Community health concepts and applications

Health

Community Health

Even though models such as the coordinated school health program (CSHP) are extensively available to address student health needs, school professionals have been not persuaded that scarce resources should be allocated to improving student health. Concern that concentration may be sidetracked from meeting academic liability goals is frequently seen as a reason not to attend to student health. Despite ongoing calls for the study of multi-component health programs in relation to educational accomplishment, the understanding of the extent to which adherence to the characteristics of CSHP contributes to or compromises academic outcomes over time remains unfinished.

In the article a Retrospective Examination of the Relationship Between Implementation Quality of the Coordinated School Health Program Model and School-Level Academic Indicators Over Time by Rosas, Case & Tholstrup, (2009) a retrospective study was conducted of CSHP implementation across 158 public schools in Delaware, serving grades K-12. Using a doubly multivariate design, this study examined 3 levels of CSHP implementation across 5 school-level academic indicators for 3 years. Indicators incorporated school performance, school progress, and aggregated student performance in 3 content areas -- reading, mathematics, and writing. Data for the years prior to, during, and following implementation of CSHP were looked at.

Acknowledgment of the interdependencies between educational system components is vital to understanding the consequences that desired changes in one part of the system have on other parts of the system. It is well understood that the main mission of schools is the academic preparation of students. As a result, any activity perceived to draw human or financial resources from achieving academic goals is frequently placed in conflict with academic priorities. Consistent with recent research that shows an affirmative relationship between multi-component school health programs and academic outcomes, the results of this retrospective study suggest that quality implementation of CSHP does not negatively impact school-level academic indicators over time.

As a group, the 3 groups in this study showed significant increases on both the school-level accountability indicators like performance and progress and the core content indicators like reading, math, and writing for the 3-year period. This was expected and likely due to the importance placed on academic reform throughout the entire state educational system. Holding time constant, the level of implementation was an important factor, particularly on the reading and math indicators. Schools implementing CSHP at a low level had a considerably lower proportion of students meeting both the reading and the math standards than schools implementing CSHP at a high level.

Interestingly, schools implementing CSHP at a low level also had a considerably lower proportion of students meeting both the reading and the mathematics standards than those schools not implementing CSHP at all. This finding was not surprising given that for academically struggling schools, upholding fidelity across multiple programs and content areas is tough. Staff attitudes on viability and benefits, level of staff knowledge, types and extent of professional development of staff, administrative support within schools, and district supports are factors affecting quality implementation.