least 90 percent of school lunch and breakfast services to be consistent with the Dietary Guidelines for Americans and for at least 75 percent of schools to provide nutrition education from preschool through grade 12 U. Department of Health and Human Services, School nutrition can also have an effect on the goal to reduce the incidence of being overweight to a prevalence of no more than 15 percent among adolescents and on the goal to increase calcium intake so that at least 50 percent of youth and young adults consume three or more servings daily of calcium-rich foods.
Children's cognitive, behavioral, and physical performance is impaired by poor nutrition Center on Hunger, Poverty, and Nutrition Policy, ; Centers for Disease Control, ; Meyers et al. Awareness of these findings is important for school administrators and teachers, who are likely to view nutrition as a priority only to the extent that it facilitates their primary mission—education American Dietetic Association et al. However, despite the clear connection of nutrition to health and of health to education, there is a wide variance in the priority placed on school nutrition and foodservice across the country.
Students today have increasing food options at school. Some of these choices contained as little as 20 percent of the recommended dietary allowances RDAs for certain nutrients, and none was equal in nutritional value to school lunches that met the USDA-mandated goals of one-third of the RDAs for key nutrients. School lunch participants ate more fruits and vegetables and drank more milk than did nonparticipants and were more likely to get their carbohydrates from grain and grain mixtures than were nonparticipants, whose carbohydrate sources were more likely to be sweetened beverages and salty snacks Gordon and McKinney, The USDA has published regulations requiring schools to plan menus with the goal of having no more than 30 percent of calories from fat and 10 percent of calories from saturated fat in the average meal selected by all students over a week.
The regulations became effective in the — school year. Prior to the issuing of the USDA's recommendations, the School Nutrition Dietary Assessment study found that in 44 percent of school lunch programs, students had at least one menu option with no more than 30 percent of its calories from fat, but in only 1 percent of schools did all available school lunch menus have this low fat level. Many intervention studies have focused on environmental changes and have shown promising results in lowering the fat content of meals selected by students Ellison et al.
Data collected on this baseline measurement cohort during the period to show that in intervention school lunches, the percentage of calories from fat decreased significantly more The level of student self-reported daily energy intake from fat also was significantly reduced in intervention schools Policy decisions are important to maximizing program influence on current and future eating behaviors of students.
Among the policies that local schools and communities must address in order to achieve a school nutrition and foodservice program that meets national goals are those that relate not only to nutrition standards but also to consideration of student preferences, purchasing practices, production methods, professional development of school nutrition staff, team building for school staff and community members, development of eating environments that provide optimum time, space, support for healthful choices, positive supervision, and role modeling American School Food Service Association, Policies are also necessary to guard against such problems as those that recently arose in the New York City schools, where foodservice management was reorganized after criticism that it approved shipments of outdated meat and covered up outbreaks of food poisoning Rousseau, Funding for school meals also has major implications for program outcomes.
Private funds raised by the community financed the first programs in the late s and early s. Local boards of education later added the program to their budgets, and limited federal support, primarily through work programs in the s, provided subsidies that encouraged schools to provide school lunches.
The first specific federal legislation was the National School Lunch Act ofwhich provided an incentive to local schools to operate nutritionally sound programs. It was not until the s that additional funding was provided for schools with large numbers of low-income children. In the s, federal support for school nutrition programs declined significantly.
Adjusted for inflation, federal funding for school lunch is only 58 percent of its initial level Citizens' Commission on School Nutrition, Local and state funding has also declined, and school nutrition and foodservice programs in many communities are expected to operate as businesses with no local support.
SHPPS reported that 29 percent of all middle or junior and senior high schools were expected to generate funds beyond the costs of the program. Profit-making has become pervasive in the school nutrition and foodservice environment. SHPPS reported that more than one-third Decisions on food offerings often are based on the food item's profit margin rather than on its nutritional profile.
Some observers maintain that such decisions send the message that it is acceptable to compromise health for financial reasons, a message inconsistent with classroom education American Dietetic Association, The degree to which students' nutritional intake and lifelong eating behaviors are influenced by this environment and by the local, state, and federal policies that impact the environment merits further study.
Policies that promote universal access to healthful meals are widely viewed as important to the health of children and youth American Dietetic Association et al. However, the increase in for-profit options in schools has not only encouraged students to make selections that are not covered by nutritional standards, but also emphasized the social distinctions between students with unlimited dollars to spend on for-profit foods of their choice and students receiving free or reduced-price meals or those from working poor families who can afford only the price of the paid meal.
A USDA study identified 4. Children's recognition of the importance of healthful eating is increasing.
School health services
A Gallup survey of students between the ages of 9 and 15 found that 97 percent agreed that a balanced diet is very important for good health, 96 percent liked eating different types of foods, and 87 percent agreed that eating smaller amounts of a variety of foods is better than eating large amounts of only a few. Yet one-half the respondents 51 percent said they skip breakfast and 28 percent skip lunch International Food Information Council, The dynamic nature of school nutrition and foodservice requires directors and managers with strong skills in financial and program management that include the ability to provide services for students with special health care needs, to coordinate the instructional component with health educators and teachers, and to serve as an effective member of the school—community health team.
Strong inservice programs for food-service assistants are critical to successful implementation. Increased understanding by school administrators and other community leaders of the relationship between the school nutrition and food-service program and children's health and education will lead schools and communities to establish expectations consistent with community values and resources and to implement policies that maximize outcomes.
Extended Services The term "extended services" is used here to refer to the rapidly growing area of services that go beyond traditional basic school health services. Extended services often target individual students with limited access to services and students at risk, are usually supported with funds from outside the educational budget, and typically involve collaboration between the school and personnel from community agencies. Much of the information in this section is adapted from a paper on extended services that can be found in Appendix D.
Questions are sometimes raised about whether extended services go beyond the basic mission of the schools. The committee believes that these services should not be the sole—or even major—responsibility of the schools but require leadership and cooperation from other community agencies and providers.
In examples described in this section and in Appendix Dextended services are not another responsibility that must be shouldered by the school; instead, the school is considered by community agencies and providers as a partner and an effective site for provision of needed services—services that will ultimately advance the primary academic mission of the school.
This view is consistent with that of a recent report from the Committee for Economic Developmentwhich states: Schools are not social service institutions; they should not be asked to solve all our nation's social ills and cultural conflicts.
States and communities must lift the burden of addressing children's health and social needs from the backs of educators. They must, of course, arrange needed services for children and their families, often in collaboration with the schools.
But other state and community agencies should pay for and provide these services so that schools can concentrate on their primary mission: There is no single 'best' comprehensive school health program model that will work in every community. Programs must be designed locally, and collaboration among all stakeholders in the community is essential if programs are to be accepted and effective. Characteristics of Effective Programs There are eight elements that characterize high-quality school health programs.
These elements are described below. A focus on priority behaviors that affect health and learning. School health programs were initiated early in the twentieth century, in large part to address the numerous infectious diseases afflicting children.
School Health Education - Characteristics of Effective Programs, Conclusion
At the beginning of the twenty-first century, the etiology of health risks facing young people—and the adults they will become—are most often social or behavioral. These behaviors are tobacco use; unhealthful dietary behaviors; inadequate physical activity; alcohol and other drug use; sexual behaviors that may result in HIV infection, other sexually transmitted diseases, or unintended pregnancy; and behaviors that may result in intentional injuries i.
The leading causes of death among adults—including cardiovascular disease, cancer, and diabetes—are closely linked to these health-risk behaviors. In addition, these behaviors tend to co-occur, they tend to be established in youth, and they are preventable. Children and adolescents need to learn, and to practice, making health-enhancing choices before health-damaging behaviors are initiated or become ingrained. Most states, and some large cities, also conduct the Youth Risk Behavior Survey.
Results from these state and city surveys, and other available state and local data from education and health agencies, can be used to plan school health program activities. A foundation of support for every child and adolescent. Whether a student engages in health-debilitating or health-enhancing behaviors depends on the interplay of assets and deficits in the influential support systems surrounding the student, including friends, peers, family, community, and schools.
Three protective factors have been found to frequently help young people overcome stress and adversity to become healthy competent adults with a sense of purpose: For example, the ongoing National Longitudinal Study of Adolescent Health has found that students who feel "connected" to schools are more likely to adopt health-enhancing behaviors respectful and caring teachers are among the factors related to students feeling connected.
School Health Services - Schools & Health - NCBI Bookshelf
Applying a "positive youth development" approach, schools should aim to develop a full range of "life competencies" among students—not only academic and vocational competencies but also healthful living skills, personal and social skills, ethics, and citizenship. A complete set of program components. Many national organizations and membership associations, as well as CDC's DASH, promote a school health program model consisting of eight mutually reinforcing components that communities can shape to fit their needs and circumstances.
These eight basic components are health education; school health services; a healthy school environment; physical education; school nutrition services; counseling, psychological, and social services; health-promotion programs for staff; and family and community involvement. Health education consists of a planned, sequential curriculum taught daily in every grade prekindergarten through twelve that addresses the physical, mental, emotional, social, and spiritual dimensions of health and is designed to motivate and help students maintain and improve their health, prevent disease, and avoid health-related risk behaviors.
A quality curriculum allows students to develop and demonstrate increasingly sophisticated health-related knowledge, attitudes, skills, and practices while addressing a variety of topics, including personal health, family health, community health, consumer health, environmental health, sexuality education, mental and emotional health, injury prevention and safety, nutrition, prevention and control of disease, and substance use and abuse.
Well-implemented health education has been shown to improve the adoption of health enhancing behaviors and school achievement. School health services are provided for students and are designed to appraise, protect, and promote health.Making the Case for Prevention: Community Partnerships Benefit Students, Schools & Health
Services should be provided by qualified professionals such as physicians, nurses, dentists, and other allied health personnel. Health services via school-based clinics that are linked with enhanced academic services have been associated with reduced absenteeism, improved academic achievement, and improved health status. School-based or school-linked health centers are becoming more common, however, and many of these centers offer a wide range of physical and mental health services.
A national survey identified a total of 1, school-based health centers that provided in-school care to children during the — school year. Thirty-seven percent were housed in high schools, 16 percent in middle schools, 34 percent in elementary schools, and the remainder were off-site. A healthy school environment attends to the physical and aesthetic surroundings and to the school's psychosocial climate and culture, thus protecting the health and safety of students and staff and promoting health-enhancing behaviors.
Physical environmental concerns include indoor and outdoor safety hazards, biological or chemical agents that might be detrimental to health, air temperature and quality, water quality, sanitation, precautions for infection control, lighting, noise levels, and access for persons with disabling conditions. The psychological environment includes the interrelated physical, emotional, and social conditions that affect the well-being and productivity of students and staff, including physical and psychological safety, positive inter-personal relationships, recognition of needs and successes of the individual, and support for building self-esteem in students and staff.
In considering the school environment, there are things that both large and small schools can implement. In fact, a large body of research in the affective and social realms overwhelmingly affirms the superiority of schools with small enrollments.
Bullying and harassment can have damaging effects on students' health and well-being. Those who manage school environments also need to actively encourage health-enhancing behaviors by assuring that nutritious foods are available as an affordable option whenever food is served or sold, providing convenient and appealing opportunities for physical activity, enforcing tobacco-free policies, and conducting educational campaigns to promote positive health behaviors.
Physical education is a planned, sequential curriculum and program of physical activity taught daily in every grade. Cognitive content and learning experiences should be provided in a variety of activity areas, such as basic movement skills; physical fitness, rhythms and dance; games; team, dual, and individual sports; tumbling and gymnastics; and aquatics. Quality physical education should promote lifetime activities and sports that students can enjoy and pursue throughout their lives.
Physical education needs to be taught by qualified teachers. Studies have found that well-prepared physical education specialists teach longer and higher-quality lessons than those not professionally prepared in physical education.
Elementary schools also need to provide daily periods of supervised recess, and middle schools and high schools should provide multiple opportunities for all students to voluntarily participate in intramural programs, sports and recreation clubs, and interscholastic athletics. Links with community-based sports, recreation, and fitness programs should also be sought and fostered. Studies among adolescents have demonstrated that physical activity is consistently related to higher self-esteem and to reduced levels of anxiety and stress.
Conversely, low levels of physical activity are associated with high-risk behaviors such as cigarette smoking and marijuana use.
Studies have found that students who participate in extracurricular programs tend to have higher grade point averages, better attendance records, lower dropout rates, and fewer discipline problems than students generally. School nutrition services promote the health and education of students through access to a variety of nutritious and appealing meals, nutrition education, and a school environment that encourages students to make healthy food choices.
The school food-service program can provide opportunities for students to practice healthful eating on a daily basis—more than half of the young people in the United States get one of their three major meals from school food programs, and 10 percent get two of their three main meals at school. Sound school food-service programs reflect the current U. Dietary Guidelines for Americans DGA and other quality criteria necessary to achieve nutrition integrity. These programs provide pleasant eating areas for students and staff with adequate time for unhurried eating, offer opportunities for students to experience learning laboratories for classroom nutrition and health education, and serve as resources for linkages with nutrition-related community services.
In large secondary schools a community health nurse may be based at the school. Allied health professionals in the community health team may also be involved with programs that are run in the school You are helping us to improve school-aged health services Child and Adolescent Health Service — Community Health, in collaboration with the WA Country Health Service, have undertaken a review to identify ways we can further improve the community health nursing services provided to school age children.
For more information refer to the 'Review of school-age health services' section below. What services are available? Students are better prepared for learning when they are healthy, safe and happy. The school health service staff can: The school health service is a free and confidential service.